 Okay, this is the House Health Care Committee. It's Friday, March 12th, about 2.30 p.m. And we are reconvening to continue and hopefully conclude our deliberations on House Bill 210. So, yes, I think everybody's here. So, again, I wanna, oh, so since I saw you last, I took a side trip to Appropriations and I was just forgetting, it's like, okay, yeah, that was since I saw you last, did an enthusiastic presentation of our proposal to them and hopefully that was helpful. And we will, so they said, well, we'll look forward to seeing your bill. I said, okay, well, we haven't finished it yet, but we're working on it, we're getting close. And I also want to express my appreciation again to Ann for stepping in this morning and helping move things forward, both in my absence and once I was back. It's great to have a team. I'll tell you, it's great to have a team who can step in for each other from time to time. And that was greatly appreciated on my part as committee chair. So I was trying to think about where we are in our process here today. And I'm aware of one other piece that Representative Donahue actually would like to bring forward and I think she got caught up in doing what I usually do, which is chairing the meeting and mentioned to me that she forgot to put her hand up. So as to something she wanted to bring forward to the committee. So why don't we start there and then we're gonna check in with others and see if others have further things. And then my thought is then we'll check in with Katie because she's done some redrafting for us. And then we'll see where we are as a committee and possibly proceed to committee discussion, but see whether we are, whether there's any other additions or suggestions that need to be brought forward. So Representative Donahue. Thank you. And again, my apologies. I actually wrote it down a little note to myself so that I wouldn't forget. And there I was sitting saying, anybody else? Nobody else? So folks will recall that I think it was Wednesday. I mean, we had some testimony that made reference to the impact of the eugenics movement in Vermont. And that same day I'd been asked to go in and testify to the general housing and military affairs committee on the eugenics apology resolution. And I forwarded to committee members the package of information that I had researched and done several years earlier on the issue. And as I told the housing general and military affairs committee, I mean, this just is very much connected and related to the work we're doing in terms of a very strong example of something that happened in history that we all now recognize was a significant injustice and that to this day, significantly affects those community, those impacted communities. So I would like to propose an addition to our findings based on the testimony we heard and the materials I shared and ask Katie to draft that and she has it available now for folks to look at. Great, so Katie, would you share that with us? Yes, let me switch my screen. Here is the new proposed finding for Vermont's 1931 sterilization law that's impacts on individuals who are black, indigenous and persons of color, individuals who are LGBTQ and individuals with disabilities as an example of past injustice in the healthcare system that continues to impact members of these communities in the present day. Thank you, and you wish to comment further? No, I think that summarizes it. And I had forgotten to ask Colleen. Colleen has now posted the materials that I shared with the committee, I guess on Wednesday when I sent out. A lot of the background information about what happened at the time and so forth. So I'd like to ask a question because but I'm fine with what you have proposed here. In fact, I want to support what you proposed here. I'm interested that it does not make any reference to the term eugenics and thinking that for many people as we move to have a eugenics apology resolution as there's a rising awareness of eugenics and what it's meant for the state of Vermont that to reference the 1931 sterilization law, there may be people who don't make that connection. And I'm wondering if we might add a reference that uses the term eugenics so that there's a link between what we're doing here and the other work that's happening in other parts of the legislature and in the public. Thank you, yes. I mean, that's absolutely is what I should have suggested. Oh, I just want the question. You can work that right in. Okay. Friendly amendment. Yeah, okay. Representative Burroughs, sorry, Burroughs. Do you think we could add something about forced sterilization? Well, we could get a lot longer. But I mean, I just kept it brief. I think eugenics needs to be referenced, but because of the point in time we are, I would have liked to have thought of and drafted more, but it actually, it gets into a longer discussion because it technically was not forced. It was technically always with consent. The problem was that it was not, clearly not true informed consent. And in the materials I shared, I even shared an example. I remember reading that, yeah. Yeah, but that's much longer and we didn't take tests. Yeah, you're right. You're right. Thank you. Okay, Representative Cheney, is that your hand? Yeah, okay, Representative Cheney and Representative Golden. I just want to say that I appreciate this addition, especially after the testimony we heard. So I do appreciate it. And I will review, if you sent it already, I didn't see it. I just wanted to look for those documents or I'll review. I apologize, I did not email it. It was just Katie just put it up on the screen. I will, oh, on the screen. Are you referring to the actual language or what she's proposing, Brian? No, and you mentioned that the other day there was testimony or something. I'll go with you. Oh yes, I did. That's right, you should have that. I can resend it easily. No, I can look for it. I'll review it, but I can support this without seeing your testimony because I'm aware. The one thing I would ask you is with all the other findings in this bill, we've identified a source material and put it in that list. So if there's a way you can send me things, I'll add them to that list and we'll update it. So we have the most accurate possible list. I already, Katie asked me for it and I sent it to her. So all I have to do is forward the email I sent her. Great idea. I will fix it during our meeting today and send it out to you all within a few minutes. Okay, and Colleen just sent a note. My material is now also on the committee page. Great, thank you. Thank you, Brian. Representative Goldman. I was just hoping you could post that paragraph again. It went by fast and I just needed a moment. Well, it's been adjusted as well. So we all need to see it there. Oh, perfect. Yes. Thank you, Katie. That's great. Does it exactly right? The legislative issue and regarding sterilite. Okay, sterilization law, obviously. Okay, yeah, I see that. Thank you. Okay. Anyone else having questions or comments about the addition of this into the findings? Hearing none, I think there's consent and consensus to add this to the findings. So Katie, if you would do that. I have one question and go ahead and add it. It's not, we're on our pages that Ann's material. Now, I read through some of it, Ann. I think it's the same stuff I read through that, but I'd like to. We're on the committee page. Is that the question? Yeah. It's under today's date, under witness Ann Donahue, H210 files related to the Verna. Okay, okay, okay. I got you. Thank you. And I have to say I've read some of it in the past, but I have not had a chance to review it again. I look forward to doing that, but thank you for sharing it with us. Okay, well then let me ask following up on the work that Ann was doing with the committee. Are there other issues to be brought forward by committee members to either make an addition or a change in the substance of the bill? So the one change that I know that we noted just toward the end and was when Susanna Davis was with us, had to do with the reference to the number of meetings. And Katie, perhaps you could review with us, propose language that would address that issue. Sure. I wasn't sure if you were moving forward with that suggestion. So I just put a note to myself instead of writing it out. But right now it says for not more than six meetings annually and the change would read for as many meetings as the appropriation permits. What if we were just, can I make a suggestion? Because it picks up on what Susanna Davis said and I think, but say for meetings as deemed appropriate by the commission, but not more than, not more than beyond the appropriations. There's something better wording, but I would just leave the appropriations out. Well, I think the concern was, as deemed appropriate by the advisory commission within the appropriation provided. Because Susanna did make the point of saying like, okay, we're gonna have to work within that but give us the discretion, not how many, like maybe it's not five meetings of the full commission. Maybe it's 10 meetings of three subgroups or that type of things. Does that work? Can I make a recommendation? Please. Just be silent. Don't mention any amount of meetings so it just inherent. You don't have to be specific about the meetings. Just don't mention how many meetings you're gonna have. Just say they can have for deemed compensation, reimbursement expenses as per the statute, at the end. Well, I think the only issue, I hear you Nolan and I know having been in the appropriations committee that they're going to raise this question and that will then leave us absent or silent on what our thoughts are. And I think, because I think that would, if we knew that that was a, it leaves it open ended, I'm not sure. Well, let's only open this as a committee for thinking about that without getting lost in the issue but represent golden. Well, I was hoping that we could add the language advisory commission or work group to acknowledge that there will be per diem for work groups. So I don't know how people feel about that. And then I guess we do need to have a top number. If we're gonna have to say within, within the allocation of whatever that, whatever that rate language would be but I don't know how people feel about adding work group compensation. I think the way it's worded, it's any kind of meetings. Yeah, I think this gives the commission flexibility to determine when and how. So that's the deemed appropriate then? Yeah. Okay. Thank you. It doesn't say necessarily as a full commission meeting. But what to Logan, I mean, Nolan's point. If we leave it, so the appropriations committee does want a number, right? Is that what you're saying? Well, they haven't, they're not. If it's too open-ended, they may put parameters on it that we don't want. Yeah, that's what I'm saying. We don't give them guidance on what we're thinking of what we mean that there's some control here. The control is the advisory committee deeming it appropriate rather than totally up in the air. They may put in language like, well, we think it should be six meetings a year. Right, yeah. That makes sense. I think I'd rather leave that in and leave it to the advisory commission to how to structure it because otherwise, yeah. I think this, yeah. I think that's my best judgment right now. Okay, not seeing other major comments or objections. I think I'm gonna suggest that we go with this language for now. Okay. Katie, let me ask you this because there were a number of suggestions that you integrated on behalf of, as a result of the walk through and markup that was happening. Have they been integrated into this document at this time or are they just, what's the status? Yes, all the changes have been integrated. I'm calling this amendment 4.1. They've been making changes as we go. It has not been edited yet, but if you would like a walkthrough of what you've added, I'm happy to do that if that would be useful. Can you do that? Can you highlight for us the changes that you've added? Sure. That'd be terrific. Let's see. Okay, so the first section is findings. Sorry, I'm still getting to the top of the document. So the only change I believe in the findings was the new subdivision 10 with regard to the eugenics movement that we just looked at. So I'm scrolling down to confirm there are no other places where we have yellow highlighting. Great. So this was the only change. The yellow highlighting so we can tell what's what. Right, yeah. I really appreciate that. So this is the new finding that you just looked at. So I'll keep moving. Next, there was a change or an error caught in section two, which is removing the second time that physical structure of communities is mentioned. So this won't appear at all, but just for the sake of acknowledging that I caught it, it's struck through and highlighted. The next change. See, now we're in the health equity chapter. There are no changes to the definitions with regard to the commission now. We had new language around membership. So there's language that any other members at large, the advisory commission deems necessary to carry out the functions of this section, including ensuring equitable representation and a balance between impacted communities and healthcare provider perspectives based on a majority vote of the members. And then we have sort of language here about the terms. So the term of office for each appointed member shall be three years with the exception that members at large, which is what we just created and subdivision BB shall each have a term of one year. And then of the members first appointed who are not designated as at large members for shall be appointed. So that's just to kind of create some parameters and not get into trouble with all of our numbers for the rollout of terms in this subdivision too. Yeah. Next we have. Can I speak to you about that? Okay, Representative Goldman has a question. I was wondering if we talked about capping the number of at large. So we didn't go into, you know, extremely large. Yeah, we had a whole discussion. We did discuss it. I think where we had, we had ended up at the time was that we weren't, we were going to leave it to the commission, but. Oh, I thought the other way that we would have a number, but I can go, yeah. I mean, I could see having like three or four, just at least, I mean, if we, I want to come back and say we want to add 10, that sounds big and large. So just to at least have some reasonable, reasonability of size. So people don't say, well, what if they want a hundred people on there when we go and present it? Just seems like an opportunity for pushback. If you wanted to do that, the language could read something like, not more than four at large members of the advisory commission deems necessary, just change the lead in language on that subdivision B.B. I had been some discussion of capping the group at 30. There's currently what, 27? I mean, it's still a large group, but maybe. That's only three, yeah, three others. I'd rather leave it to the commission and they've already, they're already bound by. They're bound by the appropriation now. Yeah, they'll have fewer meetings if they have too many members. Yeah, I trust that they'll be able to figure this out. Okay. I feel that way. But I'm just catching, I'm not sure if we may be missing a comma in terms of the concept of the at-large members. Cause I think, I was thinking of it in terms of sort of two categories. One category is including ensuring equitable representation and a balance between impacted communities. The other category and it is in, that we are including healthcare provider perspectives. The kind of thing. Oh, that's rather than suggesting that it's a balance, equitable balance between impacted communities and healthcare provider perspectives. Okay. And with you, Ann, I noticed that too. I thought that's what you were trying to say, balance between impacted communities and health. Okay. Now, okay. Let's see, so. In order to carry out the functions is right. Then including ensuring equitable representation and a balance between impacted communities, comma. Okay. And in other words, and ensuring healthcare provider perspective. Yeah. I don't know if you need to repeat the ensuring or not to make it. Yeah. I was just wondering if I break it out into a list. Maybe I will. Including, maybe not ensuring. Cause, you know. Including, right. Ensuring means it's a directive to do it. Yeah, yeah. And, or, and to include, yeah. Oh, and that, how about that? Well, it helps if I write in English that healthcare provider perspectives are, are taken into account are. Well, are included. We want their, right? That healthcare. I was trying to stay away from. Included. Double use of the word. Right. I think it starts to get confusing. Yeah. Yeah. I mean, healthcare providers perspective are. Are represented. Are represented. That's great. Perfect. As well as healthcare provider perspectives. And that healthcare provider perspectives are represented, right? Cause you want to keep the same syntax in the phrase theology. I'm sorry. Are you asking for a change? No, I'm agreeing with what it is. Okay. I think this works. Generally. Yep. Okay. Could you go to age 16 at the bottom, please? Yeah, that's good. Cause I was having trouble where, where it goes. Could you now slide down to be be again. Have both pages on the screen at once. Yeah. Yeah. Because what I'm kind of thinking that the, that it's a little more proactive if we say the advisory commission made deem necessary to include. But it's just language and forget it. It's kind of a list. Yeah. Makes it a little tricky. We don't want to start it like it's a new sentence. I know that's where I'm hung up. Thank you. Yeah. Okay. Are we folks ready if I keep scrolling? Okay. So the other change in the commission. So I, I did a word search to make sure I had advisory committee. Kind of interchangeably with commission. So I've tried to catch commission every time to make sure that we have the right terminology. And then with regard to the report, there's the data collection sentence. So the advisory commission is encouraged to base recommendations on the data collected and analysis completed pursuant to section 253 of this title to 53 is the next section. And there were some changes there. With regard to compensation and reimbursement, you've decided not to cap the meetings. So for meetings as deemed appropriate by the advisory committee within the appropriation provided. So next one, the data collection section. Again, I corrected committee to commission. And then we have language in this subsection B. This was about the department of health. Analyzing equity data. And so there's a new sentence that the department's analysis shall be used to measure over time the impact of actions taken to reduce health disparities in Vermont. The data informing the department's analysis shall be made available to the public in accordance with state and federal law. So there are no changes to the duties of the executive director of racial equity, meaning edits by the committee. There is a proposed change in addition. There were no proposed changes to the report on continuing education. There are no proposed changes to the appropriation section or to the effective day section. Okay. So I can tell you that the editors are expecting it. I don't know if you want me to send it preemptively while you discuss. So they have just so you're not waiting for it. Okay. So my question, the question before us right now is, are there any other suggestions to bring forward? I see representative Peterson's hand. I don't have a proposal for a change. But I'm suggesting when we're done with this particular piece of the process, I think we can get that bill back and be given like 10 minutes to take a look at it. It has a whole bill. Oh, okay. You see what I'm saying? Yeah. Yeah. Sometime to digest. I hear you. Yeah. Okay. We can, I think, I think within the timeframe at this point, we can do that. But should Katie also send it to the. The editors for the technical best to do the technical. First, I want to hear whether represent page is bringing forward another suggestion because if he is, then we would want to try to integrate that. Represent page. It's just a thought. I know there was some. Testimony emphasizing. LBGT to use. And God, I hate to suggest this. Because you know how much I hate these missions. But we need a member of the youth. To be a member of the commission. And I'll just throw it out there and let you think about it. I mean, we've got members of everything else. And I know it was a big deal with the testimony, but. It's just a thought that maybe you might want to include. A younger member of the generation. And I'm sorry, I couldn't hear all of Woody. Can someone just. Please say, saying, should youth be included on the commission? And I'm wondering if that's help. The, uh, add the at large members we added. In order to get equitable representation of the affected groups would allow them to do exactly that with one of those. Outright Vermont, which is a youth serving organization could appoint you as their representative. So they're on the list. Oh yeah, right. That's what I was going to say. That's what I was going to say. I'll lower my hand. I was going to say, you know, we out, we could just talk without right, or we could write in, like we could write in, that's a youth, but I think we could just talk with them and. They'll figure it out so much. There's been so much emphasis on younger generations participating in our government and other activities. Yeah, it's just a thought. It's a good thought. Yeah. It was a good thought, Woody. Anything else. Oh, I'm seeing hearts. They're for Woody. Cause we love Woody. Okay. Okay. And I love all of you too. You're like 30 feet tall right now, Woody. Oh yeah. Well. Okay. Let's focus or something. Okay. So I think with that, I'm going to suggest, I'm not hearing anyone else asking to bring something forward at this point. Oh, represent China. I just want to, in terms of like, it's just a detail, like I'm trying to finish that findings document. And Katie, can I like, have you look at how I tried to document this testimony and see if it's acceptable. And then if it is, I'll share with the committee the final document just for the record. I'm happy to look at it. I'll send you an email really quick. Okay. Trying to get things done. Okay. And Katie, I would say then base and what do you see your hand is still up and I'm assuming it was from before. So Katie, I would say with that, I think you could send the document to the editing and let them edit. If we make a changes, we'll have to deal with it. But that's at this point, we have gone through the process of markup and invited any suggestions. And I think we've incorporated a fair number. And so. And I think. Okay. So, so let me, so let me just. As a chair, let me see where we are. We've gone through the review of the document. We've gone through the markup. We've incurred incorporated editing. I'm thinking, let me check with representative Peterson and others, but maybe now is the appropriate time. For us to take the time for people to actually. Look at and digest even prior to editing, because editing is not going to change anything substantive. We have, we have now the document before us. And it would seem to me that maybe before committee discussion is the time to give everyone the chance to actually look at the document in full. Incorporate, you know, as the new language has been incorporated, give people a chance to digest that. And then come back and engage in committee discussion. Does that. Does that meet what you were looking for represent Peterson? Yeah. Okay. I think. I think. The question that new language is if we go to the website where it says bill, that'll be. Katie needs to send it. Okay. So look for our email. Okay. Yeah. Yeah, we'll have Katie send to our committee members. Yeah. So we'll be looking at the same document. That when we anticipate it comes back, it might be like, comma was changed, but not changing substantive meaning or something. You know, editors, you know, pick up on things that we made out of notice. And the reason I asked that chair. It just. There's so much going on with it. I just want to make sure. It's a completely reasonable request. And it's something which we often actually do. And so that's, that's, I appreciate your. You're asking for that. Yeah. Because it's easier to remember to do that and say that when it's like, we've got all the papers. We're sitting around with like, okay, now I need to read through the whole thing before we jump into discussion. And it's not unlike what representative China has requested on several occasions. Can I have the time to read through this? Before we actually take any action. And represent Donna. He was. Done that. I would actually, I would request it again too. If no one else had. Honestly. Yeah. So what, so let me, let me ask this. How should we do this? We can, we can. We could go off. Maybe we could go off of YouTube. And let's go off YouTube. And let's give ourselves this now 304. What if we were to go off YouTube for how much time shall we take? 15 minutes, 20 minutes. Is that sufficient? Is that not sufficient? I like 15. And then we can. We can convene and if we're not ready yet, we can. Not go on YouTube and just. Go back out and walk around the building and. Okay. That's the name of this name a specific time. I'm going to say that we come, it's now 304 on my clock. Let's say we return at three 20. That gives everybody 16, 15 minutes. Now it's 305. So let's return at three 20. So for those who are following us on YouTube, we're going to take a 15 minute break. And we're going to reconvene the committee at three 20. At which point. I'm anticipating that we'll engage in committee discussion.