 OK, thank you all very much for being with us this afternoon on this beautiful Vermont Spring Day. I am very proud to announce that the Federal Qualified Health Center Programs of Vermont, which have a participation rate greater per capita than any other state in this country, will be receiving over $33 million in order to improve the quality of care that they are providing to 187,000 patients around the state of Vermont. It is not widely known, but the community health centers in Vermont, those are 11 FQHCs, 11 community health centers, with 66 sites located in almost every region of the state, are now providing primary health care, dental care, mental health counseling, and low cost prescription drugs to almost one third of the people in the state of Vermont. That is just an extraordinary achievement. And in talking to the head of the Community Health Center Program in Washington, he informs me that per capita participation in Vermont is higher than in any other state in this country. And when we talk about a overall health care system in America, which is largely dysfunctional, and we know how bad primary health care is, that tens of millions of people, even those with insurance, are having a hard time getting to the doctors or the dentists that they need. What we are accomplishing here is a real achievement. It's a model to the country. And we can and will do even better. And I want everybody to know that what a community health center is about is a facility open to all people, not just low income people, but all people. And it means when you walk in the door, you're going to get primary, high quality primary health care. You're going to get dental care, which is a very serious problem in our state and throughout this country. You're going to get mental health counseling, and you're going to get some of the lowest cost prescription drugs that are available in America. And that is why almost 1 third of the people in the state of Vermont are now accessing community health centers. If anybody has any question about where a community health center is located in their part of the state, they can get my officer ring at 1-800-339-9834. 1-800-339-9834. Now, this $33 million amount of money coming into the state is the single largest investment in the history of the FQHC program, something I worked on very, very hard. And it's part of a $12 billion program that will take place throughout the country. In addition to that, we put into the American Rescue Plan $800 million for a program called the National Health Service Corps. And what the National Health Service Corps does is fulfill an enormously important function. And that is in many parts of America, rural America, urban America, areas that are medically underserved find it very, very difficult to attract the doctors and the dentists and the nurses, the psychologists that they need. And that $800 million will mean that in Vermont, facilities can expand, can make sure that they have the staffing that they need. And that is a serious problem all over this country. Many parts of the country just cannot attract the medical personnel that they need. So we are very excited and grateful to the great work done by the 11 federally qualified health centers in Vermont in their 66 locations. And we think this money, this injection of money, will make their lives easier and allow them to do even more than they're doing today. And with that, let me introduce now Tess Cuning. Tess is the Bi-State Primary Care Association CEO. She, Bi-State is both Vermont and New Hampshire. Tess has for many years done a great job for the folks here in Vermont. Tess, take it away. Thank you. So thank you very much, Senator Sanders. Really appreciate the honor of being here with you today. And so on behalf of those 11 health centers that are serving almost 190,000 people, and as the Senator mentioned, nearly a third of Vermonters, we want to extend our sincere gratitude to the Senator for his unyielding support to bring these essential programs to services to the Vermonters, especially those most in need. And the per capita number that he talked about is due to him. He has been an ardent supporter and a champion of the health centers for his entire political career and the role that he had in the architect of a rescue plan to focus in on need. Well, in short, the bill is just transformational. And the bill has been noted to reduce child poverty in half. That's nothing less than really monumental. So in my view, this legislation has the thoughtful and meaningful changes in programs that we haven't seen since the Johnson administration war on poverty. So thank you, Senator Sanders. Senator Sanders sees the tremendous value in the health center model. He's described it well. And the other thing that the health centers do really well are the social causes of health, like the root causes of health inequities, the food security, the housing, poverty, racism, access to education. And there's a tremendous amount of support in this bill for all of those things. So yes, we're at 66 sites. We're in all 14 counties. And then, of course, the provision in the bill, not only for the health centers, that's $7.5 billion across the nation. That's $33 million. And I would call it a tremendous investment for Vermont health centers. And then, of course, the other provision that he talked about was the National Health Service Corps and how important that is to our workforce. So I'll pause there and move it onto somebody else, but I'll be here for any questions. Good. Tess, thank you very much. Keep up the great work. Our next speaker is Jeff McKee, who is the CEO right here of the Community Health Center of Maryland. Thanks. So thank you. Welcome to Community Health Centers of Burlington. It is so nice to see people here in person. You don't get enough of that these days. And thank you to everyone else who may be watching online. And thank you, Senator Sanders, for being here today to make this announcement. It is truly such a pleasure to be able to host this event where we can talk about the tremendous support the American Rescue Plan will provide for the health of our communities. We are so grateful for your years of support for health centers. And more recently, your advocacy to ensure these resources are made available to sort of vital community needs. The FQHEs across Vermont will be the conduit, as you said, for more than $33 million in enhancements to our health care system. And each of the 11 health centers in Vermont will be working extremely hard to leverage those funds for the maximum benefit of the communities we serve. This year actually marks the Community Health Centers of Burlington's 50th anniversary. We are so excited about that. And in spite of all the growth and change that has taken place across that span, our mission has been the same, to improve the health of all within the communities we serve. Not just improving the health of patients who enter our doors, but also those that cannot make it to our doors. We understand that there are financial, cultural, language, geographic, and many other barriers that prevent patients from getting the care they need. Our commitment to health equity requires that we do our very best to support all members of the community in addressing these challenges. And that is why we are so excited about the funding we'll be receiving from the American Rescue Plan. These funds will support our mission to provide the best care possible to all. We're still working our way through the grant requirements. In fact, just in the last hour, we got our formal notice of award. We're thrilled about that, as all the FQHEs did. And so we'll make our way through those. But we're already started envisioning what we'll do with those funds and how we're gonna serve our community. So I'll just go through a few of those things. First, we'll be adding resources to provide mobile testing in vaccine administration services to underserved populations across the community, living in rural areas, or our BIPOC community members. And it will allow us to respond quickly to locations where testing or vaccination events need to be conducted in response to an outbreak or other urgent need. It will be our goal to be fully prepared in the case of a resurgence or another outbreak. We'll also be moving quickly to hire community health workers who live within and understand the communities we serve. The community health worker model has been shown to increase access to healthcare, improve communication between patients and providers, and increase delivery of culturally competent care. They will provide outreach, health education, care coordination services, and act as a liaison between the neighbors and their communities and the healthcare system. And lastly, we think it's important to increase our capacity to track and report on community health outcomes. Healthcare centers are great at collecting data, tons of data, but we're not very good at making use of it to shape programming and care delivery. The ARP funds provide an opportunity for us to develop the capacity to demonstrate the impact of our work. And in collaboration with many partners in the community, we'll be able to identify those in the community who are being underserved and develop interventions that break down barriers to access of care. And as I mentioned, we're still going through the details of the ARP grant and trying to match that up with what we know about community needs and priorities. So we're so excited to have the funds available to us that allow us the freedom and the creativity, the flexibility to apply those funds where they're needed within each community. So thank you again, Senator. Now we're gonna hear from Pam Parsons. Pam is the director of the Northern Tier Center for Health in Richford. Pam? Good afternoon, and I echo all the thank yous. We're very excited that the Northern Tier Center for Health has not served Springton County and Northern Grand Elk County. We have six medical offices, two dental offices, two pharmacies, and one grocery store throughout the two counties. Not just all of the rural and primary care access as a health home for the support necessary to achieve health, not just a healthcare visit. We have responded to our community needs providing comprehensive medical, mental health, medication-assisted therapy, substance use disorder, oral health, food access, and pharmacy services. Responding to community needs was a possible closure of two local rural community pharmacies, not to purchase the pharmacies to access to, so access to pharmaceuticals in the rural community continues. And we have been able to offer sliding fee to eligible patients. There is now another rural community pharmacy on the edge of closure, and we will need to consider. During the pandemic, we built out the opportunity to bring food access with a grocery store. We have mental health services, and recognize the growing need, serving the isolation, the isolation separation, the lack of human contact, but this service needs to be expanded. And with the National Health Service Corps loan and payment program, that will help our recruitment and retention of licensed clinical social workers for our organization. We will be able to expand our program. We saw a need for our school-aged children over the year, providing free summer programs for children in rural areas, and building school-based health programs. These will need to be built out even further to meet the growing mental health needs and the dental needs during and after the effects of the pandemic. We are partnering with local organizations for our robust vaccine program, focusing on our community with an attention to our hard-to-reach populations. This includes the Abnaki, the homeless, and our agricultural workers. We will be ordering a mobile unit to help with the vaccine administration. To continue meeting the need of our hard-to-reach populations, we want to build on our new relationships with the local organizations that serve these populations. We are looking at what equipment we can provide so agencies could get this population connected to care when needed. We need to build and retain workforce. In our rural areas, we are able to find individuals with the aptitude, but for so many, they don't have the training. Medical assistants, dental assistants, pharmacy technicians are areas where we need to build out training programs so we can train our own in health. We see these American Rescue Plan resources as meeting critical community need. This is our opportunity to keep it in broad in our services so we can meet these needs. Pam, thank you very much. I'll keep up with the great work. I look forward to seeing you and not to distant future. Our last speaker will be Josh Duprein, who's the director of the FQHC in Springfield, Vermont. Thank you, Senator. My name's Josh Duprein. I am the acting CEO for Springfield Medical Care Systems. We have 13 sites. Those sites are mostly in Vermont. We do have a New Hampshire site as well. We are very, very thankful for this funding. It's gonna allow us to really strengthen the foundation of the Federally Qualified Health Center to improve access, expand access to all comers, every single person that comes in to have access, whether it's through our primary care locations, our mental health locations, which are completely integrated to shared visits with your primary care clinician, even our dental sites. And so we wanna open those doors, make sure those remain open. We have had to quickly pivot during COVID-19 and offer telemedicine visits for a lot of individuals that has been helpful. We are in the process of acquiring a mobile unit, which will go out to employers to really help employers stay at work and be able to take advantage of immunizations for flu vaccines and those type of activities, as well as reduced transportation needs to areas. So we'll be posting that in public locations to really help those folks that do struggle with transportation. We have a lifestyle medicine program. The passion of mine and the group here is to keep people off costly pharmaceuticals. We are a 340D partner, so we do offer discounted pharmaceuticals, but for us to keep people off possibly chronic condition pharmaceuticals would be the best case and that's through nutrition and exercise and to help educate people that that doesn't have to be burdensome and you can still eat great tasting food that's very healthy for you. And if you have hardship finding it, we can help you with that as well. We are looking to expand our community relations with our community partners knowing that we can't do everything but there are other individuals that are doing, groups that are doing other things that we can work very closely with. The last thing I'll mention is our dedication to school-based clinics. Here in Springfield school-based clinics now, there's four schools and while we have had some disruption from COVID-19 and the way that the schools have been rolled out, we want to increase our availability within school systems throughout our service area. There was a grade schooler that we had and I'll never forget it who had an actual abscess in his mouth and he thought that was an important part of growing up this pain. We were able to get him into the school-based clinic and then refer him off to our dental site, bring him in and take care of him. He actually has filled out a lot of forms himself and so that's the motivation. We want to take care of, we want to take care of everyone. Everybody deserves this level of healthcare. Thank you very much for the opportunity. Well, Josh, thank you very much for the great work you're doing in Springfield. Let me just say this. I think what FQHCs are about is saying that every person in the state of Vermont and in fact every person in America is entitled to quality healthcare as a human right. That means you get primary healthcare. It means we address an issue that is too often ignored in the healthcare system and that is dental care. Now we've made some real progress in Vermont over the years but dental care and getting affordable dental care remains a crisis and God knows that for a long time in this country we've had inadequate resources in terms of dealing with mental health. That situation has been exacerbated by the pandemic and what community health centers are doing and will increasingly do is focus on mental health issues and we're also gonna see more of an effort to get into schools right here in Burlegan. This community health center has a great dental program where hundreds and hundreds of kids in the Burlegan area are able to get the dental care that they need and we're seeing that all over the state. We wanna see that expanded. So again, I wanna congratulate all of the FQHCs and their personnel for the great work they're doing and this money will make our job even easier to reach out and provide quality healthcare to all people. Last point that I wanna make. FQHCs accept and are delighted to accept people who are on Medicaid, delighted to accept people who are on Medicare, also delighted to accept people who have private health insurance and importantly, if you have no health insurance you walk in the door as well and you will be treated on a sliding scale basis. So the goal here is to make sure that everybody in the community whether you have a lot of money whether you have no money gets the quality care that you need as a human being gets the dental care the mental health counseling and affordable prescription drugs. All right, our questions. We answered all your questions. On the state pension, are you able to? Well, yeah, I can just be happy to just say this. I look forward to speaking with some of our teachers and state employees. Pensions are promises made to workers. That's what they are and they say the promises that a few perhaps don't take a pay raise, you cut back on this or that at the end of your career, you're gonna have a pension. Those are promises that must be kept and I do understand that this is an issue that the state legislature is dealing with right now. It's a tough issue. There's a lot of pension debt there. A governor is dealing with that. It's not primarily an issue that I deal with as a U.S. Senator, but it is an issue we are gonna monitor and look forward to working with teachers, state employees and the state government. Do you have any suggestions on as to how the state should fix the issue? Well, I'm gonna be working, you know, doing my best to work with the state legislature and the governor and the unions themselves. One last question. What should unions be doing to resolve this issue or is this a sole responsibility of the state? Well, unions are fighting for their membership right now. That's their job. Promises were made to workers and promises should be kept. And I understand that in Vermont, and by the way, in many parts of this country, the amount of money that, the fact that the pension debt, the amount of money that needs to be paid out to workers and the fact that many states don't have it, it's a very, very serious issue. It's something we've gotta work with. In Washington, we did a little work as part of the rescue plan actually. In summary, as we need to do more. This is significantly and primarily a state issue, but I do look forward to working with the unions and with the state to see that when you come up with a fair program that solves the needs of everybody. Thank you very much. Thank you. All right. Senator, just to go back to FQHCs. Yeah. You've been such a stalwart supporter of FQHCs for, I don't know, even before he started in politics. Was there a genesis for you? Yeah. What made you so- Well, I grew up in a family that didn't have a lot of money, so that's one issue. And I'll remember this way back in the early 1970s, a long time ago. I lived up in a tiny town in the Northeast kingdom. And I'll never forget the little boy who was a neighbor of mine, just lived right next door to us. And he must have been, I'm guessing, 10 or 11 years of age. He had no teeth in his mouth. His teeth were rotten. And back then, that was not all that uncommon. And it remains a serious issue today. Now, we have made progress here in the state of Vermont. And I think the FQHCs are one of the reasons that we have made progress in providing affordable dental care to tens of tens of thousands of people. And by the way, this issue of dental care is an issue that we are working on above and beyond FQHCs. As some of you may know, right now, we are working as the chairman of the budget committee trying to expand Medicare to cover dental care, hearing aids, and eyeglasses as well. You have many millions of seniors in this country who have serious dental problems, but cannot afford to go to a dentist. And last that I heard, dental care is healthcare, and Medicare should cover dental care. So this is an issue we are working on as we speak right now in the next reconciliation bill that's coming down the pike. All right? Okay, good. Thank you very much. Thank you.