 Welcome everyone. Again, this is the House Health Care Committee and it is Wednesday, March 10th and now about 11am. So we have heard testimony earlier this morning from witnesses to help us understand the impact of health disparities or health disparities within the native communities of remarked. We are going to turn shift gears. We've heard testimony from different impacted communities. And as I said earlier, we are in the process of hearing feedback about the bill each to 10 we are taking up. This is about each to 10. The health equity bill addressing health disparities with particular affected communities in Vermont. And we have the opportunity today to hear from Will the white, who is welcome you to say more if you will, but is part of the coalition that helped originate the language of the bill. And I believe is going to bring us some thoughts and feedback on perhaps where to take the bill in next steps, given that some of the testimony that we've heard. And some of the suggestions that have been put forward in the course of that. So with that will I'd like to turn it over to you, and have you introduced yourself, as you wish. Further. Thank you, Robert. And thank you. House committee on health care. My name is will the white, and I appreciate the opportunity to speak with you today about each to 10. I'm the founder of an organization called mad freedom, which is a human and civil rights advocates the organization whose mission is to work to secure political power to end the discrimination and oppression of people based on their perceived mental freedom and visions of world where every person regardless of race and gender and sexuality and ableness class and mental state has the freedom to live their life on their own terms without coercion and with the quality under the law. By training and experience I'm an attorney in a business woman. I was a plaintiff's trial lawyer primarily in New York California in Massachusetts, and also a management international management consultant, and I've started businesses and run businesses. And I was also the inaugural executive director of the Center for social justice at the University of California Berkeley School of Law, which is my alma mater. And also the former executive director of Vermont psychiatric survivors, which is a almost 40 year old organization here in Vermont. That advocates on behalf of psychiatric survivors and when I use the term psychiatric survivors. I'm referring to people who've been labeled or diagnosed with mental health challenges and mental illnesses. And also the inaugural chair of the Vermont mental health crisis response commission and H 210 with its focus on health disparities affecting based on race ethnicity LGBT status and disability is something that actually touches me quite personally. I guess I would be called a quadruple threat, because I'm a member of all those, all those things that this bill touches. And I'll explain more about that a little later. My freedom is also a member of the racial justice alliance. People who are discriminated against based on their perceived mental state is a very unique population of people because we cross all all demographics. We were, and I don't think any other group can say that we were all races all genders all whatever. And even people who don't have mental illnesses are within our, our population because they proceed this having them. We represent all those interests and that is why we're interested in the work of the racial justice alliance because the people that on whose behalf we advocate across so many of those, those, those, those issues are important to so many of our members. I'm testifying on behalf of both mad freedom, and as a member of the racial justice alliance, as a myth as testifying on behalf of mad freedom. I'll express mad freedoms observations about the bill. And in my testimony on behalf of the racial justice alliance, I'll be mostly responding to testimony that we've heard about the bill and suggesting ways that the bill might be improved or ways that we think the bill should stand on its own. I should first say that you know this is not a bit mad freedom does support age 210 but it's not a bill that I would personally normally on the normal circumstances support I'm probably based on my own background. I'm a self-help type businesses and run businesses I am very much a self-help type person. And I don't believe really the government can solve all of our problems. However, I came around to supporting and working and drafting this bill. After I saw how the state of Vermont. Should be the vaccines for the COVID-19. So the first tier were I think for like that were not like first responders were people who were living in nursing homes and the second tier were people who were 75 years and older. And I saw this as really a classic example of structural racism and structural racism is defined in the bill. And the reason I say that is because you know Vermont I feel has made a commitment to health equity the Department of Health has put out has done studies and has put out bulletins about it, but not withstanding its commitment to health, health equity, including racial health equity. It's still had a policy of distributing the vaccine in this way. And the reason I say it's an example of structural racism is because when you look at the first population that was prioritized those living in nursing homes. Nationally, 78% of nursing home residents are white. And I imagine the population that that percentage is much greater in Vermont simply because of Vermont's demographics. And because of both financial reasons and cultural reasons, many of the people in Vermont who were contracting COVID-19 lived in multi generational households, and they lived in communities where they kept their elders and their household. So even though this policy was raised neutral on its face, it had an adverse impact on people who weren't white, simply because of policies practices cultural norms in our society. And then the next batch of people who were prioritized or people who were 75 years and older. Additionally, the mortality rate the average life expectancy of a black person is 75 years old. And so, once again, they are not prioritized, even though the policy on his face is raised neutral, just because of the history of how kind of more white people are privileged and that people are not in the society, it had a disparate impact. On the other hand, I think it was in today's Vermont digger. The state has has said, yeah, black people aren't being vaccinated. And that's because black people didn't fall in those first two because of historical reasons, and also because black people are getting or I'm going to say not white people are getting the virus at lower ages. And so, I just felt okay, given that given that the Vermont has already expressed the commitment to this. But, and given that they've had this policy that really did show a classic example of structural racism. I became more interested in pursuing this kind of solution, because it's not a lack of will that we're seeing right from on is already expressed in our interest. I think it's just not being able to see the impact of these policies because you don't have enough people who are impacted by those policies making decisions. So for those reasons, I decided that a bill such as this might be helpful in addressing those really more insidious types of structural rate the impacts of structural racism. But I also want to say that this is a very modest bill. It really just aims to establish an infrastructure for working to eliminate health disparities based on rape as NISC LGBTQ and disability status. It's not meant to eliminate those disparities in and of itself, but to provide a foundation to do this work. If Vermont were to pass this legislation it would be the 42nd state in the United States who have enacted legislation aimed at eliminating health disparities. It's actually very late to this, this party so to speak. But I think how this could benefit Vermont and Vermonters is because it would gain access the state would gain access to federal funding. That's available and for grants that are available that address the limit the elimination of health disparities. Right now you know in the United States Department of Health and Human Services there is an Office of Minority Health that distributes grants to states and these other states that have these offices of health equity are able to access those grants, and then kind of these nonprofit organizations in those states that do this kind of work can also access that money and I think Vermont should access that money as well to do this kind of work. I think now I'm just going to go into the particular aspects of the bill, kind of why they were drafted that way and respond to some of the comments on the bill. So one of the first comments like who was covered. There was a letter written by the National Alliance on mental illness. And that asked why the bill did not define disability like who's included our people with mental health challenges included. Well, the bill didn't include a definition of disability, because the, we felt like the behavioral risk factor surveillance system upon which a lot of the data in the bill is based defines disability actually too narrowly. So disability to include anyone who reports, having serious difficulty walking or climbing stairs, concentrating or making decisions, hearing seeing dressing or bathing, or who because of a physical, mental or emotional condition has difficulty doing errands alone. So that's the definition that that generated the data that's in the findings in the bill. However, you know, disability in practice is much wider than that and the people who suffer discrimination and oppression and health equities comprise a much larger group than that. And so if we were to put a definition in the bill, I would suggest that it just have three elements one, recognize that both physical and mental impairments are included that they substantially limit one or more major life activities. Or you're regarded as having that impairment so this is something that I can speak to personally because I don't personally consider myself disabled, but the world treats me as if I am. And so I'm discriminated based on that and suffer, you know, and suffer some of the ill effects of that treatment. So, while I would agree with Nami that it would be helpful to have a definition in the bill, I think it does need to be broader than the statistics, broader than what Vermont has used. And I think it's important to make clear that it does cover both physical and mental limitations. So then I would move then to the findings section of the bill I didn't hear any of the testimony that contradicted any of the findings. And so I'm not going to spend any time on that. I think those speak for itself. And I'll just move then to the portion of the bill that proposes the creation of an office of health equity. Again, this is this is that infrastructure that I talked about the sole purpose of this office is to actually provide a sustainable infrastructure for supporting the work, work that I hope is driven by the community that's most affected. But it would be it would support the work of the commission which we'll talk about later in it will be able to apply for those grants. And it'll be able to communicate with other offices within government to prevent some like, like that circumstance I alluded to earlier in my testimony about a vaccine policy that because of structural issues has a disparate impact on in this case, racial and ethnic minorities and I use that only in a numerical sense. There was some testimony about whether it was more important for this organization to be outside of government for purposes of independence and trust. I actually think it's really important to keep this this health equity office in government, because I do think it's important to educate government and to communicate with all kind of government systems I think it would be much more sustainable and helpful to have this entity working within government. People want to create an organization outside of government either using grants at this, or that this position should should, you know, apply for and receive. I think that's helpful to be helpful for them to be working in tandem. But at this juncture, I think it's really important for this infrastructure to be situated within state government. There's also some testimony that the Department of Health just doesn't have the capacity right now to hire this person who would lead this effort, and also get this organization, this entity up and running and that's understandable given the pandemic. And so what the racial justice alliance would propose is that, you know, the bill be amended to delay the effective date of the creation of the Office of Health Care equity and in its place, charge somebody with hiring a contractor putting out an RFP hiring a contractor who would come in to do two primary things. The first would be to get the commission up and running. And the second would be to start applying for grants to support the work of the commission and to support the provision in this statute that allows for distribution grants. And I believe that you know the money that would have been allocated for paying the director of health equity could easily be transitioned to funding this request for proposal to do that work, because as I do think I think of the Office of Health equity as the bones of this proposal and I consider the commission its heart and mind and soul because they would be driving the process and so I think it's really important to try to get that up and running. And I don't think you need a director to do but I think it could be done through an RFP. The Health Equity Commission itself. It doesn't seem to be a lot of, or any testimony against the idea of creating this commission. What I heard and read where people questioning why some people weren't on it. And what I would, and about unpaid labor. What I would say is that the commission is really important, because, as you notice, it's, it's, it's popular, it's intended to be populated by people who are most affected. It's something I learned, I heard Madeline Cunan say, you know, and I repeated every time I have the opportunity is the people who are closest the problem or closer to the solution. And so I think it's really important to have people who are familiar with what, what is stopping them achieving greater health, be advising the Department of Health equity. It's also important for people to realize that, even though we've kind of lumped people together under kind of race, ethnic and LGBTQ and disability status. None of these groups, either separately or together is monolithic, even within those groups there's great diversity. And so it's really important to, to have a lot of different voices from a lot of people within those communities on this commission. I think one of the more unfortunate things is this new kind of language about BIPOC because it's, it's, it suggests that these issues are all the same for these people and you've heard this morning that there's simply not. I heard the indigenous community talk a lot about access just financial access to healthcare. I would hear like, you know, black people also more talk about discrimination and receiving healthcare. So I think it's really important to have as many voices on this commission as possible. But I think it's at the same time it's really important to have only the voices of people who have lived experience of these, of these, of these challenges. One of the other things that the National Alliance for Mental Illness wanted was a place at the table they want a family member of adult children to be on that table and the racial justice lines would probably push back on that because adults can speak for themselves. And they should speak for themselves. And the experience of family members of people with mental health challenges is very different from the experiences of those who have those challenges themselves. And I know that because for 30 years I've been the guardian of a brother with a mental health challenge. And what I learned after having my own experience with the mental health system is just a great deal different from when I was advocating for him. And so I just know you, it's very different and I don't want the voice on this committee to be speaking for other people I think it's really important for people to speak for themselves. We also included to address some of the points raised by Don Stevens, a per diem because we realize how difficult it is for people to do this kind of work for free. So that's why there is a per diem allocation for attending meetings. It's not meant to cover all the costs but it is to say that we respect that this is, you know, there's an opportunity cost to participating here and we want to try to recognize that and and compensate you for that within the limits of a, you know, a public body. And then I'm so then I'm going to next move to the grants for the promotion of health equity. And I think this is really the work where I'm excited about, because it really is consistent with my own philosophy that people can do for themselves. But what the problem is we don't have the same kind of access to these funds and so that's why there's the grant in here that people can apply for to do projects that they think are most geared for helping themselves. You heard feedback this morning from Beverly Little Thunder that grants are really problematic for some communities, which is why we took great care in this bill to put in the bill, the requirements for getting the grants because we wanted to be transparent about it. We didn't want people going around, like, after like the bill was passed for people to create unreasonable grant expectations that would limit access to them. And so our purpose in putting the grant requirements in the statute was to make it very transparent and to generate feedback about whether they felt that these were too onerous, or not, or wouldn't achieve the results that we set out to achieve. And I didn't hear any testimony that the grant provisions in the statute were too onerous or would not achieve the results that the bill was aiming to achieve. So the bill has wants to do some data collection for all the reasons that the Green Mountain Care Board suggested in its presentation on race and ethnicity data in the Green Mountain Care Board healthcare database. In order to reduce disparities you have to, you know, detect understand and understand them. And so I think that's a really important vision in the bill and I didn't hear anyone saying you didn't want to collect them it was just that's very difficult. And this bill, again, it's just the very beginning of trying to centralize the collection of this data in order to we can see how we're doing. And finally, the last piece of this bill this geared towards medical education, and it has written only addresses the education of medical doctors. Which as which we don't, we agree is only the tip of the iceberg. And yes, everyone who's involved in healthcare needs to increase their awareness of issues of health disparities health inequities. But it was it was a challenging it was challenging to write a bill that looked at all the allied professions and figured out how to implement or institute a continuing education requirement. So this like I said is a very modest bill and just a very first step. And she did receive some testimony, oral in written about this medical education requirement. You know, Dr Avila suggested that it should be, you know, expanded. No doubt it needs to be expanded. And that goes to just the beginning of this, the Vermont Medical Society on the other hand, did express some opposition to a kind of blanket two hour every year training. And I don't disagree with their opposition to that because they didn't think it would be that effective I know as an attorney I have to do. And I think it's a combination of bias training periodically to and after you know being a lawyer for almost 40 years, it's, it just, it's, you don't even pay attention no one pays attention anymore. So I do think that it, I think I would like to see this stay in the bill but I'd like to also see probably a sunset on it. So it can be revisited. I think the bill could be improved in the way that the Vermont Medical Society suggested by including in the bill not only UVM College of Medicine but also the area health education centers and the Vermont program for quality and health care. But I also would also say they should be working alongside the Commission, and doing this work, because, you know, people who don't have the live experience of this don't know what they don't know. And I think it would be a really strong collaboration if we had both the UVM College of Medicine, those that the Vermont Medical Society suggested in consultation with the Commission, coming up with some really robust and helpful training programs. So that, I think pretty much concludes my testimony bill I really appreciate your attentiveness, and I am available to answer questions if any of you have any. Thank you I'd unmute myself thank you, thank you will do. Let me let me set the outset say I, I appreciate your walking us through the bill, the different areas of the bill and I'm just going to speak for myself at this point to say that I, I appreciate the framing of this as to point that this is this is actually about establishing an infrastructure that would then be in the position to actually take some of the substantive steps, but that this infrastructure is an is an is an important and necessary infrastructure to establish in order to facilitate further further steps as necessary. And so I think I think that's a, that's a helpful framing. And I want to thank you for that, that piece. Okay, I see we have some questions and again, I'm going to, let's just be clear that we're here to clarify and to ask questions that are clarifying and not to question the presenters information represent Peterson. Thank you, will the thank you very, very much for your testimony, this was the most, the clearest concise this testimony about this bill that I have heard and I really appreciate it. It opened my eyes and a number of ways. In the very beginning of the testimony sounded like you were skeptical of bills like this. I am also very skeptical. Tell me why I should support this bill. It would depend on what you're what you what you are trying to if you believe. So I'm going to just assume you're a person who believes in Vermont, you're doing that job because you want to make Vermont a better place for all Vermonters. So, if I assume that's your motivation for serving as a legislator. I think this is a bill that you should support, because it makes Vermont a better place for all Vermonters, because it's very difficult. You know I love Vermont. Sometimes I think Vermont doesn't let me back. Because, you know I've lived all over the world and I live in Cal I say I say this people tell me Vermont races I said no Vermont is no more racist than he but by place sells the way we experienced racism is different in California the way I experienced it is like everybody just objectified me they just assume they knew everything about me. Based on the color of my skin and Vermont mostly you ignored. I actually prefer being ignored to being objectified. However, when it comes to health care being ignored can kill you. Right. And so I think in this case because this is a bill that addresses health care. We all have access to health care, because if all Vermont is healthy, all you know Vermont is healthy. I think this bill can do some of that work. And that's why I think you should support it just because it's really hard in a state where, you know, that's 90 something percent white to remember that not everybody is white, and we all have different challenges, because of that. And so I think this would make Vermont just better for all Vermont right because we you don't want to, as you, you don't want to be spinning more on other things that come from not having healthy Vermonters right, and I think this bill could help you reduce those expenses you know if people actually have more health care they wouldn't be running to the emergency room that's already a saving. If people had you know access to some of these determinants of health care like if they were saying I need this to be healthy. Right, you would be saving in other areas. And so that's why I say this is a bill that looks at health inequities for people who aren't wider people who aren't you know, heterosexual, but it helps all of us. That's why I think you should support it. Okay. And again, thank you for your great testimony. Appreciate it. Thank you. Representative Peterson. Representative burrows. Thank you very much for your testimony this morning. And it is still morning. An actual clarifying question. It's still morning. The second question is, I've been writing down what you've what you've said, and in the part where you were talking about the definition of disability, you said to recognize physical you said three things. Yes, recognize physical and mental impairment. Recognize those who've who are regarded as having that impairment. And what was the third thing. I probably didn't say it and should have a recognizing people who've had a history of those because they're still, even if you've had a history of it, you're, it's no longer an issue, it still follows you. Got it. Yep. Thank you. You're welcome. Representative China. I want to thank Wilda for making time to come in today to testify to the health care committee. We've one of the some of the feedback we've heard about the bill from the Department of Health is that currently they're very consumed with keeping up with the impact of the coronavirus pandemic, and that it would be hard for them to take on the duties these right now of hiring and managing a director of health equity and setting up an office of health equity. And we've been considering ways to keep moving that work forward, being mindful of that challenge. And one of the ideas that has floated around was that perhaps the bill could be amended to fund a position whether it be the director of health equity or some precursor to that position and have that position work with the office of health equity, the office of racial equity, and that we would fund that position and fund that work and better fund that office so that the commission could be convened and that work could begin and then there could be some kind of transition to an office of health equity. And I know you and I have discussed this not in this space, but I'm curious if you could speak a little bit more about the Racial Justice Alliance's position about any kind of adjustment in that area. Okay, I thought I tried to speak with that where I said that I thought that you could hire a contractor to do that work. But what's really important if you want to shift it to the office of racial, what's it called the Racial Equity Director's Office? Is that, it's not an unfunded mandate, right? They already have too much, just. Right, absolutely. Yeah, that office is just as busy as the Department of Health Office. And so what you wanna do is make sure that resources go with the directive to that. I think that office could handle just sending out the RFP and fielding responses and hiring somebody. And then that contractor works with, works almost independently to get that commission working is the way I understand, the way I'm proposing and the way I think the Racial Justice Alliance is also proposing it. The Racial Justice Alliance does not wanna keep adding work onto the Racial Equity Director's plate without resources going there. And then I hope I'm right, Representative Sheena, I'm responding to your question correctly because I believe it's the Racial Justice Alliance position that we hire a contractor that it could come from the Racial Equity Director's office to oversee that work, but that we don't just pile on to that office without giving more resources. Does that answer your question Representative Sheena? Yeah, and I appreciate it. And I really just wanted it to be really clear and on the record that the Racial Justice Alliance has considered that compromise and that you're expressing that there's a willingness to compromise with mindfulness to the impact on the already overburdened work of the Racial Equity Director. So... Yes, and let me step in if I may and say that some of us have floated various ideas and I'm appreciating hearing that the Racial Justice Alliance's analysis is I think in many ways in alignment and to say that to the degree that I have participated in suggesting the possibility of the Director of Racial Equity having a transitional role, which is what I think we're all talking about that it cannot be done unless and until and it must be done with the staffing of the Racial Equity Office fully staffed with the positions that are in the current budget proposal and that additional resources. As you said, well, the additional resources for this task need to follow the task that they would be taking on. So I'm in complete solidarity with that proposal because otherwise it's simply not appropriate. In fact, it's more than not appropriate. It's inappropriate. So with that, I'm going to field questions first from folks who haven't had a chance to speak. So represent Paige and then represent Goldman then represent Peterson. Thank you, Ms. White for your testimony. And I guess my question is, and it's a concern. We've discussed where this office should be or shouldn't be and we've heard testimony that the Department of Health is too busy with the pandemic and I get that, okay? But we've also received testimony as I recall from the Department of Health, the Director of Planning Health Care Quality. And I just have to wonder, I mean, if you already have this office that's in charge of plans and programs and also quality, why aren't they doing this, I guess? And I suppose you probably don't have the answer to that but it seems to me that's that office should already be doing these functions without us starting up another office to do that. And then the other issue I have and I get it with the commission members, everybody have a seat at the table but it seems to me that there might be too many commission or too many commission members. And I don't know if I would call it a commission. I would maybe call it, oh, I don't know. I said, you know, commission is something that doesn't last for a great deal of time. It gets in there, it perhaps looks at a problem. It maybe writes a report and then it goes away. So those are a couple of my concerns and I'll just let you comment if you so wish. Thank you. Yeah, I have to agree with you that I don't know the answer to your first question. They're not doing what they're doing. They're not doing this work, which is, and that's not a, you know, if you look at other, which I have, I've looked at the other 41 states that have legislation that aims to address health disparities and those that have a office of health equity, it's a standalone office. There's no one kind of doing what you suggest, which doesn't mean that we can't do it. I'm not one that wants to just follow what other people are doing. I'm just suggesting that, you know, 41 other states that not all those states have an office of health equity, they might have some other kind of legislation, but the states that do have an office of health equity, they also have what you said, this other office, and they haven't charged that other kind of entity with this work. They have created kind of a separate office of health equity. Not all of them lodged into the Department of Health, but I think it makes the most sense to lodge it there. So that's all I can say on that first question. On your observation about commissions, I would probably disagree with you just based on kind of empirical evidence because, you know, you look at commissions in Vermont, there's a women's commission that's been around forever. It's an ongoing body. And there are other commissions like that, that I was on one, the Mental Health Crisis Response Commission. That's an ongoing body because there's always work to be done. But I don't, I mean, I don't think your quarrel with this is really based on what it's called. I think you seem, there's something, I hear something else underneath the question that you're asking. You've talked about its size. I think if you think about it as a commission, you would be troubled by its size because it seems unwieldy. I would agree with you with that. But what I envision is that they would work, you know, you would have attendance problems, right? Cause not everyone can come to every meeting. And they would also wanna probably do their work through little work groups to be most effective. And I think that's a good size for that model working through work groups. Because remember, like I said, this group is not monolithic. They're not gonna sit around a big table and agree that the issues are the same. They're going to probably be working how these problems arise, right? So, you know, I can see indigenous people working together who are recognized and maybe indigenous people who aren't recognized having some other kind of work group. And then, and so that's how I, and that's why I think it makes sense to have it this large. Cause I don't see them sitting around a big table collectively reaching decisions. I see them in small work groups, solving problems. Well, thank you very much. I guess I would look at it as maybe a board or a committee for a specific amount of time. And then I guess the other question regarding this commission is, you know, how much authority are they gonna actually have as commission members? Will they be able to, you know, call another department? Call somebody in the department of health and say, you want this data, you know, we would like it at such and such a time. Well, the way the bill is written, it's written really to give them the power to do that, to be, and what I really wanted in the bill and what's in the bill is that they actually have the power to apply for grants and do their kind of own fundraising. And that's not something you see with a lot of commissions, where they actually have the ability to raise their own funds and accept grants. So, and you know, and they're charged with kind of writing a report. And so that means they're gonna have to do some work. And so I've tried to put incentives and safeguards in the legislation to make sure they actually have some powers and make sure they have incentives to use that power and then report out to hold them accountable to the people of the state of Vermont. And once they write this report, will they, how long will this commission last? I mean, I suppose it could last forever, right? It could last forever, but you know, that's up to you as legislators. You could make it time limited or you couldn't. I mean, it would be great if, you know, the need for such a commission could go away soon. But I always feel like legislation should revisit. You know, if you pass legislation such as this, you should revisit it periodically to see if it's making strides and if it's not change it. You shouldn't just say, we're gonna pass this and go away and never see you again. I think that's not prudent. So I mean, I would encourage you, you know, lots of people write reports and they never get read. I think that's not appropriate. I think that you should read the report and you should look at the data to see if this commission, this structure has had any impact whatsoever. If you have this, if you pass this legislation and you look at data five years down the road and you've seen no budge, I think that means you gotta, you know, revisit, you know, it's effectiveness. Thank you very much. Thank you. Representative Goldman, I'm watching the time as well. Will has been generous with their time and we also have a goal of finishing. Certainly we had said 1145, but we can take some more time. So Representative Goldman then Representative Peterson. Thank you and thank you for your testimony. I just wanna sort of expand or understand more a little from the questions that Representative Sheena had asked you about sort of the structure. If we can't go through the Department of Health and then you use the word delay and my chest hurts. So I didn't want it to go there. So you talked about hiring a contractor and I don't really have an image of what that is of like who could be a contractor that could do this work meaningfully. Where would the leadership come from? How does that, and you may not know, but I'm just trying to have a little deeper. It's maybe too weedy, but a little deeper understanding of how contractor would work. And could you give an example of who that might be? Yeah, yeah, actually this is something I can comment on. So I said before I spent some of my life as a management consultant. And so I'm very familiar with entities such as this Office of Health Equity putting out a request for proposal for people who do work in this area of health disparities. So for example, if one of the witnesses that you heard from Dr. Avila, if she weren't at UVM she could be a contractor. She would respond to a RFP such as this. There's lots of people nationwide doing this kind of work. And they do it both affiliated with universities or they do it independently as consultants. So what I probably should have said instead of contractor was consultant because that might be a word that you're more familiar with. I use the word contractors because I wanted to let you know that this you're not hiring an employee. You're hiring somebody for a limited amount of time to do a specific project and then it's over. Does that help? Yes. Had a little mute event here. Thanks. Okay. Okay. Thank you. Representative Peterson. Yes. Thank you. Wilda, you mentioned 41 other states have an Office of Health Equity. I think she said they passed legislation regarding health disparities, but wouldn't you correct that if that's not accurate? Right. I said that 41 of those states have a legislation that address health disparities. Not all of them do it through an Office of Health Equity, but many do. Okay. Well, my question is, is there empirical data in those states that shows that whatever they have established have actually had a positive effect on the health disparities? In some states, you can see changes. The states that have collected data, you can see changes. I think California has seen some changes. I think there's some states in the South that have seen some changes as a result. Well, I won't say as a result, but there's a correlation between establishing this office and seeing improvement in eliminating health disparities. Yes. Okay. Thank you. You're welcome. Okay. I want to raise one further point. And again, I said earlier that Susanna Davis is here as listening in because she and her office have been mentioned on numbers of occasions as possibly involved in this and to be hearing our testimony and thinking. One of, I'm going to, and I know I'm also aware of the time, but one of the things that Susanna, I think brought forward that I appreciated was to name the issue of process equity as well as in thinking about the commission's work. And in the current draft, the commission is prescribed to have three meetings per year, but that we in this possible revision of this, that perhaps there should not be a stated specific number of meetings. And again, I just welcome any input on that, or there should be something more than the three. I don't believe, I mean, I, the draft, Maybe I'm misstating what you said. When I wrote this, I put down that they could, they would have them, they could have a minimum number. There was no- Yes, you're correct. I'm misstating. And then when the council got it, they limited the meetings that you could be paid for. Yeah. But anybody, and we put in the bill that anybody could, the meetings are typically called by the chairpeople, but a quorum, it said how many people to get together and say they wanted the meeting as well. Yeah, I stand corrected. Thank you. Thank you. Okay, well, thank you. Thank you, Will. I appreciate you're joining us this morning and I am gonna call this to a close at this point. Representative Peterson, is your hand up or was it left up? I think it's left up. Yeah, that's what I thought. Okay, we're all technologically working to get our hands up and down and mute on and off. Again, thank you, Will, for making the time. Thank you for your input on behalf of the alliance and for your comments as well. So- Thank you. I appreciate your time. Okay. And thank you committee members. We are, so let me just say that I'm, I'm a little, our schedule now says that we are adjourned until 15 minutes after the floor. We have scheduled a number of witnesses this afternoon and on the secure residential proposal. And what has been suggested to me is that the floor might be a long floor today in a way that I had not anticipated. And so I think we're going to need to, so I'm going to ask of this. We may need to ask some witnesses to not be heard today, depending how long the floor goes. I, you know, I don't appreciate having witnesses waiting and waiting and waiting, but that's the nature of after the floor. But what I would ask of you, is it, would it be agreeable for us to come directly to committee after the floor, rather than taking a 10 or 15 minute break in order to be respectful of any witnesses who can wait until whatever that unnamed time is? Is that, I see a bunch of nodding heads. So, so my request, and if, and if that does not work for you, I think the committee should still go ahead immediately, you know, like within five minutes come to the committee. We'll then hear what witnesses, who is available at that point in time. In the meantime, we'll be working that out with witnesses, depending how long the floor goes. Representative Donahue. Yeah, just to, to mention, and Colleen can correct me if I'm wrong, but I think, and I'm not disagreeing, we may not be able to fit everyone in, but these witnesses who were, you know, people who had written letters, as opposed to organizational and so forth, they did get a heads up that they, they are more, you know, public hearing type. They will be fairly brief, maybe five minutes, not 20 minutes. Yes, I think that's right. And these, every, every, every witness here has already sent something in writing to the committee, but we wanted to reach out and see if there was something further they wanted to add in order to have the breadth of comment on the issue. Okay, well thank you. And I know there's also, there's a childcare luncheon today, and there's other, other commitments, but I really think everyone should go outside, at least for, at least for five minutes. Carve out five minutes. The sunshine is glorious. Where I am, it's reflecting off the snow. The temperature has risen. I'll bet the sap is running. So, this also, squeeze it, squeeze in something outside. And I'll see you back here five minutes after the floor. Okay, thank you all. This has been helpful.