 Okay, so this is the House Health Care Committee again. It's Friday, March 12th. It's a few minutes after nine. We are going to turn our attention again to House Bill 210, which we're referring to as the health equity or the health equity bill. And in the interim since yesterday, we've had, we received a new draft in which our draft person, Katie McGlynn, has incorporated our request and at the suggestion of several members, has incorporated into the findings sections all of the references, the documents, where the points of findings are coming from. And also Representative Sheena had offered and has now put before us a document which actually provides kind of a compendium of the resources that are used to document the findings and even more wonderful actual links to the direct links to the documents. So my suggestion is that we just familiarize ourselves with those findings and not try to wordsmith the findings at this point, but I think we should familiarize ourselves and see what Representative McGlynn, what legislative counsel Katie McGlynn has done on her behalf. And then maybe Brian, you can give us a quick walkthrough of what you put together. And then that's just, we'll just take next steps. So with that Colleen, do you have the, I think it might be good to have it on the screen in front of us. If you could put up, oh, and also there, it will be posted, I see that Katie has received back from the editors and everybody knows that after Ledge Council writes language, it goes through professional editors who work for legislative counsel who then know any changes that have to be made to bring it into conformance with the, with any standards that may have been missed or frankly spelling errors and the kinds of things that we all do. So- Would you like me to put the bill up and then I can scroll through it as you walk through it since I know it with the material? Yeah, that'd be great. That'd be great. Yeah, you and Colleen, whichever who can do that, put it on the screen. I think you have to be host or co-host to do that. If you need me to do that, I'm just gonna make sure it's not my to-do list that you see. Yeah, let's not do that, Brian. It will traumatize you. We won't have time for that, all of that. This looks like it, if it's not it, sorry. Okay, this is it. This looks like the most recent. It says 454, 3.1. I just wanna confirm that is the one from email. Pretty sure it is, but- That's the one that's on the website. Yeah, okay, that's it. All right, so I can scroll as you speak, Chair. Okay, so let's just scroll down. And again, okay, I'm just gonna be noting the changes rather than us trying to delve into them deeply. But yeah, so again, we're seeing that references are being made to the Department of Health's 2018 state health assessment. And we have actually had testimony about that health assessment from the Department of Health, if you recall, in earlier testimony before our committee. And that's when we in part discovered that this bill was completely in alignment with health disparities that the Department of Health had reported in their health assessment. And then again, we see that there's 2018 Department of Health Behavioral Risk Factor Surveillance System Report, which is the source of the next section of findings. I mean, I wish Katie were here because she could comment further, but is this helpful to do this or is it's just not- I see a hand on the chair. Yeah, I see it. Representative Peterson? Let me get off of it. The one, what I did when I saw this Health Behavioral Risk Factor Surveillance System Report, I went through it and I pulled off the percentages, okay? I'm not sure what you mean when you say the percentages. The actual stats, okay, that shouldn't say percentage, the stats associated with what's shown here. For instance, A, this is less likely to have a personal doctor. Yeah, you know, when you look at the numbers, it's accurate, but it's not. It's 80, one as a whole, 86% have a doctor. People of color, 77%. Yeah, this statistically less, but I just, this whole first section bothers me in that we're going over so many statistics. I don't know why we would have a bill that has that much stuff on it. Well, typically we wouldn't, but to be honest, but because this is trying to provide information to folks who otherwise may not have had occasion to review this kind of material, I think the intent is to try to put information in front of folks to frankly demonstrate that there in fact are statistically significant health disparities. Okay, so let's look at that personal doctor, okay. Can I just interrupt for a minute and say that what I'm suggesting is that we're not at this point into the specifics of it, maybe, I mean, to be quite honest, I mean, you have expressed your concern about the bill in general. Right. And I hear, and I think we've heard your concern and we hear your concern. What I feel like is important is that at this point in time, I'm willing to actually hear your concerns, but I need to make room for the bill itself to be understood by the committee and to look at how we, if there are basic structural changes within the bill that need to be thought about before we have a debate about whether one finding or another is sufficiently satisfactory to you or to someone else, because we can get lost there very quickly and I'm not willing to have us do that. All right, thank you. Chair Lindberg. Yeah. Can I just say a quick thing about the findings that I understand that they are pretty extensive and detailed and we really felt it was important to have a case grounded in data and grounded in what the state has seen over the last few years. But in addition to that, I'm just gonna be honest that when you're a member of a minority group, whatever that group may be, it might even be a religious minority in some situations that often you have to work harder to have the majority listen. And I think that we felt like we had to really make our case because people aren't hearing us. So I think that's part of why there's so much detail is we felt like we really needed to prove why we were asking for something. So I'll just leave it at that, but that's part of why there's so much detail. We face extra scrutiny. So Katie's here now, by the way. Yes, Katie, thank you for finding your way to us. We appreciate it. So Katie, maybe I could ask you to simply review with us the documentation that you've integrated into the findings again, and as I suggested to Representative Peterson, I'm trying to find this balance. I'm wanting to have people voice their concerns, but it's clear that the majority of this committee wants to move forward. I do wanna hear what you have to say, Representative Peterson. And the point right now for me is that if we could get lost in debating every single finding here and never get to the underlying proposal of the bill. And so that's where I wanna put our attention first. And that may seem backwards. I get that, but I think it's a challenge that we have to face right now in terms of the time that's in front of us. So Katie, would you help us see where you've integrated the documentation? Sure. So in subdivision one, there is a statement about Vermont residents experiencing barriers to the equal enjoyment of good health based on race, ethnicity, sexual orientation, gender identity and disability status. And this came from the introductory language and also from the results of the 2018 State Health Assessment. So that is that finding. And then in subdivision two, we move on to non-white Vermonters R and there's five or six statements there. And that came again from the 2018, not again, the 2018 Department of Health Behavior Risk Factor Surveillance System Report. This is quite a large report that breaks down data by different population groups and also looks at different risk factors and different diseases. So that's where that came from. And you'll see this particular source again and again because a lot of the data came from this report from the Health Department. The next finding is subdivision three. So this information is about, was produced by the Department of Mental Health. They completed an analysis in their statistics unit that is just broadly called race data, the PCH admissions, so Vermont psychiatric care hospital admissions. And that was the data from May 1st, 2019 to April 30th, 2020 about the populations present in the Vermont psychiatric care hospital. In subdivision four, this one was a little trickier to write just because there are multiple statements in it and I wanted to make sure as attributing all the statements to the correct place. So we have a broad introductory statement and then we go on to support that statement with different findings. So in the second sentence on line nine, there is a data brief created by the Department of Health in December, 2020 about, it was entitled COVID among Vermonters who are black, indigenous and people of color and BIPOC. And that was, I wanna just emphasize that BIPOC was part of the title of that document, which is why I included it. I know there's kind of questions as to whether that's the right term to use, but that's why it's included here. So that data briefing provided a lot of this data on COVID and different population groups impacted by COVID. So the statistic that one in every five COVID cases in Vermont are among black, indigenous and people of color, even though these Vermonters make up approximately 6% of Vermont's population, that came from that document. And then online 14 UCI have, according to the same data brief that refers back to the Department of Health data. And then in the next sentence, because we were still talking about the incidence rate, I didn't say again, according to that data brief, I assumed that it could be inferred there, but if the committee would like that added in there, I'm happy to again, write the statement according to the same data brief. And some in subdivision B, I started off this new subdivision by saying, according to the Department of Health data brief, referring to the same data brief on COVID, the December 2020 data brief. And this gave us information about COVID cases among non-white Vermonters tend to be younger than for white Vermonters. And that the average age of persons testing positive is 33 for non-white Vermonters versus the average age of 46 for white Vermonters. In subsection C, this sentence is a little confusing because I have two different sources that I'm using. So is this where it was? Yes. So in subsection C, while according to the 2018 behavior risk factor surveillance system, so that's the report that was referenced up above, there are not statistical differences in the rates of preexisting conditions, such as diabetes, lung disease, cardiovascular disease among white and non-white Vermonters. The data brief, the December 2020 data brief indicates there are disparities in the rates of preexisting conditions among Vermonters. And as stated in the brief, the preexisting conditions among COVID cases is 19.4% for non-white Vermonters and 12.1% for white Vermonters. And according to that same data brief, the December 2020 data brief, this suggests that non-white Vermonters are at higher risk of exposure for COVID due to their type of employment and living arrangements. And again, there's a statistic here and at the end of that last sentence, line 17 and 18, as stated in the Department of Health's December 2020 data brief. So then we move on to the section pertaining to adults with disabilities and this language just sets up the source for all of these statements is the 2018 Vermont Behavioral Risk Factor Surveillance System Report. And then I think you could scroll down to six. Thank you. Yep, there we go. Six pertains to adults who are LGBTQ. And again, I have this language according to the 2018 Vermont Behavioral Risk Factor Surveillance System Report. And that again, ties to all the statements in this subdivision. That brings us to section seven. Seven was the new subsection that was added since the bill was introduced. And this is the language pertaining to youth who are LGBTQ. And this source for all of this data was the 2019 Youth Risk Behavior Survey that was conducted in Vermont. So you'll see that that applies to all of the statements in subdivision seven. And then if you scroll down, we get to eight. And eight came from testimony, written testimony. Well, I think it was presented also, but it was also written in the committee record in 2018. So this is preliminary data from the 2018 State Health Assessment that was presented to the House Committee on Healthcare by the Department of Health in January 2018. And this is posted in the committee's record on the website. And so all of that data came from that presentation that's posted on the committee's website. And then this is the last finding subdivision nine. So Vermont's 2018 indicates that social determinants of health are underlying contributing factors. So both the introductory language in the State Health Assessment and then the findings in the assessment indicate that these are factors contributing to the foregoing health inequities. And then if you, well, you don't just scroll down in subdivision A, each of these subdivisions has its own source. So according to the Vermont Housing Finance Agency, just Vermonters own their own homes whereas 72% of white Vermonters own their own home and then there's the national number in subdivision B. According to the Vermont Housing Finance Agency, the median household income for black Vermonters and for white Vermonters and subdivision C. This information came from the US Census Bureau in 2018, 23.8% of black Vermonters were living in poverty, well, 10.7% of white Vermonters were living in poverty. And then in addition, according to the Vermont Housing Agency, 57% of black Vermonters are in less than 80%. Sorry, the page is jumping and I can't follow it. Let's see, thank you, sorry about that. So I'm in the last finding of subdivision C and that last sentence comes from the Vermont Housing Finance Agency. And then if you scroll down, please. Subdivision D is the Vermont Housing Finance Agency and there's a definition that's used, housing problems that definition comes from the US Department of Housing and Urban Development and subdivision E, this data comes from a, called the 2020 report and time count that was produced by the Vermont Coalition to End Homelessness and the Chittenden County Homeless Alliance. So those are the sources that were used and are now integrated. And I apologize, because I'm supposed to be in another committee. So I'm gonna hop off in about two minutes. Okay, I know we're all doing many things today. Thank you, Kate. We have to hop off for the floor. Yeah, we're gonna be leaving for the floor very shortly. So thank you, Kate. I think what we'll do next is just, just in the interest of having in front of us, Brian, would you just share the document you put together? Yes, and one thing I'll tell you is, you know, this is sort of the, did something just go wrong? I think so, hold on, sorry. This is what I'm saying. You think you click on something and then the shopping list shows up. So this- That was the right one. Oh, it was? It's showing me the bill on my screen. Oh, maybe it's because I'm on the wrong window. Do you see- Yeah, we see it. I'm seeing, I'm seeing your listing of resources. One thing I will say is that we need to add one more source to this because that source about LGBTQ youth is not on this list. So we miss, I missed that last night. So I will add it and amend it for the record. But what you can see what we did here is I went through all of the citations and I eliminated duplication and made a list. It's sort of like a bibliography for a paper or something. And you can see that each source we used is here. The ones where we can find a link, where almost every single one we could find a link. And then at the end there's a see also section because this is information that informed the bill but didn't necessarily make it into the findings. And so I thought, why not include it? So people could learn more about the disparities. There's some really interesting information there. But I will add to this, I will add that youth risk behavior survey resource at some point today and make sure it's on the record. And so people could feel free whether it's in the committee or in the community to go explore the direct sources through this resource. Great. I appreciate you doing that. And it honestly wasn't hard because we had done the work. It just was organizing. It was me sorting through things, organizing, formatting. And Katie did go through this and double check everything for me for due diligence. So this is legitimately, this is sort of like the digital version of the folder that would go with the bill, I would say. I don't know if I should say that because there might be other stuff in that folder. But it's like... It's giving links to the documents that are referenced as the source documents. And I will say that, I don't think this is a bad practice for the legislature to do in general. Like if there's gonna be findings moving forward, maybe they should be digitally available for people like this. Maybe it's just a good practice. It's a little extra work, but it's increasing transparency. So I'll stop, Don. Okay, thank you. So it's 9.26. I think we should stop for the morning and go to the floor because the speaker does appreciate us being there properly. We will come back to our committee. Can we come back immediately after the floor? I think that's the plan. We'll come back immediately after the floor and we'll figure out what our next step is at that point, but our...