 We continue to face many challenges here in Vermont, and the one I'd like to focus on today is mental health. Like many other states, we're seeing more Vermonters in crisis. That's by suicide and other heartbreaking outcomes. My team, alongside community partners, providers, and more, are working to reverse these trends. And as Secretary Samuelson outlined a few weeks ago, we're tracking mental health data as part of our focus on pandemic recovery. Recognizing these issues, this year we work with the legislature to do more, including additional funding for our mobile crisis response program, suicide prevention, expanding access to services through telehealth, and breaking ground on the new therapeutic residents to replace the Middlesex facility so we can offer more secure residential beds. These things, which are focused on those in greatest and most urgent need, are a critical part of our work. At the same time, we know there are also many Vermonters who may not rise to this level, but are feeling a lot of stress, despair, and hopelessness, given all this happened over the last few years. So today, we want to take some time to talk about it and share some resources and guidance to help those who are struggling, but may not feel their issues are severe enough to get help. The fact is, there is help out there, and we want to show you how to access it. There's no doubt we've been through a lot of turmoil and uncertainty, from a global pandemic to an attempted coup at our US Capitol, a historic reversal of women's rights, a spike in crime across the country, skyrocketing prices at the pump, costs increases for just about everything, and war in Ukraine. I think we can all admit this is taking a toll, even on the strongest among us. So what I hope Vermonters take away from this discussion today is, it's okay to not feel okay, because you're not alone, and there's nothing to be ashamed of in getting some help, or just taking some time to take care of yourself. As well, I want people to know there's still a lot of good out there, and there's always reason for hope, even when better times feel out of reach. In Vermont, we tend to rely on and be there for each other and set the example for the nation. I know feeling optimistic is easier said than done, so up next we'll have Secretary Samuelson, Deputy Commissioner of Mental Health Cromf, and Katina Idle, a mental health counselor in LaMoyale County, to talk more about the resources available, how to seek help, and take care of yourself, or others you know are struggling. So with that, I'll turn it over to Secretary Samuelson, who is joining us via video. Today's Croms Conference is focused on mental health for each of us and our fellow Vermonters. As the Commissioner of Mental Health, Emily Haas, always reminds me, everyone has mental health. It's clear that over the last few years, as the governor said, we have all been impacted by the pandemic, as well as many of the tragic events in the news, including gun violence in our country and conflicts overseas. According to the National Alliance on Mental Health in 2020, 21% of US adults experienced mental illness, or nearly 53 million people. That represents one in five adults in the United States, in the United States, and so many more of us are feeling anxious, stressed, and uncertain. The point is that we're not in this alone. Everyone is feeling it. It's important to remember that mental health is central to each of our lives. It affects how we experience our days. It impacts our physical health, jobs, our friends, our families. And while we need to be vigilant and look out for those who are in an immediate crisis, which is why you'll hear more about a new 988 number that's launching later this week, it's important that we pause and assess our mental wellbeing. How is work going? How are our relationships? Are we sad or mad? Mental health is central to all of our lives, and we need to pay attention to it. For many of us, this means putting the small things that it turns out are so important back into our lives to help rebuild our reserves and our resilience. These small things bring us joy and predictability. They are different for everyone, but some examples include volunteering in our community, being outdoors, participating in community events, and gathering with friends and families. And while we don't often prioritize that, these are critical connections that help us deal with the day-to-day stressors in our lives. At a moment when we see a lack of wellbeing at both the individual and community level, investing time in these connections is important for our own wellbeing and that of our communities. Sometimes connections alone aren't enough. We need additional support, even when we don't feel like we're in crisis. One important resource available that so many of us have used and accessed during the times of stress is brief counseling support. You may simply need someone to talk to. Seeking out a counselor or a coach can be a great way to help talk about and develop simple day-to-day things to address life's daily stressors. Although sometimes these resources are limited, many work, in terms of our workforce recently, many workplaces offer EAP or employee assistance programs. EAP often has counselors available on short notice or specifically trained for short-term counseling or to help you find a longer-term solution if you're having difficulty making a connection. I want Vermonters to look forward to things, to have hope, access the resources they need and to achieve the wellbeing we all are striving for. I will now turn it over to Deputy Commissioner at the Department of Mental Health, Alison Crombe, who will go into more detail. Thank you, Secretary. Good afternoon, everyone. I'd like to start by thanking Governor Scott for bringing us here today to talk about the importance of supporting the mental health and wellbeing of Vermonters and to discuss available supports, including the new three-digit number, 988. That's the number for the National Suicide and Crisis Lifeline. Beginning this Saturday, July 16th, anyone experiencing mental health distress can call a new number for support by dialing 988. This three-digit dialing code will connect callers to the Suicide and Crisis Lifeline, where they can access free and confidential and compassionate care. Vermonts been preparing for this transition to 988 for over two years. We're very grateful to the organizations and the people who have stepped up to provide the instinct coverage needed to serve Vermonters' calling for support. The 988 service is not only for individuals experiencing their own mental health challenges, it also serves as a resource for the parents, neighbors, community members, and friends of someone experiencing a potential crisis. It can be difficult to know what to do if someone close to you is struggling. It can also be scary and confusing if you're going through that yourself. Nobody should feel isolated in these moments. Our centers are ready to support you 24 hours a day. The lines are staffed by human beings who are there to help. They want to listen and they're there for us to lean on. Other resources available include 2-1-1. You can reach out to 2-1-1 for referrals for services and supports in your area. There's also the pathway support line. That's a great resource if you're someone who wants to talk with people who can speak to you as a peer and may have some shared experience. And if you're not a big talker, the crisis text line is also available. That's a 24-7 text line where you text the letters VT to 741-741. It's a confidential and free resource. These numbers and resources will be listed at the end of our presentation today. They can also be found on the Department of Mental Health website. Today I'm here on behalf of the Department of Mental Health to sincerely ask everyone to take stock of how they're doing. And to take a moment to hear about what you can do to assist your own mental health and the mental health of others. Mental health issues were on the rise prior to the pandemic. And in response, you heard us talking to you about the importance of reaching out to one another and engaging in Vermont's spirit of community. This culture is so a part of who we are and these connections matter. But in a post-pandemic world, after a time of prolonged isolation and uncertainty, not only has the need for mental health supports increased, but that social and community fabric we lean on has likely frayed a bit for many. It may take some time to build back those connections. It will likely take patience and energy. And if you're not feeling like you have much of that lately, I'm here as a full-time working mother of two to tell you you're not alone and a lot of us know how you feel. So please give yourself grace and time, but know that it's important to keep re-knitting that fabric. We also wanna speak directly to the leaders out there today as you can really make a difference in this arena. Whether you oversee a small team or a large organization, we hope you recognize the weight it carries for you to model your own self-care and to be seen valuing it for others. It is a great deal easier to foster resilient people when you build resilient communities that can find strength within each other. All of us up here recognize that these times are challenging and we know that there's more work to be done. We also know that not everyone experiences the same hardships equally. Both national and Vermont data illustrate that the LGBTQ plus community experiences unique challenges, which can affect their mental health and that black, indigenous and people of color experience life stressors at a disproportionate rate. It's imperative we remain mindful of this as we continue to work towards planting the seeds for compassion for all. So today we encourage all of you to take care of yourselves and each other and don't forget to look for the good out there and to always reach out for help when needed. One of Vermont's best resources for mental health supports are our community mental health agencies. They're staffed with licensed counselors and with me today is one of those professionals. She's a mother, a native Vermonter and a clinician with over 20 years of experience working with children and families in schools and communities. She's joining me today to help share ways to heal and care for ourselves and others. Please allow me to introduce Katina Idle from the Moyle County Mental Health. Thank you very much for having me today. This is a topic that is obviously close to my heart and as a professional, I can say that the silver lining for me of anything about the pandemic was that mental health is for all and helped everybody recognize that we all do have mental health and we need to take care of ourselves. First things first is I wanna say thank you. Thank you to everyone who provided direct service. Thank you to the teachers, the direct service providers, our military, our clinicians, our parents and those caregiving for others. This has been an incredibly challenging time and everybody that had to take care of someone else besides yourself had to work extra hard to do so. I know we've already touched on many of these topics but for the first time in my lifetime we've had a global impact where everyone was struck at the same time with a level of uncertainty and stress that really reset how we live our lives and when our stress response impacts us what happens is we go to our back brain. We aren't able to take time to think about how are we going to make choices? How are we gonna regulate ourselves? How are we gonna take care of each other? With all of this going on we had to step away from some of the bigger structural changes we could make to just focus on taking care of ourselves. So as it has been said, it makes sense to feel stressed right now. It makes so much sense. It makes sense, all of these numbers, the increased rate in anxiety, in depression, in substance use. All of that makes sense. When you are stressed, we try to do our best to relieve that stress. It makes sense that those who had underlying mental health conditions found that they had higher symptoms of more intensity. It makes sense that our school system and our school staff feel burnt out. It makes sense that all of our children missed some level of their development. And you know what, the kids are doing okay. We're doing okay. But how do we move beyond okay? We have to acknowledge that we're experiencing collective grief, trauma, and loss. And once we can acknowledge that and be aware of it, then we can move on. When we talk about trauma-informed care, we think about trauma as this big one-time thing that happened that was like a car accident or something else life-threatening. We all experienced chronic stress that became trauma. So how do we help that? How do we build resilience? How do we build healing? It starts with one positive relationship at a time. And that is really important for us to take care of ourselves so we can be that one person for someone else. So resilience for me is not about surviving. It's about moving beyond survival to hope and choice. I am a mother of two. And when school shut down and I had no daycare and my husband and I were both remote working and we had two children at home and I had my father at home recovering from surgery. And it was helpful in my mental health community with my coworkers to be able to say that we were having a hard time. So that we could lean on each other a little bit and acknowledge this is hard. This is hard for everybody. And we still have to show up and do our jobs. We still have to show up for our kids. We still have to show up for our parents. So we were surviving day by day, learning how to just show up and be present and try again. As we've kind of reached this next phase of being able to be together again in person, we're now looking at not just how do we survive but how do we move on? How do we build so that we're thriving as individuals and as communities? So while these may all seem simple, they are incredibly important. Positive social connections. I think there's been a lot in the news around social media and kids, teens, even adult usage of social media and how that's taking up more time for social connectivity than actually in person. It is something we do need to monitor and think about technology as a tool and not let it run us. So being able to reestablish those positive relationships in person in your life. Practicing gratitude. Not an easy thing to do in the moment when everything's overwhelming. But taking that breath and taking that moment to think about what you are grateful for. That can help reset your system so that you can take another step, another breath and keep going. Purpose and passion. We lost a lot of joy when we lost the ability to do some of our favorite things. So we have some of that ability back. Refinding joy, refinding passion. Very important. Going outside. There's a lot of research that talks about how important being outside is and we live in a beautiful state. You don't have to go far out your door to look around and see beauty. 11 minutes, that's all it takes. 11 minutes outside, moving your body in the sunshine and that can also again reset your system. And creating routines and rituals. When life is uncertain and when there's too much that is unexpected and we don't know what's going on and we're in our back brain and we can't make decisions, what we can control is establishing routines and rituals for ourselves. And these are the little things every day. It's the difference between the self-care of like, I'm gonna take a bubble bath to the self-care, ongoing self-care of what I'm gonna do to take care of myself every day. The basic three, sleep, nutrition, hydration. If you can't do anything else, focus on those three. Are you getting enough sleep for yourself? Can you set up a way to shut down your phone before you go to bed so it's not right next to you? Making sure if you're able to afford healthy food, can you buy and cook healthy food for yourself? And staying hydrated. It's funny, you won't notice it, but then all of a sudden you're like, hmm, I'll feel better after I drink. Yes, drink more water. Exercise, dancing, sports activities, things that bring you joy, move your body. The arts, making music, making art, playing, just to play. Mindfulness, yoga and tai chi. Now mindfulness is not like meditation where you're gonna sit and you're gonna think about nothing. That's not what we're talking about. Mindfulness all it is is a breath. Take one breath and try again. Journaling, building, creating. All of these things that help you feel like you have some control in your world and bring you joy. And then positive community. Whether it's faith-based groups or volunteer groups, anything along those lines that help to fill you up. By doing these things, by being aware of where we have been, where we are now in terms of the collective grief and loss, we're able to move up into a more just society. This is from the PACE's connection. For those of you who know about ACEs, adverse childhood experiences, PACEs helps to counteract that, positive experiences that help to heal and counteract the effects of trauma. I'm hopeful that we are beyond trauma aware to trauma informed. I'm hopeful that we are moving into a PACE's informed society. And I am really, really, really hopeful that we will get to a healing centered community. I do believe in Vermont, we can do that. So here are some resources from a structural level. We've talked about what you can do individually, but from a larger community level, there is a trauma informed approach to the workplace that business owners can download for free, review. There are assessments you can do for your own businesses, small or large around how to support your employees. The PACE's connection, which you just saw a slide from, excellent resource. And then for schools and families and other organizations, ARC, attachment, regulation, and competency. It's an evidence-based method that works on healing trauma. SEL signature playbooks. This has come across already from AOE in terms of a resource to use in your classroom at schools. An interconnected systems framework. It is an excellent way for using it through Project AWARE right now already in the state to combine mental health and education to work together to not just support our students, but also our school staff. We need to walk forward with hope and optimism. This was an article that came out at the beginning of the pandemic, and I've been using it in all of my trainings for schools to talk about the pandemic generation as actually a hopeful and optimistic generation. We can go through, we can learn, we can use these struggles to be better than we were before. But it's not just for our kids. We are part of the pandemic generation. We have all lived through it together. So we can also be better. If we know better, we can do better. So in forming ourselves, taking care of ourselves, this will help us move forward. As has been mentioned, when it gets too much, and you are not able to reach out to that friend next door or maybe tell your mom, you're afraid to tell your mom how awful you're feeling, or you just don't know what to do, we have additional resources that you can reach out to. So as of July 16th, the 988 number, the text crisis number has already been up and running and has been used, and then being able to get peer support. So one last thought. Find a way to play every day. We lost the joy. So find a way to play every day to find that joy. Stop, slow down, put down your phone, look up, laugh, cry, yell, do what you need to do to take care of yourselves so you can take care of others. Cause you are important. And you can pass that kindness forward when you take care of yourself. Thank you very much. Going back to you. Thank you, Katina. With that, we'll open up to questions. 988 number nationally, or some of our designated agencies here in the state that administer some of these mental health services. How are we staffing some of these services? I've heard challenges in some sectors. So how is it looking on that front? I think there are challenges in every single sector. I haven't found a sector that isn't challenged. And even throughout state government, we have about 800 openings out of a workforce of 8,000. So we, along with others, and that's split up, whether it's with public safety or the Agency of Natural Resources or the Agency of Human Services, were stretched thin. But we're doing whatever we can to make sure that we provide the services needed. And the designated agencies are in the same situation. Our healthcare providers are as well. Our educational providers are as well. So that's why we have to focus on how do we rectify that? We need more people coming into the state. You've heard me talk about this often over the last number of years. We can't fix this overnight, but we need to bring more people into the state to bolster our workforce. So again, I think we're doing pretty well. I might maybe I'll ask Allison to come up and describe what she's doing in her department. Yes, I second the governor's remarks. And I think the only thing I'll add, there's been a lot of national coverage around states being unprepared for the 988 rollout. So I will speak to that, that that's something we've been preparing for, over two years now, and we do have 24 seven coverage. We also have a backup center in New Hampshire that's been trained to handle Vermont's overflow in the case of staffing issues. Once you're full staffed, everybody knows that doesn't necessarily always last forever. So there could be pockets of issues. And so we prepared for that as well. So we're feeling cautiously optimistic about our ability to maintain that staffing. And we do expect the calls to go up once the number transitions to 988. So we've also projected those numbers and are working to prepare staffing for that as well. Yeah, I have one question for you. You started off, the governor was talking about, it's okay not to feel okay. And there are people who are recognizing that they need some help. But if they call the 988 number, is that a suicide prevention line? So is there sort of a disconnect between who's calling that number or who should be calling that number? I'm so glad you asked that question. One thing that's changed with the 988 rollout used to be called just the suicide prevention lifeline. They've actually rebranded it, the suicide and crisis lifeline. And so the message is you do not have to be suicidal to call that number. In fact, the majority of people identify maybe some light suicidality, but really just feeling distressed, overwhelmed, anxious, or distressed on behalf of their child or their parent. And neither of those people need to be suicidal to call the number. They're trained to handle suicidality if it's there. But their general training is to manage mental health distress of any kind. Dr. Soutler of the Channel 5, do you think that the crime that we've seen across the state, and especially the increase that we've seen in Burlington, is also related to mental health and in that sense? I would have to say, I believe that the increase in crime has been I think exacerbated by the pandemic. Some of it is some in mental health crisis, but I would say the majority is in illicit drug activity. That's where we're seeing most of the problem throughout Vermont and throughout the nation. So it's something that we're focused on. We're doing the best we can, but that is increasing. We're down the street. There is that Burlington has quite a few police openings as does the state police. But in Burlington, the word down underneath everything is that there aren't very many applications and people don't want to become police officers anymore, especially in that town. Yeah, well, it's a difficult career. Over the last number of years, we've taught a lot about defunding the police, focusing on the worst actors within that profession. And I think it's no wonder that we are in the situation we are right now, but with different training, we are elevating that the best we can. There's a lot of good people in law enforcement and we desperately need them. We have an obligation as a government to provide for public safety. It's probably our highest priority and policing is a part of public safety. So we are going to continue to bolster that, to build that and provide for the needs of our monitors, but it is an easy career and it hasn't been made any easier in the last two to three years. Several officers I've talked to have said it's very difficult to maintain with the criticism that they get on both sides of the aisle, as far as they're not doing enough or there aren't enough of them or there's too many of them and that whole issue. I can say there's not too many of them these days. And again, we are looking to make sure that we're filling all those positions. We hear from local law enforcement who are struggling as well, looking for state resources to help. And I think if we recognize first of all, we're all in this together. And if we need to provide and we are changing the way we train law enforcement, I think that's been a positive sign over the last couple of years. But again, this respect and civility on both sides of the aisle on this, I think is important. So we'll continue to do our part. We're going to support those in law enforcement and provide for a different training process for the future. That's on their side of the thing. But what can be done to change, as you say, the negativity or the positive side the attitude that folks have now about? I don't think, you know, it's sometimes the loudest voices are from limited numbers. I think the vast majority of Vermonters understand we need law enforcement to protect us, to provide for public safety. And we don't talk about that enough. And they don't talk about that enough. They're appreciation for local law enforcement. So again, I think it's incumbent upon all of us to recognize we are in need. They play a role, a pivotal role, an important role in providing for public safety in Vermont. So just that respect and civility, again on both sides of this debate, I think is necessary. But I sense it is changing. I think even in Burlington, I think we're recognizing, they're recognizing that they need to fulfill the positions that have been vacant. And maybe there's a different attitude in trying to work together to accomplish the same goals. Hotline, does the state plan to make public any of the data on the utilization and the effectiveness of the hotline as we roll it out? That, I don't know. Allison, can you address that, or is it Jen? So the national lifeline requires data reporting and they are building a dashboard that will be reflective of each state. I wanna make it clear that it will not have identifying information. But you will be able to note how many were maybe imminently suicidal and then did not go on to attempt suicide. That's one of our indicators, how many needed an emergency response, things like that, as well as satisfaction. So consumer satisfaction of their experience of the lifeline. And you'll be able to sort by state on that. They do have the lease utilization by state and they're building the dashboard right now. So I can't tell you for certain all the variables that'll be on there, but we'll know soon. Got it, thank you. National Guard is investigating allegations of misconduct. Of course, this follows a report last year, I believe, outlining a so-called boys' club with culture within the Guard. How do you think the state is doing it's sort of chipping away at that culture? And what do you make of this newest investigation? Yeah, culture change doesn't happen overnight. It takes time and a lot of effort. And I'm thankful for the leadership of the Vermont National Guard for talking about this publicly as well as those in the Guard feeling comfortable enough to report it. I think that that's important as well. So it's unfortunate, it's happening at all, but I think from the very beginning, we knew that this was not going to change overnight and it was going to, the culture change is going to take a number of years to evolve into what we want. So I'm thankful again for the leadership of General Knight and his team for talking about this publicly as well as for those who are reporting these incidents. HRA Farma submitting approval from the FDA for open accountability control. And if it is approved, would Vermont look to carry it? Yeah, again, I don't know the intricacies of that. That might be a better question for healthcare providers than me. I think we're very well positioned and protected here in Vermont with state law. I think we have with Prop 5 that is coming up in November. We have the ability to solidify that and through the Constitution and we'll see what Vermonters want to do in that regard and we'll know more, obviously, after November. But in the meantime, I think we have taken steps to make sure that we're protecting Vermonters and making sure that they get the healthcare they want and that's between them and their provider. Do you think Vermonters should be bracing for a pretty tough campaign in the fall over Prop 5, given the sort of national feeling that's going on, do you think it's gonna be difficult here? I don't, I believe it will pass, but I don't know, you know, politics is fickle and we'll see what happens. That's just my feeling and when I take the temperature of Vermonters, it seems as though most would agree that we want to protect the ability for the freedom to determine your own health and make sure that that's between you and your healthcare provider and excluding the government from getting involved. So I would say if you, you know, I view it as freedom and others who would, might describe it as a right, but I look at it as a freedom of choice, freedom for you to determine what you wanna do with your own body and making sure that's between you and your healthcare provider. I was wondering if you think that Vermonters is gonna be a battleground from national interest groups on this issue? I don't have the answer to that. I'm sure that there will be some, but again, that's up to Vermonters and voters. And I would say this is an opportunity for those who are either in favor or not in favor to exercise their fundamental right to vote and get out there and do it. And then we'll know in November. Go ahead. The COVID question, if I could, we've got rising infections from VA-5 nationally, the Biden administration is weighing whether or not to recommend another booster for adults over 60. Do you know if the health department's going to be making any recommendations? And I know you had said that you were waiting potentially maybe until late summer or fall for your booster. How are you feeling about that? Yeah, I'm still maintaining the course I set previously. I think once fall hits in Vermont, we will see an uptick, I believe, because we'll be going inside. We've said all along that we should expect different variants and whether they make a change in the vaccine, as a counteract that or whether the vaccine that we have right now is the one to help with VA-5 will yet to be determined by the experts. But this is, again, when we're going from pandemic to endemic, much like the flu, that changes every year. It's a different variant every year and they try and determine the vaccine and make sure that they have a vaccine that will be successful in preventing flu season. So I expect this will be the same for years and years to come. So I might ask, is Dr. Levine on? Maybe Dr. Levine would like to weigh in on this as well. Thank you, Governor. Just for a situational update for people, the Northeast currently is having the lowest numbers of new cases when viewed in a national context. The rest of the nation is having much more of an uptick. It's increasingly with the VA-4 and specifically the VA-5 variants. We are seeing that variant here as well. We estimate in the Northeast, it's about 50% of all the whole genome sequencing that is being done. But we're not seeing a super high uptick in disease activity, whether you look at cases or hospitalizations or deaths. So that is all good news. With regard to vaccine, an extra booster that's now being entertained for those who are below age 50, since it's already been recommended for those above age 50. And that won't be a Vermont decision. That will be a national decision that will probably happen in a number of days, I would suspect, because the Biden administration has just announced that they're strongly considering that. But the agencies that provide medical guidance will all be discussing this in the very near future. And the main reason, if they did say yes to this, would be not because they view everyone under 50 as under extraordinary risk, but because of the phenomenon of waning immunity. Just the fact that for most of them who might have gotten their first booster, that was so many months ago that with a new variant, that is especially immunovasive as it is termed, that we'd like people to have the highest level of immunity they could have to protect them against those serious outcomes. Monters who have had two booster shots already be expecting to get a third in the fall? Yes, especially if the third in the fall could be what has been proposed, which is a vaccine that not only incorporates the original SARS-CoV-2 virus, but those in the Omicron and the Omicron subvariant era, especially including the one that's circulating now, BA4, BA5. So that's what we're hoping for. That's what at least Pfizer is a little bit ahead of the game on in terms of already beginning to test. So the goal would be sometime in October, such a vaccine would be available. That would, for those who've been up to date thus far, be their third booster. But I would rather they view it as their annual coronavirus vaccine shot, just like the governor was saying, we do with the flu, because that's the way this will be designed, trying to keep ahead of the virus, if you will, even though it's so rapidly mutated. Let me ask you a question that I've gotten from a number of people. On one hand, the BA4 and BA5 variant is considered to be the most infectious, and I've heard you talk about, that's the nature of viruses, the ones that survive are the ones that are the toughest. At the same time, we've really dropped all our mandates and everything is optional. What are folks to make of all of this? What kind of risks are they at? So this is a highly transmissible akin to the measles. It is a virus variant that is going to cause a lot of illness around the country, but at the same time, we're not seeing yet in this country, major, major increases in hospitalizations or deaths, though they have increased to some degree. In Vermont, we're actually quite stable with regard to hospitalizations, and deaths are of course a lagging indicator, but they are very, very low at this point in time. So Vermonters need to continue to take into account all the things they always take into account when it comes to their own personal risk and their own tolerance of risk. And continue to look at the community levels that we're publishing in our surveillance report weekly. Right now, community levels are low and masking is not strongly recommended. But the caveat here is that there's two conditions that people need to think more closely about when they make their decisions. Number one is the degree to which they have somebody in their life, whether themselves, their family member or somebody they're close with outside of their family unit who's especially vulnerable, maybe in your compromise, has some kind of vulnerability because that should influence their own behavior regarding interactions that might harm that individual. And the second thing is just the fact that we don't have a lot of information because it's too soon to know about long COVID with the newest variants. And there's always a risk of long COVID. We believe that risk is significantly but not totally decreased by being vaccinated and up to date. But just consideration of the long COVID state and wanting to make sure that they can protect themselves as much as possible from getting ill so that that potential outcome doesn't become an issue for them. But otherwise, rest assured that if you're very well vaccinated and boosted and if you do get ill, you have access to therapeutics if you're in a vulnerable group and eligible for those. And that we know how to actually exist with the virus to a greater degree than we used to. People can mask as they wish and protect themselves more fully when they do that and consider those around them, consider crowded situations, et cetera. But most of the ways people are behaving now, taken into consideration their experience with the virus previously and I think they can manage even with the new variants that keep coming our way. So I do wanna jump over to the phones and we'll start with Andrew from the Caledonian record. Thanks, can you hear me all right? We can. Excellent. I'm wondering, Governor, if you or one of your team can quantify the impact of the pandemic on the need for mineral health services, that are we seeing a big increase in the number of calls and people looking for assistance? And is there an expectation that with this transition to the endemic phase that some of that is going to abate all on its own? Sure. So quantify is a tough ask, but I do think what we know is when the pandemic first hit, there was a very distinct suppression of people trying to access care. A lot of folks who had regular appointments with their therapist took time off from that. So, and we saw that with healthcare as well, less people accessing their healthcare supports. So we do believe that that suppression led to people either no longer well managing the care that they needed and not getting that on a regular basis or holding off when it became a new need because they were uncertain. And so we do think that suppression led to an uptick. You know, it eventually boiled over once we said, go forth and please access. There were more and more people coming for that access and they were sicker when they got there, both in the healthcare realm and the mental health realm. So we have seen, I can tell you, for the suicide prevention lifeline. Three years ago, we had about 150 callers a month for that lifeline. This January, we had over 500 in a month. So yes, we know from that. We see that as a good thing also. More people know about it and we're saying please access that line, but it is an indicator. We're also seeing our emergency services for mental health. Those are your crisis services where they go either out to you or they see you at the emergency department or at the mental health organization for a mental health crisis. Those have increased significantly over the past two years. So with those indicators, we do see enough data to tell us that it's not just anecdotal. People are reaching out more and when they're reaching out, they're having a higher level of need. And do you anticipate? I apologize. I was just going to speak directly to that in terms of the clients that we serve at the Memorial County Mental Health Services, which are on the DAs. So the clients that we had currently in services that remained engaged, especially through telehealth, which was an option that was not available widespread before, they're still in services because during the pandemic, they didn't necessarily get better, right? Things got worse. So they remained in services. And at the same time, we were getting new clients in as well who are now we're having difficulty. So there was a suppression, but there was also the clients that were in services remained and now we're also getting new clients on top of that. I will say that for the children and families we serve, the telehealth did not work well for the children. That's better in person. Adults are easier to access that service and that seems to be very helpful for them. And the main thing that we have been seeing recently has been the adolescents where they kept it together for a long time or shoved it down and now they're the ones that are reaching out for help. So that is an area of population that we are really trying to outreach to just like this line. Thank you. And if I could for Dr. Levine, just curious if he could provide an update on the rollout of vaccines for children five and under. Wondering how many doses have been administered and if that's meeting expectations, that's going well. Sure. If I could just add on to the previous discussion. We have youth risk behavior survey data and there's plenty of survey data of high school and college students that indicated that pre-pandemic, there were alarmingly high rates of anxiety and depression in that population. And if you talk to some of the school nurses and school counselors, none of that got better of course, during the pandemic, it only got worse. So these are not quick fix problems. These are things that take time. So they're going to obviously be addressed very comprehensively, but they are going to take time to resolve. With regard to the children from age five and below, as of yesterday, 2,200 children have received their first dose. 50% of those occurred in the healthcare setting, usually in the primary care setting. And we have abundant vaccine still present. Now, the 2,200 children are out of an eligible population of about 26,000. So that's about seven to 8%, which having only been going for a couple of weeks with vaccine newly arrived in the state, I consider that really a very positive feature and a good finding. And it's probably about three to four times the rate that the national rate is right now. So Vermont, as per tradition is leading, there are still plenty of children to get vaccinated. I suspect many will do that as part of their general healthcare, because that age group sees pediatricians a lot more frequently than older kids. And they're not rushing in to get their vaccine, but they're getting it as part of their routine healthcare. And best resources for parents who are trying to decide between which of the courses to choose. Any advice on where to steer people for that? Yeah, we're gonna stick by what we've been saying throughout most of the pandemic, which is the vaccine that you can get is the one you should get. There are some differences between the Moderna and the Pfizer. Often a healthcare setting office will only have one or the other. So my advice would be to talk with your healthcare provider and have the conversation about the differences, but don't use that as a reason to delay because both vaccines are going to be effective for this population, and now would be the time with the new sub variants in circulation. Okay, thank you everyone. In terms of the previous question, I think we've talked a lot about there's no single answer to some of the mental health issues that we're seeing. And again, with the adolescents seeing an uptick there, this is something that we were seeking to make sure that we had our after-school programs or summer matters programs, the summer camp program under summer matters. And that's been hugely successful. So I'd like to think that we saw this coming in some respects, and we did something about it with Senator Sanders and others in our team in putting all this together. And again, I think it's been hugely successful and beneficial for our kids. Chris Roy and Newport Daily Express. Yes, good afternoon. This question might've been asked. I couldn't hear the question from the gallery very well. Can the 988 number be reversed like 911 can? I don't know what that means, Chris. Maybe you could explain that. Oh, sure. So when you call 911 and you hang up that the call taker on the other end can determine where you're calling from and do a call back or do a wellness check by authorities. So I'm told that the phones, the phone system that they use can identify the phone number for a wellness check if needed. It is not the same robust system as 911 where you have the opportunity for GPS and other things where someone's calling from a cell phone. So it's not as sophisticated, but the call can be traced back. Okay, and up here on the Canadian border we have spotty cell phone service in places. And a lot of times calls roll over to Canada. So if somebody's roaming off Canadian Tower calling from our US cell phone, what's gonna happen? So the call is routed by your own phone number. So if you are in 802, that's how you get to Vermont. No matter where you're calling from. And so I know that might come up with a list of other questions, but right now it is based on that routing. They are working towards having it be around hanged off a cell signal in your own state. That's gonna be the next step, but for right now it's your phone number no matter where you are. Okay, because in Canada sometimes if you call, excuse me, on the border if you call 911 sometimes it'll go to a Canadian 911 answering point and I didn't know if there would be something similar for this 988. Right now it's my understanding it is national to the United States, but that's something we could look into and get back to you on. Okay, great, thank you. Come on, business magazine. Hi, Governor, germane to the mental health issues, the general financial situation of the healthcare industry. And as you know, well know that the hospitals are struggling mightily right now and costs are going up. UVM, M.C. just increased nurse pay by quite a bit which is good news on the one hand but obviously it increases expenses on the other. Is there any kind of path forward to fixing the general financial situation of a regulatory path forward, changing the regulatory system? What do you see as the path forward to that? Again, as you might remember I signed somewhat reluctantly a bill that provided for a $4 billion study the Green Mountain Care Board has access to. And I said in my signing letter that we're all in this together so to speak and the executive branch, the administration as well as the legislature in the Green Mountain Care Board the healthcare providers and the hospitals we all have to work on this together because it's going to be a huge lift and this is going to be our next challenge, healthcare providing healthcare at a cost that people can afford and provide it when they need it. So this has always been a challenge but it's been exacerbated by inflation and the pandemic. So again, there's no easy answer on this but I'm pledging from the executive branch that we will be working with the Green Mountain Care Board understanding they're an independent body but working together with them and the hospitals and the legislature and all of us need to play a role in providing the future because I don't think anyone has the answer at this point in time but everything working together and in unison we have an opportunity to make this accessible again at a cost that people can afford. You do have a little bit of control over the membership of the GMCB to some extent. Do you see a new direction or a different direction on the people sitting on that floor? Well, obviously there is going to be at least two new members and so we'll see. We look again for competence and making sure that they have the right attitude to provide for the path forward. But again, anyone we are interviewing, anyone we will be dedicating to the board won't have all the answers either. It's an independent body and they will work together and they have $4 million to access outside help and support as well. All right, thank you, Governor. Compass for Ma. Thank you. I just wanted to follow up on the jobs that are needed to be filled in the state. This is purely anecdotal but I have received this from about a dozen different people and it seems that a lot of folks that have applied for jobs with the state have never gotten a reply whatsoever and they never know what happens with their applications and I was just curious given the number of openings. Was this a selectivity issue? Is it a lack of staff to respond? But it seems like there are folks out, some folks out there looking to be employed as a state but not getting too far. Has that changed at all since it started? That would surprise me but it may be and I'm gonna ask Secretary Clouser to talk about this a bit. But if they're applying for a specific job maybe and that may be something we need to take a look at because if there may be some other opportunity that they may have the aptitude for, the interest in that we need to explore. But Secretary Clouser, do you have a response to that? Thanks, Governor. I too am surprised to hear that because we do have a lot of openings and we've been trying to highlight both recruitment efforts and retention efforts here at the state. So I'm happy to follow up and try and drill down a bit and would be curious to hear what sections or applications folks are not getting a response to so we can look into that. I appreciate that. I could send you, like I said, this is purely anecdotal but there was a consistency to this story. I'll dig and get a little bit more information on what departments and types of jobs they're applying for. Maybe that will help, but I do appreciate it. That would help tremendously. Thank you. Okay, thanks. No other questions. Thanks, Governor. Guy Page. Hello, Governor. In a recent candidate forum for Chittin County State Attorney, both candidates seemed open to reimbursing retailers for retail theft losses from sources other than the shoplifters, most of whom are indigent drug users. What do you think of the idea of using any state or local government money to make good shoplifting losses? It sounds a bit like a slippery slope, but I've never contemplated that. I mean, where do you stop? And is it the obligation of the state to provide for, let's say, someone stealing catalytic converters, which I just saw in the news this morning at some dealership? Is that, would that be the responsibility of the state to reimburse that dealership? Where does it stop, I guess, is my point. I have a great deal of sympathy for retail theft in particular, and it doesn't seem as though we're prosecuting many of those and it may be just because of prioritization, but I don't know as the answer is the state or the municipality getting involved in reimbursement. So I just haven't ever contemplated that. Thank you. Also, you and Mr. Levine, I've been talking about vaccination coming up this fall. Is that something that will be required for state employees as it has in the past? And do you expect healthcare related employers to require vaccination for their employees? Well, we haven't talked about that, but I don't believe that it will be required. We didn't require them before. We strongly suggested that. And I will be getting mine. And as far as the healthcare providers, they are like a separate entity. A business can require that and that'll be up to them. I don't know whether they will be doing that or not. I know some require flu shots every year now, I believe, but I don't know what they're going to do with this vaccine. And I'm going to steal one third question. Six of the seven gun homicides in the last six months, as best as I can figure out, are related to drug crime in some way. Can you please tell us more, what the state is planning to do to reduce the drug-related gun crimes? A crime problem? Yeah, it's a difficult guy, as you might imagine. Building these cases isn't something that happens overnight. It takes a long period of time to gather all the information, to make sure that we're getting to the root of the problem. It's not the selling or the buying of drugs like on the street that is the issue. It's how the system is working, where is it coming from, and how do we cut off that source? So it takes, again, a lot of effort, a lot of people, a lot of law enforcement to build a case to be sure that we can be effective, because every time we take, it seems as though, every time we take something off the street, there's always somebody else to replace that person. And while I'm at it, I do feel that we have to take a look at what we're doing in the state in terms of expungement of records and so forth, because if there are youth that are involved in the illicit drug trafficking and are being used as mules, we never know about it if we don't, if they're not prosecuted or if their records are expunged. So again, I think we have to look at this holistically and figure out how do we stop this from happening, because it is growing, and you're right, there is a lot of gun activity that we're seeing that is directly related to this illicit drug trafficking. So we are doing all we can, but we intend to do more. And I'm not going to communicate how that is, but we intend to do more. Thank you. That's it. All right, thank you all. I'm so sorry, I just wanted to ask you about the front of those people really quickly. What does it mean for the state, for state racing and the community at large? Yeah, well, it's something that came back. The Governor's Cup is going to be this week. There is a NASCAR driver that typically comes in, they're trying to master Thunder Road and has not been successful yet. This year it's Kizlowski, but we've had some others in the past, whether it's a Bush or a Tony Stewart or some others that have not been successful. It's a difficult, difficult racetrack. So there's a sense of pride in what we offer and the quality of racing in Vermont and it should be a good race. And again, it brings some notoriety to the Vermont itself because a lot of folks, a lot of the NASCAR folks that come in don't associate racing in Vermont together. So their eyes are wide open after that and somewhat humbled when they leave. Well, we know this is not taking a lot this year. I am intending to race this year. I haven't been very successful this year at all, but I will be attempting to qualify and see what I can do. You never know. I'm sorry to keep piling on. What's the latest on state gas tax holiday? Well, again, this was an initiative that the Biden administration had floated, which I said we would take a look at and we would take a look at if there was a sense in Vermont that they wanted to seek relief from the gas tax. But I've said all along, we'd have to backfill that somehow, it'd have to be done with general fund. I'd have to get the legislature involved. We can't do this on our own. It's something that would have to either a special session or going into the new session. But again, we utilize that money, that user fee, so to speak, the tax to leverage money for the 90-10 match or the 10% match for the 90% federal funding. So we need it. But if it comes out of a different pocket, that's fine. But I think there's other ways of providing relief as well. I mean, we had a few ideas over the last few years. We had one last legislative session, a much broader tax package than was passed that would have helped with those with low income, the EITC tax credit for those on fixed income with social security and many other provisions that would have been much broader than what was passed. But again, I was thrilled that they took up any tax relief package and we'll see what happens next year. But I think there's another way to provide relief for those who are in need because folks are struggling. I mean, when you see the price of fuel, the inflationary price of labor and materials, everyone is impacted. But those, the most vulnerable, those on fixed incomes are people we need to pay attention to and I believe we should have paid attention to them in the last legislative session. Okay, would you have your wrap up? Okay, thank you very much.