 as well. Good morning. This is the House Health Care Committee in the Vermont House of Representatives. I'm Representative Bill Lippert, chair of the committee. We are continuing our testimony on a proposal from the Department of Public Safety and the Governor's budget that proposes adding mental health counselors to the Vermont State Police to assist with crises that where the Vermont State Police and other law enforcement are often called where there may be a mental health issue or is a mental health issue involved. We've taken testimony for several days and today I'm going to turn the chairing the meeting over to our Vice Chair, Representative Ann Donahue, who has helped organize the testimony for today and has an update for us as well. So with that, I'll turn it over to you, Representative Donahue. Thank you very much. Yeah, this is our third day and final day under a fairly crunch schedule to try to get some broad perspectives from various stakeholders on this proposal. And I really appreciate the way people have responded and made the time to join us. I mentioned when a few people weren't on yet and we hadn't gone live, we do have one addition to the agenda because we did have a committee member request and I thought it made sense to ask for somebody a little bit more at the front line level from the law enforcement perspective of how they see the program in this case that's working in the Northeast Kingdom. So that will be added. We had a few of our 15 minute slots where people were not able to come. So we did have a little bit of time to work with. I'm also hoping we'll end up with maybe about 15 minutes at the end to have a brief committee discussion on what people's sense is of where we might want to look at in terms of recommendations. But we're starting this morning with the one person who has a little larger block of time and so I want to give a brief background. It was this committee three years ago that passed a bill that created the mental health crisis response commission and that was very specifically in response to concerns about use of force and in particular use of deadly force with people who appeared to be in a mental health crisis. There were a lot of concerns about some deaths that had occurred and the concept was that although we had systems in place to review whether an officer had acted wrongly or not, we didn't have anything that looked more at what are the opportunities for the future? What can we learn from something where things may have gone wrong but there was not a liability necessarily. But what could we learn and what recommendations might come out of that? So it certainly would make sense to hear recommendations. There was the first report of the review of that first death that came out early this year and unfortunately our whole world turned upside down in terms of planning that we might have had to hear about that report during the regular session. And so that's why I want a little bit of extra time. We have here the chair of that commission, Wilda White. I wanted her to have a little bit of time at least to give an overview of that report as well as what recommendations she might have from that specific perspective in particular on this proposal. So, Wilda, welcome and you're on. Give me a second. I'm looking for my mouse so I can permanently unmute myself. There. I found it. Thank you, Vice Chair Donahue. My name is Wilda White and I've been invited here as the chair of the Vermont Mental Health Crisis Response Commission and I'm also hoping to speak personally or on behalf of other psychiatric survivors about this proposal as well. Specifically, my invitation to speak here today asked me to talk about the Brennan Report but also asked for and I'm going to read it. The committee is also interested in any perspective you have regarding any additive impacts of racial and psychiatric discrimination so I'll also be addressing that topic today. Just to give you a little bit more information about my background, I do consider myself a psychiatric survivor meaning that I have suffered abuse and harm at the hands of psychiatry. I also have been labeled with a severe mental illness for which I receive no mental health care which according to the Treatment Advocacy Center makes me 16 times more likely to be killed by a police officer so I take these issues very seriously and I'm very pleased with the invitation to be here today because it is for me a matter of life and death. The Brennan Commission I want to say at the outset is taking no position on the proposal that you have before you but I will begin by giving you a summary of that investigation in our conclusions. Phil Brennan was a 76 year old man who was killed in his apartment in March 2016 by the Burlington Police Department. Officers, excuse me, and what we found was that Mr. Brennan's death was the result of the majority of the commission felt it was a result of a kind of a service and communication failures between several agencies and I wrote a kind of additional opinion that his death was also the result of the failure of the Burlington Police Department to follow its own policies and that failure to do so was a result of implicit bias against people with mental health challenges. Essentially what happened was that Mr. Brennan had been deteriorating for almost a year after his case worker at the Howard Center left and he had quite a close attachment to her. That case manager had been his case manager for the longest of any of his case managers. He had received care there for almost 18 or 19 years and he had been assigned a new case manager like every couple of months but finally he was with the case manager who he had been with for at least two years. They developed a close working relationship. She moved on to another job and he was devastated by it. So he stopped taking his medication which was not recognized or documented by his psychiatrist but it was clear to his psychiatrist that he was becoming more and more psychotic and psychosis for those of you who are not familiar with that term as used by western medicine it's when people can perceive things through the any of the senses that others don't perceive or where people can think things that are not part of the consensus reality. In Mr. Brennan's case he believed that the police department was coming to his apartment to kill him and he reported that to his psychiatrist and while his psychiatrist did warn certain people like street outreach that was never conveyed to the police department. So on the date of his death a neighbor had called street outreach to complain about noise coming from Mr. Brennan's apartment and so street outreach who was at the time embedded I know that's a charged word but that is the word that they used embedded in the police department attended roll call and asked the sergeant to assign some officers to accompany her to his apartment. She this street outreach worker had been told that she couldn't go to Mr. Brennan's apartment alone because he had threatened to harm people who came to his door. Street outreach had been going to his door periodically he would never let them in and that each time they came to his door he had called the psychiatrist and said stop sending these people to my door he thought they were going to kill him and he was going to protect himself with knives and self-defense if they continue to appear. So this day in March he showed up at his he he the street outreach worker got two officers to come to his house and while they were en route they received another 911 call from the apartment manager who also called to report that Mr. Brennan was making noise in his apartment threatening to kill people or to harm people although he never left his apartment and no one saw him. When you know police officers arrived they knocked on his door he didn't answer they used the key to enter and when they opened the door they saw him standing there holding two knives. They immediately drew their guns shouted for him to drop the knives and one of the officers threatened to shoot him twice or not threatened to shoot him two times but threatened twice to shoot him. So Mr. Brennan de-escalated the situation by closing the door at the same time that the police officers discharged their tasers so over the next four hours the officers tried to get him out through drilling holes in his apartment through shouting commands through telephones and none of that got him out of the apartment at at the end of four hours Chief del Posa made the decision to go into the apartment he said because he was concerned that Mr. Brennan would kill himself because an officer had falsely reported that Mr. Brennan said he was going to kill himself Mr. Brennan never had done so and no witness reported they went in they had several plans to try to get him he was found hiding in the bathroom they had several plans to try to get him out of the bathroom ultimately they decided to use a taser to get him out of the bathroom after pepper spray failed to drive him out of the bathroom the bedroom the the way the apartment was configured it was very small it was actually he was in a bathroom that entered into a bedroom that entered into a living room the brothers and police department chose to cram seven people into his bedroom one of whom shot a taser into the bathroom immediately before shooting the taser the man said as soon as I see him I'll hit him Mr. Brennan thinking that the police were there to kill him um as soon as he was hit with a taser twice he came out of the bathroom the committee decided in self-defense to try to defend himself as he said he would because the bathroom because the area where the police officers were were so small not all of them could get out of the bedroom in time to avoid the charging Mr. Brennan four became trapped in the bedroom because it was too small with too many people in there um and then one of the officers then had to uh the committee found um shoot Mr. Brennan because they had no means to escape because the area was too small uh Mr. Brennan was taken to UVM medical center and pronounced it seven minutes after arriving um cause of death was homicide by law enforcement so um that's the general factual background um a couple things that were important there um kind of Mr. Brennan's death kind of was put into motion when his treating psychiatrist decided to allow him to decompensate until he came to the attention of the police department um secondly uh you know the Howard center when Mr. Brennan started missing appointments the Howard center started sending out street outreach other uh kind of workers everyone except his treating psychiatrist tried to visit him as an apartment but he wouldn't let the men because his psychosis made him fear that they were there to harm him um unfortunately his psychiatrist went on vacation at some point and no one was left kind of in charge of his care so he essentially kind of fell through the cracks when he sent an email to his psychiatrist warning her to stop sending police to his apartment or street outreach to his apartment and said he was going to defend himself the psychiatrist actually received that email when she was on vacation and then alerted certain people but not the police that that was his position and she also did not reach out to Mr. Brennan or they didn't have a treatment plan to address his his this fear and they basically decided to wait for Mr. Brennan to contact them if he wanted care rather than reaching out to Mr. Brennan um this is true even though um Mr. Brennan in the three months before his death made several threats against people to kill them and the Howard center gave a um discharges duty to warn those people but even though they're giving a duty to warn which you give when you feel that someone is a danger to others they didn't use that same assessment that he was a danger of others to use any kind of involuntary procedure to to give him care so that was the first thing that the um the commission found was problematic about um the events that led to Mr. Brennan's death what the police did when they arrived they they um they did not follow any of their policies um they had a policy that when you are dealing with someone who you know is impaired because of a mental illness and who was unable to follow your command they have a policy about containing the person and not um duly encroaching upon their space both things they did um they drove him out of his apartment when there was no need to do so the policing dollars that Mr. Brennan had committed no crime he was not under arrest it was apparently a welfare check and instead of giving him space um they they they kept encroaching on him even after they entered this they say because they thought he might kill himself even after finding him safe and unharmed and hiding in his bathroom they still continue to try to drive him out of the bathroom when it was not safe to do so because of how small the bedroom was how unprotected the officers were they continued to do so violating their own policy they also have a communication policy about how you talk to someone in this in this case also they did not follow that they were supposed to ask open any questions they never asked an open in the question you're supposed to be honest and truthful they never told Mr. Brennan while they were there um they shouted at him using command presence um even though um most people dealing with people who um are in extreme states uh you know that command presence is actually triggering um rather than um deescalating um they also had a policy of using um crisis counselor crash crisis negotiators also known as hostage negotiators and not um deciding to use you know less than lethal a lethal force before consulting with the crisis negotiators about the decision. Burlington police never consulted with the crisis negotiators about their decision to enter the apartment and drive them out. In fact the crisis negotiators were in the process of setting up an alternative means of communicating with Mr. Brennan when they learned that Chief Del Poso had made a decision to enter the apartment and by the time the crisis negotiators entered the apartment the police department had already made entry were already demanding Mr. Brennan to kind of leave the bathroom so we found that that was another um problem they also had a policy not to use a taser on a person with a known um mental health issue um before talking to um um a crisis worker. On site at the time that this whole endeavor was uh happening was a mental health crisis worker from the Howard Center she was never consulted about how to approach Mr. Brennan she would just sat in the car across the street during the whole four-hour operation um and uh I could just for one second I think this is really important information and I think the committee um needs to and wants to hear from it we also have kind of circumstances beyond our control in terms of timing so um if you could sort of move to recommendations including your own personal thoughts and recommendations um that would be great because we want to have a little bit of time for committee questions um as well thank you for understanding. Okay um so obviously the first recommendation would be to you know you follow your policies um though they would have made it they would have prevented Mr. Brennan's death another I want to just say the last policy it didn't follow which was most critical was to use time um as your friend and um and and take the time to get the equipment that would allow you to safely take someone in the custody there was a safe way to take them in the custody they didn't have that particular tool and they made no effort to get it um so our recommendations were basically um basically the committee came up with all these recommendations that would have prevented his death and then we looked at Burlington Police Department's policies it was clear that they had all of our recommendations were already included in Burlington Police Department's policies and so I looked further to see why those policies weren't adhered to and I found in several instances that I thought it was because of just an implicit bias against people with mental health um challenges both the derogatory language that they used um the um falsely reporting that he was going to kill himself falsely reporting that he wanted to be killed by police all of those things played a played a role in Mr. Grennan's death I will um and and and then just not even using the crisis workers who were on the premises um and the other thing that's it may be a little counterintuitive this was just not an appropriate um case for street outreach Mr. Grennan had a psychiatrist um and street outreach the well intentioned every time they tried to reach out to him he it triggered him um and the street outreach worker who was on who came to his date house the day he lived day he died talked about how how in over her head she felt that this was not a situation that she felt that she had been trained to deal with um um so in terms of um the uh looking through this um for kind of through a race lens um I mean the the primary problem is is that um this proposal will definitely adversely affect people black people and people of color um because it should not be left to law enforcement to determine whether an individual in need of mental health referral it should not be left to law enforcement determine whether an individual is in need of mental health referral because implicit bias will definitely um play a role in that and will perpetuate the disproportionate number of black people indigenous people who are referred to mental health clinicians and diagnosed with mental illnesses currently in our society black people and native americans are disproportionately diagnosed with mental illnesses um there's a long history uh in our society of inquading race with insanity um and anxieties about racial differences have historically shaped clinical encounters uh in fact uh in the 1970s and 80s so many black men were being diagnosed with schizophrenia simply based on their race that it became known as the protest psychosis in vermont black verminas are disproportionately represented in the highest level of involuntary hospitalization at vermont psychiatric care hospital 15 percent of the patients held there are are black and people of color so allowing police officers to use their lay understanding of mental illness coupled with their implicit biases will exacerbate the disproportionate rates that black and indigenous vermonters are diagnosed with mental illnesses um two years ago i gave a keynote address at the national conference talking about what i saw as the transformation of mass incarceration into mass medicalization that is turning black and brown prison inmates into black and brown mental patients um as a way to um preserve um basically traditional uh uh gym crow cast system in our society so i find proposals like this that further entrench both uh both systems of social control the mental health system and the law enforcement law enforcement system uh as we further entrench those into the lives of black people and further surveil them we will see years down the road um basically you know going from the prison system to the convict leasing system to the gym crow system to mass incarceration into mass medicalization um so i think this is a really dangerous proposal um i think that it's while you know maybe at the beginning of the year it might have seemed progressive i think in this post-joyed floyd post uh covid um that this is actually um an idea whose time has come and passed um i think uh it's just incumbent upon us to get law enforcement out of uh mental health um and it's really incumbent upon us to get mental health practitioners more aware of their racial biases um to deliver better healthcare to uh black and people of color so i will stop there very much appreciated are there around any questions from uh committee members you've clearly been really clear um in your testimony we we have another minute or two uh even though i'm trying to keep things very um focused um so don't be shy representative christensen we understood what you believe is wrong with the system do you have a solution that we could actually implement that is not a long term change the entire system um for what you feel is needed yes i appreciate your question um i think one thing that would make the biggest difference in the delivery of healthcare especially mental health care in the state of remand is the inclusion of people with lived experience at every at every level and i say that because we are currently being excluded from everything we're silenced we're censored we're socially erased and i think that our silence is killing us and i'll give us i'll give you an example um when i went to the team two training um it for me it was like the blind leading the blind you had mental health practitioners who were doing things embedded mental health practitioners who were doing things that were um really ill-informed for example during one scenario the embedded the way the embedded mental health worker approached the person who was playing the person in crisis the first question out of that person's mouth was are you mentally ill um i think if if a person with lived experience had been involved in coming up with that scenario we would have told that mental health worker that that is the absolute wrong question to ask somebody that you suspect of having a mental illness because that is very triggering and disrespectful um you know another thing that happened at that team two training was um there's derogatory language used to describe people with mental illnesses um that was not even no one even called anyone out on it um if a person who lived experience had been there we could have immediately said hey that that's that's not conducive that portrays an implicit bias we need to talk about that in the philgrin in case the police officers talked very close like within 10 feet of him and said everything they were going to do to him without knowing that people who um are in extreme states particularly psychosis have super acute hearing a whisper is like a shout and so he could hear everything that we're going to they were saying about him and it can uh for example they were going to slam him to the ground they were going to taste the shit out of them they were going to hit him with this they were going to blind them with pepper spray all of these things he's hearing most likely um which triggered them because the police had no knowledge about this condition called hyperacusis that comes with psychosis if they were working more in concert with our community um of psychiatric survivors they would learn these things and I think because they don't know these things it really actually led to the death of philgrin and so if you want to do one thing you're asked for one thing that didn't because the whole system to change you must include psychiatric cybers at every level of these interactions with psychiatric with people who are experiencing these mental crises thank you representative Smith thank you a question about the individual that was in his own apartment had had he maybe the condition his his mental condition caused him to rebel and and fight this police that when they stay I think they sound like they went into their his apartment not on the right track apparently but had he lied down on the floor and said I'm not going to do anything he probably would be alive today wouldn't he I don't really understand your question had he not had he not come outside the bathroom had he not been had he had he not been psychotic yeah he'd be probably alive today well with with the condition that he had uh was that the reason that he was rebellious and chose not to uh not to move I wouldn't say that he was rebellious I would say that mr grinnon thought he was going to be killed and he was acting in self-defense what happens when you're psychotic you don't really lose your ability to reason you're necessarily you you're operating a set of facts that may not be correct any of us I believe who thought we were going to be killed would likely do something to prevent it that was what mr grinnon was doing he just that there was no threat all right thank you representative courtes thank you I was um I'm just supporting what um thank you for uh your testimony I was just I'm going to support what uh her response to uh representative Smith um I think any of us regardless of what kind of uh mental or emotional stress or conditions that we had uh I would if I were a black man in his situation um or anyone I would have responded the same way whether or not I was experiencing psychosis uh so just to say that and it feels a bit like uh victim blaming to uh so I just want to say that um and another I'd like to counter the notion that um aside the the notion of aside from completely revamping um our system I actually think that's um what we need to do I know we're not in discussion right now so I'm just going to leave it at that but I felt like it was important to say thank you yes I think we need to hold off on discussion because of trying to get through our our witnesses um but uh we we want to take one last question representative page and then we're going to we're going to move ahead yes um thank you for your testimony I'm curious uh uh I'm finding that perhaps you know our mental health practitioners or individuals who have life experiences um we may have issues trying to recruit those individuals to our various state designated agencies you have any ideas how we could better do that here um and I suppose would you recommend also not just having these individual practitioners individuals life experiences but also have more training for our police officers I have no ideas about recruiting mental health uh clinicians that's outside my bailiwick um um I I think it would be relatively easier to recruit uh people with uh psychiatric histories um who who also would require some education and training um and I don't think that the training then education that that is required is limited to just law enforcement I also think that uh mental health workers could benefit from some training led by psychiatric survivors so that they uh understand us more and understand our our lives I think that people who work in this field have a limited understanding of us um because they're working at the extremes of what they might think of as pathology and there's a great range of how um you know mental distress and extreme states are are expressed um that I don't think they see and they don't really see us in our day a lot day day to day lives outside of clinics and they don't understand how some of the things that they do and some of the things we experience in discrimination and oppression we experience in a large society affects us um and I think that uh as a psychiatric survivor I would benefit from my conditions having a more holistic understanding of uh me and my daily life thank you thank you very much uh will do much appreciated um for your insights and we are going to move to hearing from representative pages and representative Smith's neck of the woods and that is to hear jointly or or one after the other we're again keeping to that sort of 10 minutes with a little bit of time afterwards for committee discussion but to hear both from um uh Jennifer uh sorry I'm Harlow and you can introduce your position and background and and uh if you could share with us um your perspective uh from your vantage point on the issue of engagement in a mental health crisis and the role for mental health clinical folks as with the proposal that's before us and um then you'll be followed up by uh Thomas Junkersky from northeast kingdom mental health who I think you uh is the agency that you work with yes ma'am thank you very much um so I apologize I've not been able to read through all of them the discussions that have been partaking so far in this and I was given extremely short notice but no I I want to say yeah we're very grateful that you were able to come on very short notice and very maybe don't don't worry about the background but just a snippet of your your experience um in uh working with northeast mental health and that will that will help inform our background and we really appreciate you uh really I think on about 15 minutes notice or so helping bring this perspective to the table well thank you and I'm glad to be here so my name is Jennifer Harlan the sheriff for Orleans County I'm newly appointed this past January I have over 24 years in law enforcement and I worked prior to my position here at the sheriff being becoming sheriff I was with Newport police department for 16 years I have um I worked patrol I've for nine of those years when I was with Newport I investigated sex crimes involving adults and children so I was assigned to the special investigations unit as a detective and investigated internet crimes against children as well so there was a lot that I'm not going to get into but um so I have quite a bit of experience and as far as what we're talking about today I can only talk about my personal experience um involving this so you know law enforcement in general we don't we are on the same page as all of you are we are not we do not feel that we are equipped to respond to all mental health crises but we are being called to do so and we have thankfully received a lot more training than we did when I first started my career and I'm very grateful for that and I actually took it upon myself to further my education in certain areas so that I had a better understanding of the population that I was dealing with um and working with in this community so I've taken um as far as having a social worker with working with law enforcement I have not seen it I've not seen a lot of negative things in that situation I've only seen really positive things now as I'm sure you all can realize and know it has to be the right person who's working together whether that's you know the right law enforcement officer or the right social worker when we're responding to these calls and in my experience when we are dealing with people who are facing a mental health crisis they may be calling the the department several times a day and they're not actually having an emergency they're just wanting to talk to somebody that's when we have you know referred that to their case manager or gotten them involved with somebody who can actually just make those phone calls to them to reassure them get them whatever they need um so they're not contacting law enforcement and so that we're not necessarily the first ones having that interaction with that person but where I've seen incidences where um and unfortunately we can all do things better and it you know I'm very sympathetic and to situations that have gone bad and you know thankfully we are hopefully we have learned and made ourselves better at responding to those situations but again we're getting called to situations where people are in crisis at that particular moment now they may have weapons they may have you know hostages things you know the people in their family things of that nature we're not you know and and then we're also responding to very various um sorry if I'm stumbling a little bit various degrees of crisis but when law enforcement is responding and if you ask a social worker or somebody from mental health they're wanting us to be there because it's our job as law enforcement to make sure that everybody is safe and that includes the person who is experiencing the crisis so when we've had workers that the new port police department has worked very well because one this person may have a background with this individual already they're obviously more trained have more education around what that person may be um suffering from or maybe they haven't been diagnosed with anything yet and maybe it's you know we don't know at that particular time but we are always and have always in my experience been willing to have that person step forward and be that first point of contact but we are we can't do that nor do the social workers want us to do that until it's safe to do so because we don't want to put anybody in harm's way that is not necessary but I've been in situations where we've had um you know the social worker the crisis worker come to a scene with us we've assessed the situation made sure everybody was okay and we and law enforcement has stepped back we have spec stepped back far from our cruisers and we've even left the scene depending to make depending on what the situation is and if it's safe to do so we have done that and allowed that social worker and that person to meet and do whatever needs to be to happen next um you know I've heard it's been extremely frustrating in certain circumstances sorry in certain situations here with the speaking for the sheriff's department um we only have a few people on the road at certain times right now so I'm really working on building our our department but as I can speak from experience with Newport working for that department where we're much that department is much busier having a lot more calls um involving those who are you know suffering from a crisis but that we're constant this is very time-consuming and we don't want people to be you know Tamaz can also speak to this that we've had meetings with them and the state's attorney has had meetings with them this is not a we do not want to put these individuals who need help in the jail system nobody wants to do that we know that that is not the right place for them but unfortunately sometimes our hands are tied in order to keep that person safe as well as the community that is what needs to be done in order to get them the services that they need and that is a last resort trust me um I can't speak for everyone's experience throughout the state of Vermont or through the country but in our experience here in the northeast kingdom for the most part and dealing with the new port police department and the sheriff's department which I have obviously intimate experience with is that we do everything in our power to make sure that they're connected with who they need to be connected with um and getting the help that they need not necessarily us being there and it is extremely time-consuming where we have you know calls for domestic assaults or you know crashes or things like that are happening when we have law enforcement that's tied up at a hospital with an individual waiting on different things to be happening when we should when you know we shouldn't be hopefully we don't have to be there but we're there because nurses don't feel safe doctors don't feel safe with the with how this person's behaving with what you know is being said the threats so we're dealing with really severe situations where law enforcement you know is in is dealing and I've had you know I've listened to the radio I've listened to dispatch calls um where you know social workers or mental health is calling law enforcement to go do welfare checks on these individuals who are on their caseload and they haven't heard from them because they're worried about the children or they're worried about other people in the homes so again we're being asked to respond to these situations where we're going to because we want to make sure that people are safe but we also recognize I don't think that there's one law enforcement officer that will tell you that we're the right person for the job we're not always are we there to make sure that we hopefully contain the situation make sure people are safe and then we bring in other people in my experience we have we obviously default to the social worker or the mental health worker who's working because they know what's that you know they know what's how to deal with those search and situations certain diagnosis is what's going to help what's not going to help we also try to work with our community and family members so that when we when and if we have to respond to these individuals within our community that we have a better understanding of that so this is what triggers this person this is what might be helpful to this person these are the conversations that this person enjoys having um these are the people that you don't want to mention because it may trigger that individual are we going to get it right every single time absolutely not but having that person co-located in um you know Newport police or the state police within our area it's going to be beneficial to this community and who we're responding to so I could probably talk for a lot more longer but if anybody has no but I think it was very valuable to us um Tomas if you could maybe just add a few words um from your perspective and then we'll try to fit in a few quick questions um so that we're not running too far behind but uh uh Tomas sure thank you good morning everyone for the record my name is Tomas Jan Koski I'm the President and CEO of Northeast Kingdom Human Services and I have served in my role for just over two years and uh Chair Donahue and the members of the committee I'd like to thank you for the opportunity to to spend a few minutes with you and certainly a big thank you to um Sheriff Harlow for her time and and such a passionate uh statement that she made and I appreciate it very much as our organization our organization works very closely with all the law enforcement agencies in the Northeast Kingdom and we are very proud of it as a matter of fact we have been engaged over a number of months in conversations uh with the with the top leadership that also includes the attorney attorneys general uh from the from the three counties or from the two counties and uh COVID definitely worked its miracle in preventing us uh to move on this topic quicker than we anticipated uh I think that those two agencies are inseparable I think we have a an incredible opportunity right now uh when so many stakeholders are included in the conversation to come together and really debate and come up with the best ideas because in my judgment there is no one solution that that fits at all and uh and I think what we currently know as the co-located um approach uh may may need to morph into some other approaches I think our organization as we are working on the co-located system with the police we are also looking at the peer-to-peer support and in our definition the peer-to-peer support is our uh employees our workers presence on the street as a matter of fact we are developing a program that's called uh talking benches and we would like to have them dispersed throughout the city where people and and market them accordingly so people can gravitate to and our employees our workers our peer support people can approach those individuals sitting on those benches and engage them in a conversation hopefully address issues that may be brewing or perhaps prevent things uh any or issues from uh escalating we have had multiple positive experiences of um the escalating um very um very tense situations I was a witness to one when I spent a couple of nights a couple of night shifts personally uh riding along with the newport city police and the Vermont state police those experience to me are in in invaluable and I think they open my eyes as the leader of this organization to appreciate the very hard work our police is investing in the well-being of our communities and frankly we cannot do it alone alone they cannot do it alone and we cannot do it alone there are many circumstances as as uh Sheriff Harlow mentioned where there is going to be an inherent risk involved and neither party can effectively work in isolation and and so I could not be more supportive of the work that your committee is doing and the and all of the stakeholders in all of the stakeholders impact on this process and I certainly would like to volunteer my organization in my own time in continuously working on finding the solutions that are going to really bring the the value to the communities that we all are charged with serving thank you so much we have time for maybe just a few brief questions if somebody has a you know burning follow-up here uh representative rogers thanks I just have a follow-up for Sheriff Harlow um we were hearing in testimony yesterday about kind of the difficulty at times of people knowing whether they should be calling 911 or reaching out to the designated agency or I who to call I guess I'm curious if there's instances where your department would receive a phone call and from the and from the phone call it's clear that it's actually not an issue the police should be responding to it's an issue that would be more appropriate for the designated agency so that's that's the first question and then the second question is what options do you have in that situation are you pretty much completely obligated to send out a law enforcement response because the call came to you or do you have an option to just say we're transferring this this situation over what what what options are you left with if that situation arises thank you for that question and so it's a really good one so we have so we do have options if somebody is calling us and we can um clearly and safely you know for instance I've also dispatched in my years and had to cover the desk and we had this one individual who just would keep calling 911 or keep calling our office and he just wanted to talk so clearly um that was you know not an emergency or anything like that so what I did was that I contacted I was able to speak with him long enough and you know try and figure out exactly kind of what was going on he was able to provide me with a caseworker so I was able to contact that caseworker myself advise them what was going on and then they were able to make contact with that person if we're dealing with somebody um you know who just made me to talk with somebody uh then we would refer them to northeast king and human services and contact a crisis worker and say we just got into contact with a certain individual we don't believe there's a police um response needed here's that here's that information we give that to the person who's also the client who's also calling and also the um the on-call social worker the problem is is that not the problem but what we see mostly is that we don't have those cases we have these cases where people are calling saying you know I'm having a really difficult time I feel like I might be hurting myself and we obviously have to respond to those situations to make sure that that person is not harming themselves harming anyone else or anything of that nature so when we're responding to those you know we can talk with them do you have any means we ask them straightforward questions you know are you thinking about killing yourself now do you have a means to do so do you have any firearms do you have any weapons in the home when they are saying no to all that and we figure out that we're all safe and that they just need to speak with somebody then we quickly you know can move forward to um having somebody respond to the residents or bringing them to the hospital where they can speak with somebody what I forgot to mention earlier is that when we're dealing with certain situations um they have to be cleared medically these individuals have to be cleared medically to make sure that they don't have any alcohol if they don't have any other illicit drugs or things of that nature on board so that they can be and um Tamaz can answer this more efficiently than I can but in our experience these individuals have to be cleared to make sure that there's everything is out of their systems so that they can be screened by workers and that way they can best determine what is going on with this individual if it's clearly and you know something of a mental health or is it a combination of mental health and you know using alcohol or maybe there could be so many varieties of instances and examples of what can happen but there is definitely a process for short but did that answer your question representative mostly yeah did you I'm sorry did you have anything that you need me to clear up or um no I think that that's just a bit I guess I'm just trying to understand the the instances in which the police or law enforcement response would would take the initiative to decide to step back versus versus not so I think I got the gist of it thank you right so if we if we responded to somebody who maybe um was thinking about harming themselves or had you know hide ideation ideations of that and then we we responded and we learned that they were safe and that they didn't actually have any um means or weren't actively in that state then we could definitely step back bring in a social worker would then if they felt safe being with that individual then we would step back and possibly leave the scene completely if it was safe to do so and I've and as I explained earlier I've been in situations where we have done that everyone's felt safe and comfortable and we've left the scene and you know we don't respond back unless needed thank you and if I if I could just add one point to what the sheriff said is that I think this time also creates creates a unique opportunity for us to rethink and streamline the current triage system we know it today as 911 and we know that it works in most cases it might not work in some cases but I think we have to seize that opportunity to rethink this algorithm that would instead connect those calls with the people who are best able to to serve individuals afflicted with mental health or substance use conditions for appropriate service so so I think we have a system in place I think we can only build up on it and and we are our own limiting agent agents it is up to us to change it in a way that it actually continues improving value in the service to those who need it in those for example two categories of of illness I was about to say one more question I represented Christians and also wants to ask one but then we we need to move on in order to be able to hear the other folks we've asked to come today so representative Smith thank you sure time is of the essence if you receive a phone call where someone is in need or there's a there's a situation that you have to determine or your department has to determine whether you should make a phone call to a mental health service or not and saying that time is of the essence is this going to deter anything when you have to determine whether should I call human services or should we pursue this or would you pursue it anyway you know what I mean I think you're there I believe I do know what you mean we're always going to err on the side of caution and be responding to these situations to make because people are calling for a reason you know they're not they're not usually calling just for no reason at all so you know we're definitely going to respond to make sure that everyone is safe and to make sure that we're not missing anything because again we're not you know dispatchers you know 911 calls from Wilson then it gets put to a you know a certain department it'll get put through to the Orleans kind of Sheriff's Department Newport Police Department so things can get missed you know communication can get skewed so if there's any question what so all whatsoever we're going to respond and make sure that that person is not in need of anything immediate medical attention or anything of that nature so but thanks thank you representative Christensen yes I just had this question about um you know we think 911 we've heard from several people you know so people don't call 911 again it's a great idea but it's my understanding that the designated agencies already have a crisis line and not enough people use it they use 911 instead wouldn't that I mean it sounds like a great idea but everybody is trained to use 911 you know during emergency whether it's a physical health emergency or a law enforcement I just don't understand it's not an easy easy fix to try to rethink everybody's psyche on how who to call that's it's I guess my question if anybody has an answer to that I'd love to hear it I'm not quite sure if I have a answer you might be looking for but I think my answer to it would be to say that part of the rethinking is also rethinking how we use the resources that we currently have in place and what emphasis do we place on education on promotion I think we do have resources some of them might be underutilized or might not be perhaps leveraged in the best possible way so the rethinking in my judgment at least in my mind really speaks to the breadth of what we need to evaluate as currently existing in as our resources at our disposal and how and if we need to change some of those some of those approaches certainly rerouting the calls maybe making them more available to people by having people being aware of them is one of those those approaches but but the opportunity is there and we just have to seize it. Thank you very much and I want to thank you both again but in particularly Sheriff Harlow for for turning around your time so quickly. I'm going to ask I'm just going to keep in line of the agenda the way it's listed out so Dr. Reynolds and just for the committee's background I've been participating in the in the legislative social equity caucus Dr. Reynolds is a participant in that and so I was the one who reached out and asked her if she would share her thoughts from her perspective on the proposal and on the issue that we're discussing so Dr. Reynolds if you could introduce yourself and share your thoughts and we would appreciate that need to unmute. I thought I got off oh no I'm on no you can't see me it's funny how those there we go now we can hear you and see you perfect. This has been very interesting this morning I've been here since the beginning I'd like to be here until I have a client. My background really in in crisis work took place in Boston Massachusetts where I developed a program of multilingual multiracial and multi-ethnic team of mental health very talented people and with a psychiatrist to go into homes in the inner cities and do basically family preservation work we got a very large grant that let us set the program up and by the time we were fully established and recognized as a resource for people like the Boston Juvenile Court the Boston Juvenile Court approached us to give us a contract now we said it must be that you cannot assign people to us we will you may refer people to get services from us but we are going to be separate from you and DCF with DSS in Massachusetts because the police the DCYF the DSS people the courts they are the enforcers they are the wall when we need them we need them desperately but it is so good to have a real dependent group of people willing to go in and take care of situations now there were major mental illnesses in this group although it was focused on family and there were definitely a lot of dangerous situations at one point we as a team when we meet we said what are we all just danger junkies but we we were having so much success we just kept wanting to go on so I I have submitted the testimony and I have a long resume behind me and I'm not going into every detail of it and I want to respect your time limits because I can see that they're close so I was impressed with commissioner shirlings report and now this morning from the northeast kingdom what we heard and it is good that at least some people were embedded in some forces and that it worked out however however my thesis is that mental illness is a health care issue not a police issue and that somehow or other the mental health system itself in Vermont needs an enormous infusion of not only funding resources but high-level mental health resources and so I've made up a little thing I do want to read it because some of this is important details it answered some of the questions even this morning so why do we need to why do we need to provide a crisis mental health emergency service with mental health teams not connected to police departments first of all we are looking forward to a greater number of black indigenous and people of color moving to homes in Vermont most of the horrendous murders of black and brown people by police in our country did not involve any mental health issues however many of black and brown people in Vermont have a right to be fearful that these events could happen here an attractive black man told me recently that the scariest place for him in white Vermont was in his car and he's a very middle-class well-educated man and he's he really is frightened by that prospect and is very careful in 25 mile an hour zones and we all have read about the two prominent women of color who have been openly harassed and actually forced to move from their homes as a result of racist behavior number two Vermont is not providing adequate services for the mental health needs of our citizens by not providing sufficient funding for primary behavioral services home-based care experienced trauma therapists and more easily accessed psychiatric care right over to warehousing our sick people in hospital emergency department corridors and i've seen that we are failing for monitors i understand why commissioner shirling perhaps had no other recourse than that of embedding mental health personnel in the state's police departments oh my heart goes out to those mental health people that is a very hard job out there alone and i'm talking about teams of people who know what they're doing and some case managers aren't sufficiently trained in diagnostic work number three more robust emergency mental health services must be separated from identification with the police data reveals that in a crisis in a crisis americans with mental illnesses make up nearly 25 percent of persons killed by police officers and in addition according to an article in the washington post 115 police officers have also been killed since 1970s by persons with mental illnesses but by and large people with severe even severe mental illnesses are not dangerous and i have to underscore that many times even when they're acting crazy they are not dangerous uh physically violent if they don't have a record of that before that so what can we do about the systemic mental health delivery deficits while being mindful of equity and inclusion issues one other states have designed far more robust robust mental health systems such as home services regularly provided so the mental health to severe mental illness identified i mean trained non-case managers so that when a provider mental health provider shows up in their area they're already you know whatever wherever they are they're already known to the people that might have such a situation that the families have to call for help and they do and maria it's absolutely right 911 if something bad happened to me i'd go to 911 uh i have gone to 911 and so and they triaged it to an EMT emergency medical team okay so another example of a way to do this is to include triaging 911 calls just discussed to refer them to emergency mental health services one such clinic in Eugene Oregon received this has been critically important received 24 000 calls last year of which only one percent required police backup as part of their response we are not you're not being fair to our police to to have this in their job description number two are designated agencies with greatly increased budgets and a more decentralized flexible approach could fill possibly could fill this role they need to be providing home-made services for a myriad of problems for family therapy and social service so they need to know about social service as well as psychological services they need to understand the environment they're in elder care most certainly persons with severe mental illnesses and this is so true so often we need to be taking care of the distressed families who are trying to house our mental health people people with mental health problems skill teams of mental health provider teams yes trained in robust strategies of emergency care with excellent backup support must be created like the EMT so I went into that but I won't go into it further so three I'm sorry I didn't mean to interrupt but we were okay I thought I thought you were finished I'm I apologize number three we need to reinvent the very concept of police we need to listen to the contradicting meanings people hold for the term and deconstruct their functions I recommend we form a diverse citizen-led tax force task force to examine the job activities currently falling to our police they do not belong in schools and unless they're physical dangers they do not belong in health care there are other ways to approach suspected suspected mental crisis situations and I think I've outlined about that straight you get it I'm in favor of separating the functions but I reiterate that the state is gravely lagging in providing adequate mental health at all levels of care from from taking care of people in their media I love the idea of a peer support group we could be training and it's very much the function that we might learn from AA or in it like what happens in Vermont after Irene or now because because the communities came together and it's been an amazing thing we could do very much more with that okay and now this is my last point of course we will need protection teams of course we will this is the central job of the police people do get out of control and with our open gun laws people carrying assault weapons around are very much potentially dangerous or very scary for other people especially people with mental illnesses so police as protection teams could be respected and acknowledged as guardians of the peace diverse in makeup and training working in collaboration with citizen review panels and I I'm really surprised at the lack of conversations about citizen review panels and police in Vermont I have to say I'm a Vermonter my father grew up on a farm in Castleton Vermont and even if I was born in New York which was an accident I consider myself a Vermonter always owned a home in Vermont and even if I spent 28 years in Boston getting very good training at places like the Boston City Hospital and their emergency room I am a Vermonter and I came back here 20 years ago and I'm never leaving again anyway my conclusion is that this combination of police as protectors and guardians with emergency mental health service teams well-trained mental health providers who are persons with empathy knowledgeable about community resources above all experience and diagnosis and adequately trained into diversity issues of our citizen would be a great help so yes job descriptions of Friday's police need changing they will not serve in schools and they will not be the first called an emergency mental crisis yes their budgets will be reduced to contribute to the mental health care services so critically needed on all levels in the state I know we can do better we can examine examine models of emergency services in other states and above all we must commit to funding mental health far better far far better than we do at present in Vermont that's it thank you thank you very much I appreciate that we are running quite a bit behind if there's a burning question that someone has specifically for Dr Reynolds I don't want to cut it off but otherwise we will move forward all right thank you again thank you very much and thank you and next up we have AJ Reuben who's with disability rights Vermont welcome and please introduce yourself and share your response to the proposal hello can can you hear me yes I'm AJ Reuben from disability rights Vermont we are your mental health ombudsman as well as the designated federal protection advocacy agency in Vermont I have submitted written comments I hope you're all you all got a chance to read those of importance is our report that we issued in March of this year called wrongly confined I urge everyone to read it and specifically in this conversation it highlights Dr Reynolds comments and also will the whites comments that there's just a dearth of adequate capacity in the state and it causes crisis and it really should be what's addressed the quick points and I'll get off the off the witness seat our our suggestion is that it would be appropriate to move the funding out of the Department of Public Safety and put it in the Department of Mental Health and it would be appropriate to consider requiring the Department of Mental Health to contract with psychiatric survivors peer trained peers when creating responses to calls for 911 calls we believe that that would that would move us towards a better more equitable and a safer system and we would just emphasize that having trained educated peers be involved in the planning and training and importantly the policy development will help alleviate the harm that this proposal could cause by basically using coercive state forces like crisis workers who can eat you emergency evaluate you and police who can arrest you and shoot you it would it would alleviate those concerns I think you heard from bore yang yesterday from the human rights commission she may have talked with you about the fact that through their work they've identified that sometimes police social workers much like prison social workers wind up because they're isolated from their own peer group being co-opted and somehow not used as effectively as possible that's that's happened in a couple of states a couple of cities we've been looking at so I will refer you back to my written comments and and applaud you all for taking the time to consider this very important issue thank you thank you very much are there are there any follow-up questions for AJ Rubin appreciate the comments we do have the written comments I hope people if they haven't yet will get a chance to read them and thank you for your brevity because we're getting closer to be being back on time and I apologize I see a hand up from a witness and we can't follow that process but if you'd like to send us some thoughts or notes in writing as follow-up we would welcome that I'm sure um but like a puffer if you could join us and introduce introduce yourself and your your role and share your thoughts on the proposal alternatives and so forth thank you very much thank you thank you so much representative donahue and thank you all for having me I really appreciate so much the invitation to the adult state standing committee that doesn't happen often enough and would love to see that happen in the future as well so big gratitude for that I could you maybe I think that's a good point that we haven't often could you briefly explain what that committee is yeah um so uh we are a legislatively mandated committee that advises the department of mental health and the commissioner of mental health um on a number of issues that affect the system of care we are essentially the voice of the community directly to the department although hopefully not to the exclusion of other ways of gathering input but um yeah that's our role and we really much appreciate the invitation does that address that enough yes thank you yeah great yeah so I'm here today with multiple hats on um uh first and foremost I'm a psychiatric survivor I've experienced almost every level of care in the public mental health system in Vermont both as a child and as an adult including being shipped out of state as a teenager because the resources didn't exist in my own community or in the state and also including having interactions with law enforcement that were initiated by mental health providers where there was no no threat and and no law breaking uh so those are experiences I will be uh recovering from for a long time if not forever and uh inform the work that I do as an advocate um I've advocated for people in the community in the emergency departments in the hospital um in residential programs and in interactions with law enforcement um and um I also manage peer support services at hdrs um I've been doing that for seven years so I've experienced recruiting training supervising peer support advocates and also designing um peer support programs both within the public mental health system and outside and also I'm a leader at hcrs um beyond that role and um so of course hcrs has a police social worker program that I have interacted with and also supported people who have interacted with um so I think I'm coming at this with quite a bit of context um and I really um you know so much uh respect and appreciate the individuals that I work with who are in police social worker roles I think they're excellent people and excellent um professionals but I don't support this proposal um I love the the intention behind it which I believe is to reduce the incidence of harm caused by law enforcement when people are in emotional distress I think there's a place where people understand we have a cultural understanding that um police can be dangerous and um don't always result in people's needs getting met and I think um we're not yet at a place where people understand the ways in which the mental health system very much parallels law enforcement system and so that's what one of the things that I'd like to address and I'd like to spend time talking about solutions because I think there are real but I think uh essentially there's an assumption that well we recognize police when they show up there's some risk there um there's not an understanding of of the risk that mental health providers propose is an assumption that they don't um lead to incarceration that they don't result in bodily harm that they don't shorten people's life spans and etc so I think of police as sort of like the arm or the extension of the institution or incarceration in jail or prison they both bring people into that institution and they sort of extend the the power of the institution into the community and mental health providers especially the crisis branch of the mental health system which police social workers are part of functions very similarly as an arm of the institution of the psychiatric facility which is another form of incarceration there's no meaningful difference between psychiatric incarceration and incarceration in a jail or prison except for the way that we sort of think about it and talk about it um so so the mental health system and the crisis particularly is sort of the arm of that institution both to bring people in and to sort of enforce the power of it outside of its walls um and that is the psychiatric institutions um are posed a danger to people both because they separate us from our communities and because we are when we interact with the mental health system we're entering a system where people die on average 25 years earlier than everyone else and also psychiatric institutions when when you're discharged you're 20 times or more more likely to die by suicide so I think when we're talking about police versus crisis response we're not talking about a potentially dangerous response versus a risk neutral response we're also talking about a response that carries risk very significant risk if I were ever in a situation myself where I desperately needed help again um I would not feel comfortable calling the police I would not feel comfortable calling the police if they had a police social worker on staff I wouldn't feel comfortable calling a police social worker directly I wouldn't feel comfortable calling a crisis team if I even knew how to reach them um or if they were even available um I so this is this is why essentially I think this proposal falls short because we need another option and that's what I want to talk about but even if people did universally feel you know I'd much rather talk to a social worker who has the power of forced drugging forced incarceration um than a police officer I don't think I still think this proposal falls short in that area because as we've heard before police social workers um or embedded clinicians are generally not showing up to calls instead of police at best when they're showing up to calls with police the police are still taking the response that they're going to take um so we're not really talking about doing anything significantly different if anything this proposal might increase collaboration but but I still have very significant doubts there because that's a lot to put on one individual to bridge a huge potentially huge gap we have other ways of trying to address that um and I and I would hope personally that we we could trust um sheriffs like uh Jennifer Harlow who seems competent to identify where are the people who need follow-up after frequent police interactions and make that referral I don't I don't understand um why that can't happen through the regular ways that organizations collaborate so solutions and alternatives um others have talked about the issue with 911 and police response we need to decouple uh calling 911 with police response so that people can call 911 they can get police response that's not going away right now they can also call 911 and uh mental health crisis response but also because for me and many people like me neither of those are safe alternatives and there when someone feels threatened which both of those systems can be extremely threatening that's when they're more likely to be dangerous or violent so we need a third option when you call 911 you can get police you can get crisis or you can get peer support as many people have talked about the importance the important role of peer support and by peer support I should be clear about what I mean because many people use that language to talk about different things I'm talking about people who can speak from their own lived experience and not have in their tool belt things that will be a threat to people for struggling for hospitalization and that kind of thing those options are still going to be there but to have someone who can show up and just actually provide the connection to support people are looking for and and then also along with that we need a place for people to go other than the the ER when they're in crisis I heard Jennifer Harlow say say that one of the roles that police can do is go there show up and then if they need to talk to another human being if they need to talk to someone we can bring them to the hospital what if people could just talk to a person without going to the hospital or interacting with police first so we need drop-in spaces instead of the ER and we need peer respites instead of the hospital as additional options I'm about to wrap up I think an initial status I realize this is a big long-term vision is creating a pilot program or expanding upon the peer support programs that already exist and which are non-carceral meaning that they're not an arm of one of those forms of incarceration that I talked about and I'll stop there and see if anyone has any questions thank you very much um do we have any questions a lot that you've put out there so it may take some people thinking uh uh mr chair yes and I don't have a hand to raise otherwise apologies um so it would you you are currently managing or running a peer support program at hcrs is that that am I correct did I understand that correctly is is there do you experience an inherent conflict between working within an agency a designated agency to do peer support uh and your concerns about the role of mental health workers generally or can can peer supports be integrated in the way that it appears that you're describing uh and to have a have a have the ability to operate uh again in the level that you would like to see that's a really astute question um and um I think the answer is sometimes maybe um I think that it's it's uncommon that a designated agency is willing to provide peer support the level of autonomy um and risk tolerance frankly in terms of uh liability although I think the perception of that is very much overblown um I think it is possible um but there needs to be some clarity about what that looks like and and direction and oversight from people um like us and do you feel like you have that autonomy um yes I think the without saying knowing that we can't go in depth here but I would be interested in hearing more at some point in time to hear what the positives of the conflicts might be yeah I think we are very close I think we're there's just a little bit of barrier in the way for us but I think we are closer to that than any other um sort of embedded peer support team that I'm aware of so in some ways you're somewhat functioning as a pilot project yes except we really have very limited capacity we are four people in an agency of 600 employees and so we don't have the capacity to respond in a active mobile crisis response that I think would show what we we need to show yeah thank you yeah thank you representative christensen yes we heard from the Howard center the other day that there is a peer group peer support group within the designated agencies but it's controversial within the peer groups could you I know you've been talking about some of the controversy but can you just in a nutshell say what that controversy is that makes it clear or is it different depending on the different peer groups and different da's yeah I can't speak for Howard center I'm not so intimately aware of the the challenges there but I think generally what the controversy is about peer support within a da is that if the agency is putting an expectation on peer workers that well if someone says they might be thinking about dying you need to involve crisis well then that's not really a different kind of support because that threat is still ever present in the conversation um if that if that makes sense a little bit so I think so if if peer support was existing outside of the system altogether and I'm responding to you and you're having a really hard time maybe you're thinking about dying or you you're having some beliefs that that might potentially pose some risk you and I can decide together as individual people do we need to bring in police do we need to go to the hospital do we need to talk to a clinician we can decide that as as people together rather than the agency imposing on me as the employee here's your prescription of how you're going to respond if x y z is said or done so it's not that we never use emergency response but that there isn't a sort of a formulaic or um a prescribed situation in which we bring those folks in that's that's where there's sort of a rub I don't know if that's the controversy at Howard center at all that's I think in terms of the the situations that I'm talking about where I think there's potential challenge in doing this kind of work within a da system because they're not likely to tolerate that degree of mutual case by case individual decision making that I think is really necessary to create safety do you not think that there should be a triage system especially if it it's escalating I mean you have social workers that have training certain training they're police who have certain training for better or worse we're at this point but um do you not believe a triage system is important I don't think there is a reliable triage system that exists I think that's the problem there's there's this cultural idea that mental health professionals are able to accurately and reliably predict risk or dangerousness and that's just not true which I know by both anecdotal experience and by research that exists out there um and so let me give you an example I've been in the emergency department supporting someone who had uh it doesn't matter why they were there there was a concern that they might die by suicide and the person was saying no I'm not going to I'm going to use these supports and the crisis person the QMHP said well I'm really not sure what you're going to do maybe you'll be okay maybe you won't but in order to play it I want to be on the safe side and so I'm going to submit an application for involuntary treatment the the default of the system is to CYA take care of you know tend to liability as part of risk which might not actually make the most sense for what is best for that individual's well-being so absolutely if triage means we're going to really think about what is the risk factors here and what are the resources and what is best for this person 100 but if triage means if you check these boxes then we're going to do our our coercive carceral response then I think that's a problem and at least in peer support that's a problem to one last just follow up so it's more of the culture of the system that you feel needs to be changed not so much a system but but the the whole all along the line the police the social workers the the da the the peer support groups only on the same page I think that yes and I don't think that's going to happen anytime soon there's so many reasons why things are the way that they are and so what I'm proposing is that we add another layer of options for people so that people still have those options but they also have the options of peer support and and sort of support that's not connected to jail prison or psychiatric facility although those are still going to be there for people if that what if that's what's needed okay thank you yeah thank you very much I appreciate your your time and testimony Malika and and we're going to move to our final witness for the morning Robert Pell and I think he would do best to give a brief summary of his background and how that relates to the specific issue before us and any thoughts he can share on that great thank you and Rob good morning I guess it's now afternoon to all who are on this call zoom my name is Robert Pell I know many of you some of you I don't I was an active participant in 20 years of policy making in the legislature spent many hours in front of chairman rippert's committee in judiciary and was representative donny you and health and welfare and others so I my background is a little unusual I I read law I was hired as an investigator in the civil rights unit of the attorney general's office in 1980 I worked for the state for 33 years in a variety of positions most notably I was defender general head of the public defender system through the 90s and then I was executive director of the human rights commission from 01 to 2012 when I retired from the state I'm not retired totally I am now a solo private practitioner in burlington area the bulk of my work is dealing with people with psychiatric or other disabilities in the employment setting in the criminal justice system um so I have a lot of experience in the areas that you're you're you're dealing with I've had the opportunity to represent several victims of police violence um who um mcadam mason who was tased to death in setford in 2012 um by uh an overzealous state police officer of my view um and then I represented a man in the middle of a mental health crisis in muski was shot by muski officer who survived I worked on other police shootings uh one in facedon where an officer rolled in and let go of nine rounds um for a person who was in a mental health crisis and drunk uh he hit him in the leg fortunately he survived and then he suicided um so I do have considerable experience in the area particularly from the uh quote victims perspective the recipient of police violence I also work a lot with police officers my background in criminal justice leads me to understand police culture which is a separate distinct culture unfortunately there are many fine officers uh and then there are those who are probably um should be finding something else to do with their lives and the challenge as many of you know is trying to separate the wheat from the chaff because we're seeing in burlington at the present time so um and I'm late to your meeting although I was glad to hear the testimony of of Dr. Reynolds and Ms. Puffer um it really set the tone for what I wish to share with you um and I did in preparation for our testimony I was speaking with judiciary about use of force by officers uh s119 so there's a lot of overlap between what you're working on what they're working on which is common in in your body and I commend both committees for taking up this very important work so late in the in this session um it's ongoing work my guess is uh once you respond to this proposal there'll be more it's constantly evolving field um and we learn more and hopefully we do better so I I did with the review uh commissioner charling's proposal with no disrespect to Mike who I've worked with over the years is during his term he's a chief in burlington in another context it's pretty standard in my view that we're back to this bureaucratic um silo mentality as to who does what who gets the money um this has been a long-standing battle within the um the executive branch for as long as I can remember and I I see many um problems in locating mental health crisis response capacity with police and let me talk a little bit about um why and I'll cycle back to dispatch and triage which I think is a critical issue that we have undervalued for forever so the circumstances that I've talked about where I've represented people have been shot or killed in the middle of the mental health crisis goes like this and and in preparation for my testimony today I reread the the excellent report uh of the Vermont mental health crisis response commission and I if you've not reviewed it in the context of this discussion I really recommend you do so it's an excellent report and what was most striking to me in reviewing it was the transcript of the initial response by the Burlington police department to uh a 911 call regarding Ralph Grennan uh who was a 76 year old man in the midst of a mental health crisis who was um killed in his apartment um I'm sure many of you are familiar with the facts and I'm going to go into them but in my view this was a picture perfect disaster and and and unfortunately very typical that when um police respond to a person of mental health crisis they tend to do what police do and their training and their orientation uh is to uh control and clear that's that's what we train police officers to do and and and I know there's been discussion and it's hopefully it will continue about the role of police officers as either warriors or peacekeepers I'm in the lighter camp that and and many cops do this very well and unfortunately some get stuck in the warrior mentality so that that's a broader discussion but I think it's important to keep that in mind when you're assessing um this proposal before you so put yourself in the position I really appreciated uh Ms. Puffer's testimony of being a person in the midst of a crisis and in response somebody calls 911 you didn't ask them to call 911 um and the response is somebody in warrior guard shows up with a siren in light uh gets out of the cruiser may have a hand on a weapon be it uh service weapon or taser uh with a tool belt with all sorts of devices to exert control which again is the police orientation uh body armor and a uniform and if someone is in a crisis mode is that presence going to escalate or de-escalate the person in crisis I think you all know the answer it's a rhetorical question the notion of crisis intervention teams is not a new one I'm sure you're aware that it's been around for a while um however if if if that capacity is within the police then you're you're allowing the police to control that capacity and not police orientation as I said earlier is control and clear um there has been emphasis in late of late and slowing down as a ADA Americans with disability act uh uh modification of practice to allow police to better assess uh better evaluate and give the person in crisis some time to adjust to the presence of a uniform but again that that's an emerging concept is far from uniform as you probably know we have something like 75 different police agencies in the state with varying policies and practices and accountability and philosophy so um but I think the uniform response to a uniform is escalation I've never seen a client calm down in the presence of that show of force I think there's much to commend the use of peer um professionals who were trained and well compensated for the risk taken in that work who who should be our frontline response to people in crisis and not controlled by police that they people who have had a lived experience of being in that crisis mode I think are and come in civilian clothes and perhaps it would be best if there was a prior relationship if you can find someone who has some knowledge of the person in crisis and a relationship and can communicate with that person in an effort to de-escalate rather than ratchet up the stress because with stress on both sides um it builds conflict to the point we're going to have tragic outcomes um and cops could escalate it as well I mean I used the term agitating and provoking in my earlier testimony which is a term well known to correctional officers who claim inmates do it but same time officers do it so it just sort of ratchets up which is what I saw in the granted situation um officers get frustrated this is not primarily what they were hired and trained to do so again I commend the use of of peer professionals who are compensated based on their skill set and their abilities to de-escalate as opposed to credentials it's easy for me to speak as an uncredentialed warrior I mean there's many ways to gain skills and capacities and competencies so I think that's a way better model and now backing back to um well let me say one more thing so so once the officer controls contains and clears often that results in the application of some form of restraint on the person and transport to another location which is more trauma uh and I understand that officers need to cuff a person in the back of a cruiser bad things happen when you let somebody rattle around in there Freddie Gray and Baltimore or the threat to the officer or the threat to the integrity of the cruiser to me it's just a very wrong-headed approach to what cries out for de-escalation so cycling back to the criticality dispatch in my view and many of you will remember five eight years ago public safety decided and it was budget budgetarily driven compressing four public safety dispatch units into two uh those folks do an amazing job they're underpaid they're overworked and under trained um I think it was Dr Reynolds who talked about 911 being the common response and it is we're all trained in time of crisis to dial 911 well 911 could do a better if we had more skilled more supported um more more evaluative people answering that phone and answering relevant questions we could avoid some of the tragic outcomes that we've seen um and the response could be to the alternatives that both Dr Reynolds and Ms Puffer spoke to in terms of people with lived experiences responding I'm not disregarding the role of law enforcement in in that response but I think they need to be staged in the background not the foreground yes some people you know this is perception the different in date is dangerous people with mental health with mental health issues or by nature more dangerous than that it has definitely shown that that's not true but the perception exists so um there are occasions where first will be necessary to control and and prevent harm to others um I was frankly happily surprised and that's 119 to show that your body hopefully will show will enact a law that says you can't kill somebody to keep somebody from killing themselves to me that's just which is happens over and over again um some people who are determined to suicide will suicide unfortunately um but killing them to avoid it makes no sense to me I'm not a proponent of the death penalty killing people to prevent to punish murder doesn't make sense to me either but um I think that sort of gives you an overview of my sense of of the issues and the need to keep funding streams separate control separate the imprimatur of and I think Malika spoke to this of and I think Dr. Maynard did as well of having mental health workers it's adjunct to law enforcement taints in the initial response it just does um I've thrown a lot out there uh I know your time is short so I'll be quiet and see if you have any questions for me thank you very much Rob are there any um specific questions um for uh Rob Appel uh because otherwise we have a little bit of time just to uh share some reactions but if there's something specific for Rob um anybody has a question let's uh deal with that first all right thank you very much I think everybody uh this morning has given us a lot to think about and we do only have about 10 minutes left but um in the interest of starting to think about uh how we put a recommendation or proposal together um and and we'll need to end up putting that in the in the format ultimately of a of a potentially like a budget um language that would replace the placeholder language that we put in um but it would be great if people could just um a little bit of brainstorming just some of your reactions or thoughts um that you have at this point in terms of the uh the type of reaction we should have as a committee uh Representative Smith I have a question for anyone on the committee uh I listened to the testimony today and Ms. Puffer mentioned a third party entering in on this now it and correct me if I'm wrong and I mean you you follow this probably more clearly than I can but uh if you've got a sheriff department involved and you've got a mental health service involved and you've got a third party uh friend or whoever involved you got three people trying to decide who should do something while this poor person is sitting out there maybe wanting to off himself or herself and three people are going to talk about it I think it's going to impede a potential disaster and what would what would you think of that I think that really goes to some of the different pieces of testimony that we received about the critical um triage kind of component um where is that call coming in and where is the skill level um when that call comes in of identifying up front who should respond first you don't want all you don't want three different I agree you don't want three different people that's my sense you don't want three different people trying to sort out is it you is it you is it you uh or let's all go and sort out when we get there who who's best to respond first um I think I think your point's well taken I think that's part of the sorting out I I found um uh Tomas Jankowski's uh testimony personally really compelling in terms of um we need to look at at how we reframe how we respond and that and I think that's part of it thank you other thoughts uh representative derpy can you hear me yep uh it just occurs to me that we've heard a lot of testimony about the triage system about the what happens when you place that phone call and it seems like there's some potential there to move the needle a little bit we haven't had any and we're not going to have time to have any I suspect testimony from direct testimony about that from people who were working there or from public safety uh it's intriguing to me it's something that I think we'll want to that the next during the next biennium the next healthcare committee might want to think about a little bit representative read yes I agree the the triage question is interesting and it seems like you're shifting a a big piece of responsibility onto that person taking that call if you're if you're trying to have them be the air traffic controller of the best place for a potential response I do like the idea of a a kind of third alternative of somebody that I think especially that point about um somebody that doesn't have the power to confine me either in jail or in a you know involuntary hospitalization I don't know if the the person having the crisis would necessarily understand that at the moment but um it it is uh I think an important piece of of making this work I guess what I came away with from the couple days of testimony is that it seems like most of the people that are closest to the situation from the mental health perspective don't think this is a good idea and I think there are some benefits and obviously that there are some models that have worked but it does seem like the models that have worked a lot of it comes down to the individuals involved being the having the right mindset to to either on the on the law enforcement side or the mental health side to to make this work and not to turn it into you know the warrior side of things so just my my perspective so far thank you representative Gina thank you I really appreciated hearing all the different testimony today um it was very detailed and I feel like it was needed and there there's been some people who said they that they never heard the argument against having embedded social workers and I think today we and yesterday we got some pretty detailed um perspectives of people who've been directly impacted by by the um the harm of the mental health system and the police and so I want to thank everyone for publicly speaking out and get and getting your perspectives on the record and um so I mean I'm leaving leaving this discussion sort of thinking more about like how do we move in the direction of some kind of changing what 911 does um and the idea that like you know when a call comes into 911 them taking a few seconds to send it to the right next step and if that step is the police then police can be dispatched but it sounds like there are other possible streams like peer support crisis um there's things that maybe weren't specifically mentioned that come to mind like maybe someone who can work with people who are houseless maybe um domestic violence advocates um but what's coming out of this is that what I'm what's standing out to me is that the solution isn't just going to be this to send social workers with police that it's going to be a more um specific response to the call in the end and I'm not sure how um and I also just want to also emphasize the importance of peer services that that that really stands out to me and that's a part of the mental health system I think we need to drastically enhance and I say that as a as a mental health clinician that I feel like that's the part where we need to like invest the most honestly um is in the peer support and in a wide range of peer support but that being said we're here because we're about to vote on a budget and I'm I'm I'm struggling at this point with making sense of how all of this fits into the current budget because what I'm hearing and maybe other committee members or witnesses could could help me with this what I'm hearing is that um what we need is not actually what we're doing so I'm curious like I've been trying to look through the budget while listening to people's 201 pages and down to who you're like the expert of the budget so maybe you could tell us what pages to look at but I'm trying to find the language that we're actually hearing testimony on to see how deficient it actually is to be honest um you know and and how how and what it's actually doing versus not doing based on the need we've heard so I think that's a helpful thing to as as we get a few final comments and wrap up this morning for where people should look back to and and maybe um send email comments or whatever to to Bill and Laurie and I um there was not language in the administration's budget there was the funding from within the DPS budget for seven embedded workers and there wasn't budget language but there was the written proposal from DPS explaining what their intent was so that's the written piece that we have on that end um the placeholder language that uh we shared when was it just middle of last week when whenever because the budget had to move we put in placeholder language that basically simply said this money should be invested in this need uh we're saying it should be in the Department of Mental Health and then from there the response proposal with the involvement of you know mental health peers psych survivors should should be crafted based on that so that's where it stands now that's the language that's in the budget as a placeholder and what we would be doing is is potentially recommending um something other than that language as what we think the house budget should include regarding that money that actually comes from within the DPS budget but that in the current budget before the house um tomorrow um is with the placeholder language set to go into the to be transferred into the Department of Mental Health budget so that that's the status uh right now I appreciate it and it sounds like what I heard is that we made a policy decision to acknowledge that the investment should be made in the Department of Mental Health instead of the Department of Public Safety is that correct and that I wouldn't say we made that policy decision because the decision was that our committee the health care committee should weigh in that potentially that that was the direction it should it should be um but that's why it's called you know placeholder language so there wasn't really a full policy decision it was sort of a temporary holding pattern that that perhaps that was the the direction that we would want to be going um if I may yep I might add that that that like that decision was made in some preliminary consultation with the Speaker of the House in terms of trying to create placeholder language that then would allow for the testimony that we're taking now that we've been taking and for the possibility or the are asking our committee to take the lead on making a more a fuller recommendation uh that the House Appropriations Committee would use in their process with the budget with the Senate proposal I should mention as well I'll just mention briefly that and we're going to need to stop here shortly that the Senate Health and Welfare Committee has scheduled some testimony I believe today maybe even I think it's mommy tomorrow tomorrow with some of the same witnesses we've heard from but in a much more reduced I think they're taking an hour of testimony and we we have time scheduled tomorrow in our committee for committee discussion not further testimony to try to see if we can come to a proposal that our committee can support to to enhance or replace the placeholder language that is currently in the budget that's going to the floor tomorrow and Friday I know we're out out of time bill if we can squeeze it and I'd love to hear you know one one sentence reactions from uh we've got uh four people who would like to share thoughts so uh that would be yes so representative court is amazing testimony thank you everyone um I can wait until discussion tomorrow the short response is no money to DPS if we're going to donate and donate in uh if we're going to appropriate money it needs to go to mental health um and clearly we need systemic change that's a bigger project and we need those directly impacted and involved in mental health leading that uh representative page it's a nice idea recommendation but I don't think we can't hear you I think this was a nice idea that the governor's proposed budget but it doesn't really get to fixing the problem I would like to see the money go to the mental health uh programs but I'd like to see where those funds go I you know we should be looking kind of outside of the box we should be looking at I think maybe it was miss puffer or maybe uh mr appell said we should be maybe re-engineering or restructuring our mental health and and and changing changing the way we do things here in Vermont with regards to our mental health so I'll leave it at that but I'm against I'm against this representative Rogers I'm having internet issues so I'm hoping I don't cut out um I I I think my sentiments are similar to Brian Sheena's in that um I'm kind of taking in a lot of really incredible testimony and trying to make sense of putting it into the budget can people still hear me um and I think I just wanted to bookmark something that that will the white said in the beginning um I think just reflecting for myself that at least to some extent this whole discussion has come up because of an increased national level of awareness of racism and particularly the intersection between racism and policing and I realize the discussion is about much more than that but I think it's fair to say that that probably is a part of why we're having the discussion now and just recognizing and remembering that we know that racism and racial disparities are documented to exist in Vermont in our police system as they are in our mental health system and so just wanting to make sure that we're we're recognizing that the issue of what is policing and what is mental health is a very important issue and isn't in and of itself necessarily addressing what is the racism that people are experiencing in either or both systems and so just to bookmark that and make sure that we're not losing sight of that piece as well. Thank you and we'll close off with Ann Marie. Yes I'm for I agree with what everybody said but I see putting this money into mental health rather than the police but I think the concept of the embedded is good but needs to change but that's not it it's like I think we should put this into the mental health budget because and earmark this for crisis workers who police can call I know down here we have such small we have a two person department they spent I talked to the police chief sometimes he spends half a week dealing with the same person who is in mental health crisis who thinks the neighbors are going to come and shoot them and stuff and he can't leave her until a mental health worker gets there so he can turn it over they don't want to be there the police but sometimes there's not enough mental health workers to answer the call so he has to wait until so I think there is a need for this you know to work together but I don't think we need to send the troops in and give the police the money too must do the troops to go in when there is a crisis I think it should be mental health workers that's it thank you everyone I'm going to turn it back over to the chair to end the meeting it's rubber time yeah we are over time but thank you everyone thank you to our witnesses and and especially several our witnesses who really did respond on virtually no notice just so committee members can appreciate particularly Jennifer Harlow I believe really responded at the last minute and I think it was a good request thank you Woody for making this suggestion I'll save my comments for tomorrow maybe I'll just say broadly that I think we have we have to think in terms of what of of what we can do now what we can set in motion and what are some of our and to acknowledge perhaps some of our already ongoing long-term commitments that this committee has made and so that we we can underscore some of those because we we the issues before us are bigger and broader deeper and more involved than this single proposal that's in front of us but it has prompted some really important testimony on the part of all of our witnesses so I look forward to us thinking together tomorrow and working toward a proposal that we can move forward to our colleagues I think it was appropriate that our committee has taken this on so thank you all will I think we're that's just as a reminder can someone help me I think we're on the floor today at two for a for a for a general caucus a caucus of the whole at two and then on the floor at three and then we're back here in committee tomorrow 12 to two 12 to two and then so tomorrow that's let's be prompt at 12 to two tomorrow and if you have thoughts I'll copy the whole committee but copy copy and Laurie and I but feel free to copy the whole committee this is a committee discussion so thank you all see you on the screen at two o'clock two o'clock yeah okay and thank you again witnesses okay I'll stop thank you if you can stop live stream yes thank you