 Thank you so much. Because we're on the record, you need to say your name and the folks who will, with you, look to me before you speak. Go ahead. And you too will have to say your name to the record. Thanks. Go ahead. I am Katherine Thomas. I'm from Twin Valley Middle High School. I'm Jaden Copperthigh. I'm from BHS Brownville Union High School. I am filling in for Amanda. That is Sawyer King. She is also from Twin Valley. And I'm showing Park there an advisor. Okay. Great. We're here today as members of our voice exposed. It is a youth led movement across Vermont. And we work together with VCAT through the counterbalance campaign. We're going to reduce the effects, well, more like prevention for teenagers. Nicotine is addictive and can affect brain development. And it is found in tobacco which can cause cancer, heart disease and lung disease. And a lot of children don't think of that when they do these things. Something that I've seen within my community is the mental health issues that have led to the vulnerability and caused children to want to start. They think that it's going to make them less stressed when in reality the withdrawals are making them more stressed. And even some of my friends, people that I really care about who struggle with mental health, have turned to nicotine to try to save themselves. I'm going to say some facts about nicotine and how it all works and just what it does. On a young age exposure to nicotine can cause a severe dependency when you get older and you would excrete to cigarettes, cigars and just smoking. And doing it for a young age and just doing it in general can cause long-term health effects. And the long-term health effects of vaping are still unknown today. The flavorings, the flavoring of the candies, what draws the children in, like elementary school kids, an unresponsal high schooler offers a bubblegum flavored e-cigarette to a kidney gardener. They're not going to know anything about it except for that it's bubblegum flavor and they like it. And the popular e-cigarette brands are like Surian, Blue and Fuse. And I know about the other first two, but I know that Fuse is one that sells the pods for juicing. And what I've seen, I've seen in my school a lot of kids selling it like in class and just vaping in class, doing it in their sleeve and passing under pables and all that. Just using the same jewel pods sometimes. And she sent photos of hidden like jewel pods that are hidden. A freshman in your eyes was curious how many kinds of jewel pods there were and I found this on vape pen last year. And it's a pen that, it works as a pen, a normal pen, but it's also, you can vape through it. And she found this clothing line that is, it's called Vaporware and it's for hiding jewelry. And they have it right here, they have it in the string right here. So it looks like you're just chewing on your string when you can fit it back into your sleeve. Internet King goes, yes, yes. And I feel like we should change how, like a lot of how, who can buy it. Where they can buy it from, like not every gas station should have it. I feel like it's just easier to steer it off the spinning racks to keep it on. They should keep it at only e-cigarette stores and just, they, that should only keep it there. And the age restriction should be, should be better. So a more mature audience can only get it. So they don't have the, so they don't pass it on to the younger people. Because the more mature they are, the less likely they're able to do that. And just how they can get it is just what they should do. And they should, we should make laws on how they can look. We should make laws on how they cannot look like a pen. They, how they cannot be hidden. They have to be easy visible and not, and they all that. Yes. Okay. I'm going to speak any more. Okay. Do your turn. Um, it is actually not my turn. Oh, it's my turn again. That's second. I'm three and two. I'm okay. So I'm going to talk about Jewel Paws specifically. So Jewel was launched in 2015. And it's a lot of high stores like it. The best because it looks like a USB drive. They can just, like that. And it's so small. You can just hide it in their hand. And they can go back into their sleeve. I've seen it plenty of times in my classes that happened like that. There's a lot of nicotine in one pot of the Jewel. It's around as, is it a 15? I think it's a 15% Jewel Paws. It's the same amount as nicotine as the cigarette can be. And Jewel Paws are like this big. Yeah. So it's all, all of that in a tiny little pot. Oh, okay. Now it's my turn. Jewel still come in flavors like mint and menthol. Specifically, it can kind of like make it easier on your throat, which can also attract kids because they're like, oh, it doesn't hurt me physically. So it's not hurting me. And manufacturers of e-cigarettes like Jewel will target you. There was actually, I think it was back in 2016 or 2017. Jewel got in major trouble because they were very blatantly marketing to teenagers. And their, their advertisements were colorful and they like featured all of these young people. And they were just really, really trying to get to teenagers. And in my school, Jewels are extremely popular just yesterday. I was asked by a student, do you know someone who has a Jewel? Where can I get a Jewel? Because kids will just pass them around because they're so easy. You can just like slip them off onto the table. Or like some kids will just like toss them to each other. Because if it's flying through the air, you won't know what it is. It looks like a flash drive. Like teachers are like, oh, that kid just threw a flash drive for some reason. That's okay. And they just do it like right there. So I told you about the selling in my school. There's just for the selling. The people who use it, the kids who are selling them to other kids are not actually the ones who do it either. They sell the people who are addicted to it, but they don't do it themselves. That's what I've seen in my school about the selling. And thank you so much for listening to us and allowing us to share the work that we do within our school and bringing it to this higher level. Well, thank you for the work that you're doing and for adding your voice to what is a very important opportunity. So thank you very much for coming to the State House. I hope you found it interesting. It was very interesting. Sorry, we'll keep down at room 11. I just want to really underline what Cherp you said. I mean, you're speaking out about this is going to have way more influence than any of ours ever will. So the fact that you're really taking this on and being leaders among your peers, it's really, really courageous and amazing. So thank you. The only thing I would add is, I've had the pleasure to work with, we have several prevention groups in our school. We have an above the influence group, a VCAT group, an OVX group, a Pride group, and it makes a real difference when you have kids on the ground in their communities working to influence their peers and thinking of prevention first. It's so much easier to deal with it at this level and it's really important for youth voices within the school building to be encouraged and whatever can be done to keep those groups going. The culture of a school can really change one way or the other depending on if that influence is alive and well at any school. So I'd love to see it at all the schools. It's not quite happening there everywhere, the way it is at Twin Valley that we're really proud of. Thank you. Thank you very much. Partly discussion and partly to see where we're going forward in terms of... These are the same, the same amendments that we went through before, but we just walked through them. Which is why we put them both up here now as to whether what we want to do, kind of thing. So my orient ourselves to introduce how to introduce. Sure. I think what we can do for us a little bit back and forth. But really to get to look, let's look at each section and see where we are. Jennifer Tarby, Legislative Council. So this is H663 an act relating to expanding access to contraceptives. The first section of the bill as introduced would require health insurance plans to provide coverage without any deductible co-insurance, co-payment, or other cost sharing requirement. Not just for one drug device or other product within each method of contraception for women identified by the US FDA and prescribed by the health care provider but for all drugs and devices and other products within each method of contraception for women. No, this is just going back to the bill as introduced and then we can just want to show this and then we'll flip it, right? And then if you want we can flip to the amended version. So and going along with this in the bill as introduced there is, I took out the language that said if there's a therapeutic equivalent the plan can cover how it works for if there's only one, at least one in each category. So I took out some of that language and then put in language saying a health insurance plan would not be, should not provide information under this subsection if that coverage would just fall by a high deductible health plan from eligibility for a health savings account. So if you remember there are limitations under federal law for what you can cover first dollar for a high deductible plan before it loses eligibility for a health savings account. That first section was possible. So then we looked at some language and possible amendments to section one the first of which would be to specify in the definition of health insurance plan that this is a plan offered, issued or renewed by a health insurer or by a pharmacy benefit manager on behalf of a health insurer based on some information some members of the committee had received from I think from Vermonters and from the insurance companies about why the existing law may not be being followed. So can we just look at that first one as we create a second draft of the bill and I'm going to have Sandy in my head when I say it'll probably be easiest if we end up having a strike all have a strike all rather than have our bill is introduced and then have a separate committee amendment. Okay. So does that make sense to folks? Why do we... It makes some sense to me. I'm just trying to figure out why we have to do it separately as a committee amendment. I think the distinction between instances of amendment or a strike all. Yeah. The chair is talking about doing a strike all but we're still from the committee. It would still be from the committee. It would be disabling. Yeah. We don't have to talk about why we have one idea and then change our minds about another idea. We just talk about where we're going. We'll be discussing the underlying of what we're discussing. A strike all amendment. When we get there. Yeah. I don't know if I'm already or not. I'll tell you the truth. Okay. So once you score, see how it comes out. So whether we do a strike all whether we do instances of amendment which we would do in terms of what we if we were to do a strike all we would be making decisions of an individual like individual whether we want peace in and then we would vote for the whole thing. But a strong call kind of thing to add this because this makes sense. I love it. Yeah. Anyone not have trouble. Anyone have trouble with that? No. Pharmacy Benefit Manager. And the reason for doing it is the reason for putting this language in is to the extent that an issue with the current law not being followed has to do with pharmacy benefit managers not not complying this language would make it explicit that it also applies to them. Exactly. Yeah. Okay. I just want to make sure we all understand. Okay. All right. So yes. Okay. Wait. The next piece is the requirement for health insurance plans to provide coverage without cost sharing and going back to at least one drug device or other product within each method of contraception for women identified by the FDA and prescribed by the health insurance provider. So instead of saying all with no cost sharing going back to at least one with the caveat that if there is one that is that if there is a therapeutic equivalent that plans may provide coverage and may for more than one and provide and impose cost sharing requirements as long as something is available in each method without cost sharing but if somebody's health care provider recommends a particular service or drug device or product based on a determination of medical necessity then the plan has to defer to the provider's determination and judgment and provide coverage without cost sharing for that product. We go up to the yellow line. The bill as introduced was trying to get to move a potential barrier by saying all drugs and devices and what this says along with the rest is that we go with the generic for the one unless very specifically and there will be no cost sharing unless very specific and there would be cost sharing if I just, if it wasn't the particular drug or device that was prescribed unless along with that prescription was it's a medical necessity. Right, I think I got a little bit lost in there but yes. So regardless of what was prescribed if there is a therapeutic equivalent that is available without cost sharing under our generic substitution law that would automatically be substituted unless the provider had said based on medical necessity this person needs this specific product. And if that happens there still would be no cost sharing. Then there would be no cost sharing for that one that was appropriately necessary for that patient. Regardless of that regardless of whether that's the way the plan's formulary typically works. So that wasn't the drug that they picked to be the $0 cost share but the doctor said it's medically necessary for this patient that drug has also a $0 cost share. Topper. And then Teresa. Sorry we're having that discussion as we. That's fine. I want to put myself in the shoes of an individual. So I go in and I buy, I want to buy a money after pill. Over the counter. So we're outside of. Okay let's get something that isn't that. I want to buy a deuterine device. Okay you're not going to get the part I mean the doctor's putting it in but. I'm not trying to be difficult. You run a particular brand name. You run about a particular brand name birth control pill that's supposed to have few side effects you want that one. Well that's the one. That's the one you want. It's not. To make those shoes on for this. So what happens to me is I get told your plan covers this one particular pill that does the same thing as the one you're talking about. So I end up with that one. I end up with the one that is the generic brand. There's probably a lot of generics and there's So if there's five different kinds that the plan is going to dictate which one I get. Is that what this means? Yes. Unless the doctor says it's medically necessary for you to have another one. So if you have a personal preference for something else then and it's within the same therapy to class and that works then you can pay the extra if you want but you don't get it without cost. And is that our generic That's under our generic substitution which I can spell out but that would be helpful. But it's conceivable that if you're having like major side effects your doctor and could be medically necessary to have another kind. Okay. I want to ask and this may sound personal but I don't mean it to be that way. You all know what I'm trying to do here and what we are trying to do collectively. Is this okay with you Yeah. Yeah. You're trying to have a question. Right. So before I do that I want to ask this just essentially is the same as what we have now. Right. So if we're trying to if you're trying to change something that's not what this does. I guess this is my question. This piece, right so this piece is the same as current law because of my understanding of what you heard in testimony from the insurance companies and others is that this part of the law is not the problem. It's not that people are getting prescribed something other than what they wanted and it's not the one that's available without cost sharing. The problem is that it's supposed to whatever they're prescribed they're supposed to get without cost sharing but they're getting charged something anyway and so that's why the language in here is specific about the PVM also being bound by this and then there's language that I was going to add but actually there's an enforcement issue on things like device insertion and removal where people are getting charged not for the IUD or LARC itself but for the insertion of it when our law says you should not so some of it may be an enforcement issue and if that's the case then opening it up to more drugs is still not going to solve that problem. But then I mean unless it's a misunderstanding in which case maybe somebody would have an easier time with the insurance plan understanding the all drugs language but considering that the at least one in each class is this same under federal law under the ACA as it is under Vermont law it shouldn't be that. Your show. No I'm just concentrating. It seems like it's enforcement and education maybe people were insert you know when there's a position or a instead of provider charge that that is that should be included in this language and that's not always happening. Yeah I think it's hard to know where the hangup is and is it a coding issue is it a compliance issue on the insurance side so it's hard to know what part of the law if any needs to that's not working. Maybe one thing would be to advise the patient that when you go get this prescription filled it should it should not cost you anything. Right except that the provider in writing it so if you look at something like birth control where there are a ton of them out there may not know which one or one person's plan covers with the no cost so they may write one for a name brand knowing you're probably not getting the name brand but they can't tell you what you're actually going to get depends on your plan's format. Right but so now I just got totally confused so but when the person arrives at the pharmacy and they substitute a generic it's still should cost that individual nothing. Yes so the physician I guess the advice they're getting at the doctor's office should still be that it should not cost you right under your plan this shouldn't cost you this should not cost you anything so at least it it importance the individual when they go there that maybe if for some reason they're now getting sorry paying $42.22 that they should ask about I thought this wasn't supposed to cost me anything but it may also be a matter of education for the pharmacy that it should come up with no cost share and if it doesn't what's the okay how do we how do we get to that point that's what you're trying to solve that's what I'm trying to get at so that sounds more like education and I it may be helpful to hear from pharmacists if they have a sense for where the disconnect is and I think what I'm hearing is that there is a disconnect between what we expect will happen because of what the law says and what is actually happening and I haven't I don't know if you have heard I haven't heard people about well this is what was prescribed in my insurance plan said it should be nothing but it's something I mean I I've definitely heard of those things but what I'm wondering is though what if the like I'm wondering if the hangup could also be the doctor prescribes the brand that she likes and the person goes to the pharmacy and there's a charge because it's not you know they have no idea what's covered on the health plan and the pharmacist just like fills that because that's what the doctor asked for because of our generic substitution law so it goes to the right so would it be helpful to pull up the generic substitution law well you're calling that can I just ask a little confused about the other kind so you go to your nurse practitioner get an IUD can the nurse practitioner charge for the work of inserting the IUD and then the IUD screen so under our so let's let's do these two things separately because that requires going that's okay that requires going back to the bill so let me let's just look at so under our existing law when a pharmacist receives a prescription for a drug that is listed either by generic or brand name in the most recent addition of or supplement to the orange book the pharmacist shall select the lowest price drug from the list which is equivalent as defined by the orange book unless otherwise instructed by the prescriber or by the purchaser if the purchaser agrees to pay any additional for a drug that is listed by generic or brand name in the most recent addition of the orange book of approved drug products the pharmacist shall select the lowest price drug to pay any additional cost in excess of what their plan would pay or otherwise to pay if their plan allows it otherwise to pay full cost and there are some various provisions under this but that's basically because there's a lot for biologics that we added in and Jen am I correct in what we talked about last time which is much of this part of the laws that we're looking at do not because of Orissa cover self-insured that's right self-insured non-governmental plans are beyond the scope of this committee and the legislature generally although many of the provisions of the Affordable Care Act do apply to those plans I would have to look I would expect that this at least one product in each category without cost sharing would apply to those plans but they would not be subject to our generic substitution law they may or may not actually because it's really about the pharmacist and the prescription so because this regulates pharmacists it may end up applying to those plans as well so some interplay of these two I think should largely apply to self-insured plans although it's very hard to tell how can we figure that out because as we try to tease out where where is the issue on this yep so the first thing is let me look at people like me who didn't know until probably ten years ago that my Blue Cross Blue Shield insurance from UVM do not have to follow all of the laws that we had just looked at them so we governmental plans and I think UVM as an instrumentality of the government would qualify as a governmental plan are outside the scope of ERISA which means the states can regulate so I have to find out for sure but I think if the state employees plan the future plans and I would expect that plan now would be within our cost sharing is different than my or is cost sharing different than my $500 deductible deductible is a form of cost sharing so and that's where we get into the piece of the high deductible plans because making something subject to the deductible requirement is a form of cost sharing that you have to pay the amount you have to pay out of pocket before the insurance really kicks in and that's the piece that the federal government decides what you can and can't exempt from the deductible for purposes of a high deductible plan and its compatibility with that health savings account so under this Jim there's a person with one of those plans that you just described the way a thing was written in the beginning it doesn't matter they don't pay is that correct I'm not sure where you're looking you just talked about a high deductible plan okay so the way the way I was what I was trying to do it didn't matter what kind of plan they had or whether they had a plan or not they got it from nothing under the existing statute where it's at least one drug device or product in each method yes because that happens at the federal that's a requirement under the Affordable Care Act that applies to all insurance plans and I'm going to verify whether it applies to self insurance if you expand it to all drugs devices and products in each category as we had in the in the beginning bill as introduced then no it would not apply for a somebody with a high deductible plan they would not get all of them without cost sharing because the federal government decides what you can take out of the deductible and they have not put all fees of contraception across all categories in that list so in your opinion the best way to go to get the best bang for what we want to do here is is to go with at least one drug so for people with a high deductible plan it doesn't change anything either way but I think it sounded like from the insurance companies standpoint there was potential additional cost to the system if you open it up to all drugs because you can have people getting more expensive brand name drugs for which that are not preferred on the insurance companies formulary and when that happens the insurance company has to pay the whole thing which means it gets spread out through everyone's premiums it may not be a lot once you spread it out so there could be nominal additional cost by doing the version as introduced additional cost to the insurance company yes and therefore to premium to rate payers so it has sent me to see if say I would make it down the only way the only way that we could assure that all of this the contraception would be available free of cost to all people who use contraception we each every method every brand would be if the state of Vermont decided to fund them and buy them and the health department or some other cost down on the street corner and so maybe and so therefore we would all be paying because our taxes would go up the only way the only way I'm saying the only way we can get around some of the insurance issues and the federal issues is if we took insurance out of it entirely and I'm not suggesting that but I'm saying that really is the insurance company would be the one that does as much money we can't tell certain we can't tell certain businesses certain types of businesses what to do with their insurance we're not allowed to fed say we can't do that and so the only way we could get around that would be to appropriate more money to the health department or diva or something and say yes I don't know I'm so paying attention no I do just want to share the health department I do just want to ruin the committee about and this is not for all women but previously what was the title 10 funding that the state has now replaced because we're not using the title 10 dollars but that does provide in the sense that kind of safety net service for women who cannot afford contraception we do in essence we do do that for those sure all just I didn't take house off for those I'm so upset yes I was just also adding to that for most self-insured plans they're ministered by someone else but a lot of them I can't say all of them a lot of them have don't have the cost sharing for preventative type things so if you go online you look up and ask if there's something it costs a certain amount if it's it's medically necessary because you're sick but if it's because you turned 50 it's they don't charge you anything so I would assume preventative for contraception wouldn't be the same way you wouldn't have to pay any of the cost share like the deductible and I'm going to get it because it's preventive for pregnancy I mean I would imagine that it's covered I have no sense for whether it would be available to that cost sharing tell me Topper what I am gathering from both the conversations reports that folks have with insurers as well as the information that legislative council is giving us around what is our current statutory and what are our parameters around what we can impact as a state legislature and what we cannot based on federal law that if your goal was to have everybody be able to get it at no cost that's not really necessarily something that we can promise we can get further by adding the pharmacy benefit people and that maybe to have some more testimony from pharmacists and others in terms of why this isn't happening could we put a line in Jen that says that if if the law is not followed there's a consequence to it in a state of consequence maybe that would make people not charge people what they should be I mean I think in DFR's existing enforcement authority there is they have fairly broad enforcement authority so I think the issue is maybe the threshold question is does DFR know of any problems is DFR doing any enforcement now I think we need to find that out because if it's not happening from what I understand it is not happening people are being charged stuff then we should get that corrected the other thing that that I'm hearing more and more about now as as word is getting out about this that the procedure itself people are getting charged for that I'm not hearing this I'm not just hearing this from what we hear last week I'm hearing it from individuals so I don't think that's what representative Brumsted was starting to ask earlier so I didn't want to come back to that so that's the language it's existing law so I highlighted it put it in bold but it's not underlying because it's existing law says a health insurance without any deductible co-insurance co-payment co-payment or other cost-sharing requirement for clinical services associated with providing the drugs, devices, products and procedures covered under this section and related follow-up services including management of side effects counseling for continued adherence and device insertion and removal so that's that's existing law and it's not working so that's why we need to have DFR coming in and maybe we can look to the inch I mean there's a part of me that's going also to look to the insurers I mean in the sense of if it's there financially if it's a coding issue or something like that if whoever is in charge of sending the bills out or whatever or I guess it's right at the pharmacy because it comes up at the pharmacy depends if you're talking device insertion removal or if we're talking I mean I don't know if there's anything about education you should hear from the insurers the pharmacists that I eat a piece of paper in English not in and I'm saying that generically in English not in language which understands in terms of its use of fancy words that most people should be able to get this for free you know or whatever you know if you or if you have you know we just asked that question how about there's a isn't there any chance for saying that well yes there are but I'm assuming that she will answer something when she's able to answer it and she may want to come back or do you want to answer it now Susan Krakowski MPP Healthcare I probably could answer it now but I think given the level of what appears to be confusion and to be honest I've gotten a little confused during this conversation so I think I would like to take this back and then come back so can you tell me what you are confused about because I'm now perfectly clear you too which is not necessarily a good thing okay so the way I understand it the current law says for each class or type of birth control we have to offer one with no cost sharing we still cover all of them or we can choose to cover all of them but the rest would be with cost sharing so what the bill is filed would do is to say no cost sharing or anything so you know every single one and every single class has a no cost sharing of course they're moving away from that back to me yeah so I think that's where I'm confused during the discussion is where you are and that moving away from and you know exactly what confusion is I believe we are moving away from it because as I understand it our generic substitution law does the same thing already does what we were trying to do effectively I mean I think I think the expansion may not get you much a much different result than the existing law because of the generic substitution law and if I may I think you know the rest of the provisions and the current law that Jen has gone through about you know if a provider says that for whatever your medical condition you couldn't tolerate the one that was at the no cost share you know so I'm going to prescribe you this other one you know the law existing law makes that clear so it seems like it's all covered on all of those levels so copper okay and now let's ask the question that I asked the person is getting a device someone else has to insert this device it says here they're not supposed to be charged right my question is are they being charged is that what you need to go back and find out well again Susan here Cassie I'm not aware of any complaints you know I think again that would be DFR perhaps you know it's DFR getting complaints I mean every now and then we do hear from DFR about maybe implementation of a colonoscopy mandate or something that has not been contacted by them about this okay let me ask the question a different way to your knowledge is anybody getting charged to my knowledge no but that it would not be like it Sally I lost her to Becky I think I also am going to ask the healthcare ombudsman to come in good idea to see if there have been any shall I say many of us around the table either because of personal experience family members or friends or constituents coming to us and indicating issues have seen this as a problem yes but they didn't even know it was a problem because they thought that they were supposed to get charged for that sorry okay so we talked a lot in this room in other contexts about the medical practice board and I'm wondering whether and I think this may be a question for the health department whether it's possible for the medical practice board to remind doctors about stuff like this you're not supposed to charge for the insurance so to be clear they charge but they charge insurance allowing there to be cost sharing for the patient this is why I'm not sure why the payers are who we should be concentrating on frankly I think in terms of this piece yeah they all have edits and they all have things that these claims have to pass through and there should be an edit there that says I've got a claim coming through for this and it's putting out a cost share that should go to an exception plan and get reviewed this should be dealing with the insurance company not the doctors right to the extent that you were interested in having the insurer having the providers the doctors or the pharmacists being on the lookout or telling their patients you know you should expect not to get charged for this you could do that but I think you're right that that it's really if the law is not being followed it sounds like it's at the payer level and then it may be a matter of either for the payers or education for us if it's a payer that's outside of our ability to regulate and will you or someone in your office be able to do some research in terms of where the intersection of federal law either around RISA or around the ACO is around these particulars yes so then I've made myself two notes one is Susan is also under the impression that it's the same for self-insured plans or RISA plans under the federal law under the ACA as it is for commercial insurance plans and you have just mimicked the commercial insurance coverage for the most part in certainly you have in this piece of your law my other question but I will also look at it specifically and then my other question to look at is just to confirm for myself is under our the agnostic as to whether somebody is self-insured or insured by commercial insurance or otherwise because it's regulating the activities of the pharmacist in doing the substitution I expect so but I just want to get confirmation thank you and who for us doesn't have insurance this is a requirement for insurance coverage it's somebody who doesn't have insurance and is on Medicaid that's their insurance whatever the eligibility requirements are for the health department's program but if you have a high earner who chooses not to pick up insurance and a paying out of pocket then they will pay out of pocket for this as well what do these individuals say about that I don't on Medicaid that are not on Medicaid yes we have a 3% uninsured rate so those people if they walk in if they have no so if they are signed up for the health department program which I think is broader than Medicaid they would be covered with no money out of their pocket under the health department program if they are if they are make too much money to qualify for the health department program there and they have not picked up insurance or coverage anywhere else they have elected to pay for health costs out of their own pocket and they would pay for health coverage and they have been signed up for a program I don't I mean other than you could appropriate money directly to have products available perhaps at the provider's office but I don't otherwise I don't know how you get them something for free people have been signed up for Medicaid are generally going to end in parenthood and a program that was previously title 10 so if you are eligible if you walk into a parenthood and you are uninsured you can get something for free devices yes hold on guys Lucy from parenthood yeah that's correct and for some reason someone is kind of way outside of the system we also have a sliding fee scale for those very rare cases which means it's essentially pretty efficient so that's section 1 unless there's more that you wanted to look at and either burn that section section section 2 requires school districts to coordinate with the department of health to distribute and make available freedom of charge over the counter contraceptive devices and products did that in your strike in your amendment no there was discussion last week about the health department and agency of education coming up with some proposed language on the two options two directions they suggested are you ready for that Kayla are you okay so I was just able to catch up with our president this morning and we should have something from AOE and ADH like tomorrow okay okay fine okay so I think yeah will that address both sections 2 and 3 section 2 is what schools are supposed to do in section 3 is what the department is supposed to do um yes it will address topics to talk about an education program for the public it does not if you'd like to you're not just talking about school kids yeah so here's what I think I think that Shayla should bring it to us tomorrow we can look at it and then we can I think it's hard to like I think you have to look at it and see it um and then we can fiddle with it and add to it whatever you want to do unless you have a specific no I just had a note make sure that there's a public um some kind of a um education program for people who are in school because we do a lot we've got a big education program in school all schools and um people like some of these are not going to school so I think one of the I think one of the concerns we spoke about and I think we should meet I think that we should sit down on top of it as well and review it but one of the concerns that came up were just the limitations of the health department to be able to you know staff wise resource wise to be able to take on some kind of endeavor like that so that's I think we could add that to our project now I mean seriously yeah if that is something right right um looking looking at our schedule you know tomorrow we have a lot lots to talk about in terms of good side there's a naturalization happening but the same time there were a lot of you know and then there's um um some more testimony around the old Vermonters um we and it looks like we can't come back to this until with any degree of assuredness until Friday or late or later Thursday afternoon looking at what's on the on the schedule um because I mean I think our Thursday full with the um and then I don't without on the floor on Thursday but I would are but let's counsel um you only have seven committees to go to what are you um what are you perhaps a little are you a little bit free um like at 330 on Thursday or three yes yes I think either one I have a bill but it's not really mine so 330 would be great okay so 330 we'll we'll get back to the 330 um committee in terms of this bill we took up we had a discussion about the bill we still have one more one more section two I don't know over one more section yeah potentially it's the the potential section on the go ahead okay so this was the the other piece that I brought to you in the possible amendments which is a possible new section on the mandatory reporter law um making clear that a mandatory and maybe I should actually mandated reporter as described in subdivision A2 which will not be deemed to have violated the requirements of this section which is to report suspected child abuse and neglect solely on the basis of distributing the secondary school students in accordance with sections two and three of the bill so if there are changes to sections two and three of the bill we may need to make some changes to this language I'm curious how can let's say a 13 year old take a consent if it's against a law they don't have the legal authority to do it um so I don't know that they they certainly have a contract I think there are uh levels of potential levels of capacity to consent in different contexts but this is really about reporting child abuse and neglect not whether people are engaging in sexual activity but making available protection in the event that they do engage in sexual activity but can they engage in sexual activity I think it's under 15 they're not at the age where they can consent to do that so it's not you know I know they do and I want to protect them and everything I'm just wondering about the legal system so I don't know that I have much more to say on it maybe somebody from our judiciary team has more to say I mean I'd have to find you this jailer is in the hospital and I have to find you the exact citation but there are certain areas of substance abuse and certain sexual activities where a minor can consent to treatment they can consent to mental health treatment they can consent to yeah consent to treatment for substance use and for sexually transmitted diseases in the law so there are prohibitions on engaging in a sexual act with another person and compelling the person to engage in the sexual act without the consent of the other person so it's possible that the activity itself would be that the sexual activity itself would be criminal but this bill is providing contraceptives so it is not taking a position on the legality or illegality it's going with I think what Sheila may have referred to as the harm reduction model that's used in other areas which is to protect the people involved so you're saying that a guy that's found to be a teacher if a student paid to them and said or nurse you know like contraception as a mandated reporter if they're that's right they're right so they are not so or to put it on the flip side the person the guidance counselor or whoever has not violated the mandatory recording requirement by not recording that a student asked for contraceptive over-the-counter contraceptive but the age is not specified right the age is not specified I mean that the age is specified in the underlying bill in the sense that it's talking about secondary school students and come on in come on in come on in come on in is that it is this one I think that Sheila has it sorry so it's talking about secondary school students which is grades 7 through 12 so if that if the language in section 2 in particular stays in it would be specific to secondary schools and that would be meeting the same what we all can take a look at is the material that was sent out by the agency of education last Friday was it just last Friday two Fridays ago that talked about the underlying requirements around health education that includes sex education and things and the what they are talking about the other go ahead is there an educational piece in this bill that's what I was you know I mean you talk about what the education department is doing but does this bill reference this no yet I think that's some of what you have asked the health department the agency of education to bring yes couple days couple days couple days we first asked we asked them to talk to each other we did that with a letter last year and then we we succeeded it wasn't easy so you know we did that we did hear a bill presentation around pharmacies pharmacies pharmacists dispensing and sponsorship we also had it was brought was brought up the across the hall in government operations they are doing a broad brother they're taking a really in-depth look at the many things including the pharmacy board and what is the responsibility of pharmacists and expanding and that's one of the recommendations general expansion of pharmacists can do it's one of the recommendations of some group that met over the summer yes I think you keep the OPR the OPR bill which is starting in Senegal would include some language around pharmacists prescribed so that that's where potentially this piece would go rather than now there's the other thought is that we should figure out as it comes to one place or another while we were taking testimony on the bill by itself it's not written from this bill but we were thinking of possibly putting in this bill what you're saying now they're talking about my question is it belts and suspenders to put it and then by the time these bills they're starting in different bodies come and cross I love belts and suspenders so do I so do I so do I I I I think that I don't want to confuse things in this bill I want to keep this nice and clean that's my position I agree with the other stuff right I no offense about this bill but I think frankly in terms of what it is that we're wanting to achieve that has more likelihood of doing it than anything we're doing in this bill it's my personal opinion before yes I agree honestly it's big it is well what I mean is I think that if we're looking to have easier access for youth in particular for anybody easier access for youth I think that that does it more additionally this is my opinion in my my sense is that it's easier to go to your business than ask for some of these things I think that it's to go through a whole doctor's appointment and all of them and some of them they can't for a while right that is the case too but I think it's easier to get options but either going to your pharmacist and getting this list of services or you're doctor and getting this list of services but you have some choices to make What can't we go from a pharmacist to a pharmacist? like an IED or something can be asserted well I think that I would rather I don't think you want to promise it to me. No, we don't want to promise it to you. I said you don't want to promise it to me. In terms of delts, and this is discussion, but this is rough draft. How many people in the language of rough draft which means it can come out of the statement another time, but would like to proceed with the belts and suspenders, which would be to add that bill to this bill, which would mean we take some more testimony. Of course, I mean, we're going to take more testimony anyway. So how many people want belts and suspenders? Raise your hand. Here's what you mean by that. By belts and suspenders? The section, the bill that would say 752, the folded it, add that to this bill. But there's no real belts and suspenders. So you're just saying add them in together? Yes. The belts and suspenders refers to what's going on in government operations about pharmacy, of practice in general. First, there's no age limitation on that bill, except 752, which I couldn't go along with. There's actually some age limitations. I think it said it's left up in pharmacists. Well, yes or no. I mean, I think we should really have an age limitation. It would potentially be up to the border. That's changed. We could specify that that was part of the board's rule. So I'm sorry. I lost my account with the belts and suspenders. I would say that if we're going to do that in the beginning, I thought it was your idea, if we're going to do that, then we really need to make a decision whether we are going to do that or not. But not because what I'm worried about is if we are talking about doing it and the people that are working on that across the hall think we're going to do it. And then all of a sudden, at the end of it, we say, well, now we're not going to do this. It's going to confuse. You know, if we ran into a border and the whole building stopped by it, then to me, we're done under justice in this area and we're done under justice in the other area. So I think, because we get close to the time when we have to start getting this thing out of here. And that's what we're worried about. I get that. So I will argue, A, that the big OPR bill I think is a big bill, and I guess I have questions about whether that's been really good this year. That's number one. Number two, my vote just now was to pull this into a draft and we start to really go into the weeds on the line. We haven't done that yet. And get testimony on that. So I'm not endorsing every word in this bill. I'm just saying, let's pull this concept into H6663 and look at it there. And we can amend it as we go along. Absolutely. But it also gives the world who are sitting around following what we are doing. I'm going to do that. The opportunity to go, horrible idea, or you know this is actually perfect, the best thing, but what you need to do is do this. I could bring up my age issue. Everyone gets to bring up their issues except Carl. Carl is going to have an orange eye. I'll take the stress ball. I got to be one today, great. I'm going to do it. I'm going to do it. Okay. So yes, as in 752 for the next draft, let's take a look at her. Meanwhile, I apologize, but I was supposed to ask Senator White how they were handling it in her bill. So I will follow up on that today. Also, that's coming back to me for the next day. We're going to take this up again right first. Sheila's going to circle back with you on that one, which you can take a look at. Thank you. Thank you very much. We have lots of people. Well, before generally, did you have anything more to say? Okay. So, Sheila, if you actually could provide us some more information in terms of that. If you want to discuss 8635 all along here. I'm sorry, what? The short form? Yes. Oh, the short form bill. Oh, yeah. Okay. Yes, since you're here, I was born on Thursday. The short form bill. And, you know, this is the Topper Afternoon. Yeah. Topper. I appreciate it. You appreciate it? Yes. Oh, okay. This is the Topper for us. Good idea. Oh, I got it. And so, and before just other people who are here for this other bill, if you would like to be testifying or if you have a group that wants to testify. Excuse me. Let us know. Do we know if that woman was or just left? No. Okay. Well, agency of education. Oh, okay. All right. I'm sorry. Okay. Well, you know, I don't always recognize people and so do you. I was like trying to say, if you want to testify, I'm going to say. Okay. All right. So Thursday, when I was gone, you took up two bills. And what happened with H635? Do we think it was a good idea? That was the receivership bill. And we voted it out. You voted it out. I was going to do it. I'm not quite sure how I was going to do it. We are from the AG's office. Most supposedly from the AG. And he walked through how the three elements of that related to the litigation that they had last year with the receivership and whatever the name of that place was. Hilterberg. Yeah. Hilterberg. And I have a testimony through Helen. Yes. And he was also very specific about how this would be helpful in future situations. So we would like to work on this. Yeah. Everyone wants to work on it. Can we raise our hands? Okay. Legislative counsel informed us that we have to do something. We have new rules. No, they're not new. So does this have to be a vote that the clerk calls or can we? I don't know. So here's all that says. The short form bill shall be drafted in standard form by the legislative counsel only if requested by a majority vote of the committee to which the bill has been referred. And then the request doesn't necessarily mean you intend to do anything with it. But then it says, oh, okay, so I. So I don't know that you have to record the vote. I'm just. Okay. You just wanted to follow. I just wanted to follow your words. Okay. So everyone please raise your hands. If we're on a second. What do you want if we're on a second. If we're on a second. I'm sorry, the camera is still on the majority of the committee. In fact, 10 members of the committee and someone left their vote, I understand. I think she's a few out here. What that means is we have the majority of the committee has requested of Jen that she draft a long form bill and now we will then we will discuss it. Yes, I do have the language. I do have the language, yes. So I guess, so I'm all set. Yeah, from Dale because I think, I mean, I don't think it's anything different than we had originally talked about. So yes, and I have questions. Actually, I think Jamie suggested a better way. Jamie from the AG's office suggested but he thought it was a better way to address one of the pieces, the part about the temporary receiver. So I will confer with him and Commissioner Hutt to make sure we're getting the right language. If she was during the festival. Yes, yes, I just want to make sure. I recall she said anything about that. She did a little, oh, you heard from a jitter from. Han Kota. Yes. I was just sitting there. You were from Han Kota? Yeah. From the department. Well, did you not give me a word anymore? I have not. No. I have. No. I have. I don't know. I've heard about it. I don't know what to say. I don't know what to say. Because we've heard from the other side already. The variety is good. Thank you. Oh, we heard from the G's office. She was. She's great. Welcome. Thank you. Thank you. Is this your? Yes. OK. So for the record, Jim Debra has a consult with Katie McLean, Office of Budget Council. Here we go. So with that, ladies, we would go through the current law first to get some more with how the current law works. And then go through the draft that the House Education Committee is considering at the stage. So the current law is here in Section 829. And I want to do all the wording here, but I want to give you a sense of how this works. So first of all, the definition of pre-kaged child is a child who is three or four years of age, or is five years of age, but is not yet enrolled in kindergarten. That right there is a quite controversial definition towards positive from it. Because it says it's not yet enrolled in kindergarten and because there's another statute that says something different in the green books, this is caused by a lot of confusion. A sort of five-year-olds who are eligible for kindergarten can still attend pre-k and get the safe voucher. So this says that if you're not enrolled in kindergarten, therefore, you get the voucher, even if you're eligible for kindergarten, but you don't go yet. That's what this says. Another section we'll come back to later on says something like eligibility to be enrolled in kindergarten. And so we come to the language of the giraffe of both two. This language will change. And basically, the change will be to make pre-k the voucher available only for kids who are three and four years of age and five years if you're not, if you're eligible to be in kindergarten, you can't get the voucher for pre-k unless you're an IEP or a 504 plan. So there's been some changes here, a lot of confusion in the field that's trying to be taken care of when the giraffe will come through. Pre-k education is education designed for this population of kids. We have a pre-k private provider. So the pre-qualified private provider, that's a term that's in the existing statute that's pre-qualified, and that's something that we're going to see kind of disappear in the next draft in terms of pre-qualification. Did you want to skip down? Yeah, I'll go with the access to being here. Oh, thank you. OK. So we have the access to publicly funded pre-k education. So currently no fewer than 10 hours a week of publicly funded pre-k is available for 35 weeks annually to each pre-k child whom a parent or guardian wishes to enroll in an available and pre-qualified program that's operated by either a public school or a private provider. And then in subdivision B2, if the parent or guardian chooses to enroll the pre-k child in an available pre-qualified program, then pursuant to the choice of the parent or guardian, the school district or resident shall do the following. Do you want to cover that? Yeah, so basically the school districts are paying out of their own budgets the voucher. The voucher is about $3,400 approximately. And the parent can either enroll their child in their public pre-k program in their town if it's offered in their town. Or the parent can choose to have the child go to a pre-k program in another town. So a public program offered maybe if you're a resident or guardian maybe in Burlington. Or you can enroll your child in a private pre-k provider. So you've got options here, obviously. No matter how it's done, the child will be counted in the resident district's ADM count, which we'll come back to, which goes to how you get equalized pupils. And the benefit you get there, we'll come back to that. But however you do it, the school district either enrolls the student or pays away and enrolls that child for ADM purposes, which we'll come back to. So four goes into language that will be changed. Because this talks about the supply of pre-k public and private providers. And if it's insufficient, this contemplates basically a conversation with both in bright futures and trying to figure out how to increase capacity after the region. Then we're going to see which is wrong pre-qualification, which I think Katie you've got. Well, sure. So pre-qualification, again, the term pre-qualification goes away in the next draft. But the concept of their certain quality criteria remains. So in this language, in existing law, it says that a rule both AOE and AHS have to determine if public and private programs are pre-qualified. And if so, they can be part of a publicly accessible database. And the rules are to indicate how a provider applies for and maintains pre-qualification status and minimum quality standards. And then we go into a list of what are those quality standards? So for private and public programs, they have to have one of the following on this list that starts with number one. So first, they can have a national association for education of young children accreditation. Or they can have at least four stars from DCF's starts program and with a plan to get points, two points from the five arenas. And I think you've had DCF come in and walk you through what the different arenas were in the stars program. One of them is families and communities, so different areas. And then the alternative option is three stars with a plan to come into compliance and get an additional star. So that's the three stars with a plan. And I highlight that one because under the working language and house education, that number C, three stars with a plan goes away. And then in subdivision two, this is that a licensed provider must employ a contract for services with one teacher who is licensed and endorsed in either early childhood education or special education. In subdivision three, this states that a registered family child care home that does not have a licensed and endorsed teacher in early education or early special education shall use regular active supervision and training from a licensed and endorsed teacher. So that's another place to pause around the words active supervision and training because that's another place where we're going to see a difference once we move to the existing proposal. OK, and then section D deals with tuition budgets and ADM. So part of this is a bit repetitious from earlier. So as I mentioned before, the district's and residents will pay the tuition from its own budget for the $10 per week to either another proper program or a private program. There are some notices that have to be given back and forth with some more procedural. And then two says that any cost of operating a pre-K education program goes into the district's budget. And then three says that the district of residents may include in its ADM any pre-K child for whom it has provided pre-K education or on whose behalf there is paid tuition pursuant to this section. We'll come to the ADM part, but basically the count for a pre-K child is 0.46. I'll come back to that shortly. The next section is a rulemaking section, which is actually pretty significant because that's part of the structure that's proposed to change. So can we maybe stop here because I had stopped saying no questions until you finish the section. The section seems to be a long section. Thank you very much. And I'm afraid that some of us won't be able to remember what our items are. And we'll start with Theresa Hill, remember. But it's only because I wrote it down. Way back in the beginning, you talked about district of residents that's not yet enrolled, blah, blah, blah. It was the eight. Where were you talking about age? Right there, number one here. OK. Yeah. The date established by the district of residents. So has there been any discussion downstairs about, so for kindergarten, there's a defined date. In pre-K, we leave it up to the districts to define it. So is there any discussion about having a defined date for pre-K? No. Because it, OK. Chat, this answers my question. I don't like that answer, but that's the answer to my question. We just, I hear continually from people that, oh, well, in this district, it's this date. And in this district, it's that date. I'm sorry, let me see if I understand correctly. But first of all, I have to send my kid to school in first grade. Do I have to send my kid to school in kindergarten? Kindergarten. Or homeschooling, whatever. I think kindergarten, I'm just checking that. I'm not sure if I know the answer. I think this is yes, I'm not sure. OK. So is the answer to Theresa's question, if my birthday is September 1, whatever year that's going to be, that makes me go to, and I go to first grade. But if I'm August 3 days, I have September 10th. If my birthday is August 31, if September 1 is the cutoff, I wouldn't go to first grade until the following year. And all zillion public schools, however many we have, around the state have that same date as September 1 or whatever the date is. I believe so. The first thing I believe comes in the pre-K area only where. So it's only in pre-K where we say. So it's confusing. I believe so. I want to confirm that for kindergarten. That's my answer. That's my answer to that as well. And there's one. OK. So then my second question was, do we know how many three-star pre-K private programs there are? I don't have that information. Could get it from CDD. Just to know what kind of impact that this might be having when we eliminate that as an option. I need you to go left. It's going to be two stars. Come on. Following up on the three-star thing, I just want to make sure I understood. Say you're eliminating the three-star program as pre-eligible or whatever you call it, even if they have a plan to go to four-star, you're just eliminating that option. Under the proposal that house education is currently working on, yes, that subdivision would go away. So they have to be four-star. So they would have to either have the accreditation from NACI, or they would have to have the four-stars. What's the certification? The National Association for Education of Young Children. All right, four four-star. Four four-stars. And what you're saying is how many students that is. Especially a starting up operation that makes it a lot longer to get to four stars to be able to do a pre-K program. Right. And the star system. The star system is also changing. So it might be helpful to know how the star system is going to be changing. And so there'll be two changes happening and then what's the end? So the information we're giving us is that the star system is changing. Downstairs is not changing it. No, no, DCF is changing. I was just making sure it was changing. Yeah. Yeah, that's a fair question. It's a fair question. Oh, you got it? OK. Well, maybe I don't. Let me make sure. It's too slow. That is too long. We're with a pre-qualification section is that program can get an inspiration on it. Shall have received, and it says A, or a four-star. So if they just have the association for education accreditation, they're OK. They don't have to have four stars. And that part of the law isn't changed under the proposal that's currently being worked on. What's being changed is the elimination of the three star with a plan to come up to a fourth star. And we'll look at it again when we walk through the draft. I'm going to show you exactly where the change is at. You might not have the answer to this, but it mentions a process by which the tuition rate will be arrived at. Do you know anything about that process and how the two agencies work together to come up with that number? I don't, in terms of, like, on the ground now, I've got rules that has worked together to do it. Right. In terms of how they do it, not sure. OK. This is so admirable. I know that the cost of the program of education is higher for people, for instance, in South Burlington than it might be in some other town. So I am assuming that the cost of tuition is it fair to assume that the cost of pre-K, publicly-publican, is going to be different in different districts? Should be. There are reasons for it to be based upon all of the usual cost-factuals that are up there. So in other words, the differences that relate to the per-pupil cost delivered is in grades 1 through 12, those same parameters are in place for pre-K. Correct. Carl, don't pour James, don't get mad at me. But assuming that I live in Georgia or Milton? I don't live in Milton. Right, anything? Definitely not in Milton. Fair few. OK, so I mean, assuming I live in one of those places where I work at the University of Vermont, so I want my kid to go to the pre-K program that is embedded in South Burlington, because it's right near where I'm going to be working, the cost of that is a bit more than in Georgia or Fairfax Field. Fairfield. I've been here two years. Who's the first person to ask if you were all right over the weekend? If you can't remember where I live. No one else cares. So I mean, who's paying the difference? Well, it goes, the cost of pre-K goes into the school budget for whatever school they offer in pre-K. Pre-K is not required to be offered by public schools, but they do, the cost goes into the school budget. So there will be differences among school budgets, specifying different cost factors, but whatever that cost is will be used for by the taxpayers. And you're not required, like in Ann's situation, the South Burlington pre-K is not required to take that student. Is that correct? Well, it's actually because the current law allows you to enroll your student in any public program in the state unless you have a geographical structural employer on, which you don't want to in the state. But yes, basically, you can go anywhere in the state, but that program in Burlington would have to have space. That's what I mean. And there's something in the current law or in the new version, the new draft, that deals with how space gets allocated. So I'm not sure how that's actually done in practice, but there has to be space for that student. I just want to make sure I understand. So if you're a three-star program right now, a private three-star program, but you have some preschool kids, you wouldn't be able to get any additional. Is that what the change is? So the change is what quality standards are in place. So currently, if there is a pre-K program that's being operated and the kids, they are currently receiving the publicly funded tuition, and that program is three stars with a plan to come into compliance and get the fourth star, then that program would no longer be eligible under the new proposal. Yes. OK. No, the rest. Yeah. So thank you. Thank you. Just to interrupt you, sir. And so it would be great to know how many kids there in the back of the question. That was the proposal two years ago by the AHS, was to get rid of three stars. Would be what? Yeah, two years ago, when we talked about this, AHS proposed to get rid of three stars. That is their idea. Mm-hmm. That was two years ago. I think we're ready to go into the rulemaking. It's really important. It is. Where are we here? We are on. We're on subsection E. So it's worth just taking a step back to kind of think about the big picture of how the existing law is different from the proposal. So the existing law has joint rulemaking between AOE and AHS and joint oversight. Whereas the new language that's being worked on downstairs has joint rulemaking between the two agencies but separate oversight. So that's what you're going to kind of see in terms of changes in the language. But I think conceptually that is what's happening here. So current law, joint oversight, joint rulemaking. So it says joint rulemaking already. Yep. And have there been rules? Have there been rules promulgated that were jointly developed and all that? OK. Yes. OK. Sorry, what's the second part of that? Is the supervision, though, that would be... So under the language that house education is working on, yes, yeah. Now, I mean, how is that different from what it is now? Right now, it's joint oversight, joint rulemaking. That doesn't seem what we've been hearing about joint oversight because there seems to be that we're putting conflict at the same time. This was schools mostly are complaining about. They have to respond to AHS and they have to respond to AOE. So they would technically have their own little universe. Yeah. But they need to talk right. Right, right. OK. Let's see how that plays out. Yeah. Sounds difficult. So in other words, under the proposed language that AHS would be overseeing the private programs and AOE would be overseeing the schools. Yeah. The one exception, I believe, is Head Start programs that are in schools would still be overseen by both agencies. And I was going to add CCFAP if there's a school program. The program that is accepting CCFAP. And they're also subject to the CDD rules with regard to CCFAP. Thank you. Wouldn't that be a loss to everyone? Yeah, how many is that? I mean, you'd be surprised, really, that that is not a universal thing. Oh, cool. What's that? I'm sorry. Not all public schools are participating in CCFAP. And CCFAP, again, stands for what? Oh, the childcare subsidy money. Or they might be for their older students, but not necessarily for the pre-K age. OK, so there's a long list of rules. I'll try to run through them quickly. But this is guidance as to what rules should be adopted and have been adopted jointly by AHS and AOE. So first, we have allowing non-prequalified private providers to create or continue existing partnerships with school districts. And the school district could provide supports to help fulfill requirements for teachers or in-kind payments. And subdivision two, allowing the district to begin or expand a pre-K program based on community need. Subdivision three, rules requiring a school district to provide opportunities for effective parental participation. And subdivision four, establishing a process for parents to notify a district that the child is admitted to a non-district program and can currently enroll in the district. And also to establish a process for the district to pay tuition in a manner that allows a parent or guardian to enroll the child in a pre-K program or ability of a private provider to maintain financial stability and to enter agreements with a provider regarding tuition payments, quality, and assurances. And subdivision four, C, providing rules around provider notification to the district when a pre-K student who has been receiving public funds is no longer enrolled in the private program. And subdivision five, rules directing the establishment of a process to calculate statewide tuition rate based on cost of delivering 10 hours of pre-K a week. Subdivision seven, requiring identifiable pre-K costs and essential early education services and district's annual budgets. And subdivision eight, requiring an annual report from each district to AOE regarding annual pre-K expenditures. And subdivision nine, providing administrative process for parents or school districts to challenge a particular action. And subdivision 10, directing AOE and DCF to develop a system for joint monitoring and evaluation. And again, I'll kind of flag that because we'll start splitting apart that joint monitoring once we get in the new draft. But the current joint monitoring, we have a list in 10A through C. So in subdivision A, what's part of the monitoring? It's programmatic details, including the number of children served, the number of private and public programs operated, the public financial investment made to ensure access to quality pre-K. And subdivision B, its quality of public and private pre-K education programs and efforts to ensure continuous quality improvements through mentoring, training and technical assistance. And then in subdivision four, results for children including school readiness and proficiency and numeracy and literacy. We're almost there. Subdivision 11 directed rulemaking around a process for documenting student progress. And the process would include helping to individualize instruction and improve program practice. And also to collect or report child progress data to the Secretary of Education on an annual basis. Okay. And then F and F. Okay, good question, yep. I might not have heard it and I haven't read this all, but is there any rulemaking with regard to access to special education services? Nothing, anything to take in that, okay, thank you. No, no, no. Sub F here talks about displaying sections of law that deal with tuition payments because it has its own tuition payment structure embedded within it. G says that nothing here shall be construed to require proper funds to be spent in a way that would violate the separation of church and state. And then H is the geographical limitations and this language won't throw it all but basically allows school districts to narrow the geographical region in which you will make tuition payments. So while the principal, the section is you can take your child anywhere in the state and use the voucher. This says no. If school district wants to limit the geography in which we're gonna make these payments to providers they can do that but there's a process for it which includes a lot of engagement with human services and AOA and input and if they do that, then what that means is wherever that region is the district will only pay a public or private provider that is within that G Rockport area. I believe there are only two areas that say they have done this. And then- Just a question. Exceptional for whatever you call it on the church and state separation. Yeah. Did you read that again? Yeah, so the language says nothing in this section shall be construed to permit or require payment of public funds to a private provider, a pre-education and violation of the constitution which is the separation of the state. So- So the private provider could not be a church is what you're saying? Yeah, well, couldn't be a program that has a religious orientation where you're on control to ensure that the money's not being used for worship. Let's say they're using a church to hold the class in but that's the only affiliate that would be our, okay? I believe that would be okay. Yeah, yeah, yeah, yeah. So I wouldn't throw that. Yeah, it has to do with the use of public funds for worship basically is where that issue is. So let me back out of this for a minute and just take you to two other areas of law. Here, this is the definition of average daily membership and this is how you begin to come up with your equalized people waiting, okay? And it says here in C that you include the district where a resident includes the full-time equivalent enrollment for each pre-K child. So if the child is enrolled for 10 more hours or pre-K education per week, they get a full count of one child, okay? But if they're enrolled between six and 10 hours, they get a proportion of one child. So say you're giving six hours of pre-K, you get a child will count for six tenths, okay? That's the ADM count. So one count for 10 hours or more and then a proportional count between six and 10 and no count at all if it's under six hours. Wherever that figure is, then you multiply it by 0.46 because that is the next section, which is the waiting. So the waiting is here and you'll see that under C, pre-K is 0.46. So if you have a child who's getting 10 more hours a week, a pre-K, they'll be kind of at 0.46 for the purpose of equalized peoples, which affects tax rates. So the higher the count, the lower the tax rate. So that's the game. Okay. I'm sorry. The higher the student count, the lower the tax rate because it's a prepuple spending is how it's done, right? Did you say something about 0.6 at one point or is it all 0.46? Did you say 0.6 at one time or is it all 0.46? 0.46, yeah, for pre-K, yeah. Okay, so we're done talking with the current law. Any questions before we move on to the draft bill? So, are pre-K students subject to the additional weights like all other students are, poverty, English language? Yeah, all that is suggested. That's, yeah. There. Yeah, yeah, correct, yeah. Back on the base statute, there was a section there where it said that the district was able to calculate the costs of pre-K and that they might differ from district to district. I'm just trying to figure out if that was part of what they could do under regulation or something, I think. How, I guess what I'm trying to figure out is right now, it seems, or my recollection is we pay a standard, there's a state set rate of what we will pay for pre-K and then it's determined somehow through magic how much the private pre-K people will get, which is roughly half of what goes out. So I'm just trying to figure out what the relevance is of the cost, other than obviously it has to be included in the district's budget. Yeah, so it's a really hard question, actually, because you have two things happening. You have, on the one hand, school district's paying cash out of the school budget of, let's say, 3,400 bucks for those 10 hours, okay? That's the outright. They get, as a benefit, though, to count that child at .46 in their ADM count. So some people have said, well, look, that's not fair because the .46 is basically half of the student. If the average per student cost in Vermont is, let's say, 15,000 per student, there's a $7,500 tax benefit over here and a $3,500, $400 payment over here. So it seems like that's not fair. But I'm not sure how, actually, you compare a tax benefit to basically a grant, if you will. I'm not sure how they actually equate to each other, how you actually do that math. So the concept there is that there is a difference here. How do they value that difference? I'm not sure. Maybe it's a question for JFR to work through a bit. So there isn't any, or is there, I shouldn't, is there any, since we're talking about AHS and AOE, splitting out supervision, is there any concept of splitting out payment and just having AHS make grant payments to private briefcase? So two years ago, the proposal was to bring all the payment at the state level up to AOE, actually. But the version we're about to go through doesn't do that. There's a recognition that it's very burdensome for school districts to pay all these different providers and having to deal with contracts, invoicing and things. So the draft we're about to go through adapts a uniform approach to that process, as opposed to bringing it up to the state level. This is something I should get from testing on, but maybe when you've heard it, it's burdensome for school districts to have to deal with so many providers. Is there an average? Like, how many is too many? I don't know. I don't know what the average is, I'm not sure. I mean, is it two or three, or is it 10? I think it's about a 10, but you have to take tests when I get out, I don't have those figures. Okay, so maybe that's something. I only ask that, not that it's not burdensome, but in our world, the equivalent to a public school might be a K-mail health center or a private non-profit agency like the Child Care Center. And oh, they have to report to, they have to turn in grant stuff and report to a boatload of agencies or even the same agency, but four or five different reporting things. So, that's all I'm gonna say, thank you. Should we go to the draft bill? Are we ready to move on? Okay, there it is, we'll be up here. Okay, so a couple of comments about the draft. So we're on draft 3.1 here. This draft does not reflect very much community discussion at this point. It doesn't reflect, that's why they've heard either. So it's a pretty early draft of this language. I'm sorry, can you, it doesn't reflect, we just went through this with another bill that we were doing, which are put draft language up here. It hasn't had discussion, but I mean, was there a committee member in charge of doing this, or is this the sort of the garbage can, every idea is here and we're gonna do that? No, it's actually been a much more controlled process. So I've worked with RepRab, well RepRab. I won't take that personally. Oh, yeah, yeah, I agree with you first of all. No, it's been controlled in a sense that it's been funneled through RepRab, RepConman and RepCooply as the people working with KDI in this language. So we talked about in committee of course, but they haven't had like a session yet that I've been at where they've actually started to figure out how to change this or whatever. And there's been quite a bit of testimony on this language that hasn't been talked about yet in committee formally. So there's gonna be a sense for it stands as we talk through about this. The, in terms of the oversight question, the bill is three main things. So the statement of purpose is to eliminate joint regulatory oversight by the two agencies to require that tuition payments for pre-K using uniform form of process and to simplify and clarify the program quality criteria, the three starters, et cetera. On the first one, just to mention, we talked as well with House Education. In my mind, at least, it might be more than this, but there are five options for oversight. I'm gonna just lay them out there so we have that in mind maybe. One is you have all the oversight of pre-K by AOE. One is you have all by AHS. We're not doing that in this structure. One is the third option is to have joint oversight and joint rulemaking. That's what the current law is, okay? And then another option to have separate oversight and separate rulemaking. We tried that in order to draft, but then we realized, we didn't realize, but we maybe realized, you have to keep those two sets of rules in line all the time. It's the one that had joint rulemaking. So the fifth option is to have separate oversight and joint rulemaking, which is what this draft does, okay? Okay, so going through the draft, first we'll come to the definition of pre-K child. I'll read this to you. It says pre-K child means a child who, as of the date established by the district of residence for kindergarten eligibility, is three or four years of age, or it's five years of age, but it's not yet eligible to be enrolled in kindergarten, or five years of age, but it's not yet enrolled in kindergarten if the child is on a 504 plan or ID. So that's changing, it's clarifying the current language, basically they're excluded five-year-olds, generally, from the voucher, unless you're on an IP or a 504 plan. And five years of age, we don't care what month. It is based upon eligibility for enrollment in kindergarten. So wherever that cut-off date is for that district. And cut-off date is the same across the state. I think for kindergarten, we'll look at the introductory language here. It says, as a date established by the district for kindergarten, so I believe kindergarten must be based upon local decisions as to what that date is. So, and I am eligible for first grade no matter how old I am if I have gone to kindergarten? Yeah, well, I have to check the rules on that for you. Okay, so if my school district says, oh, it's okay for you to enter kindergarten if you were born in a month that's in early, in the earlier part, like really early. But I love my kid and my kid's really smart, so I want my kid to be in kindergarten. But the kid's probably younger than what many of us think of as kindergarten. So they go into first grade at basically five. And they automatically get to go to first grade because they were in kindergarten. And that's possible? I don't think so. No, I mean, at least in my district, I know many people who felt their child was ready to go and they were hard and fast about that. Even though I was in kindergarten? Yes, yes. So how did you go to a place? Yeah. Pardon me? I don't know about kindergarten, but you used to go to a preschool place. Well, I'm trying to see if there's a difference between pre-K and kindergarten and first grade. It's a good touch. What gets to be local control? Right. Versus what is a statewide? And that might influence my views of what needs to change. I mean, I think other things need to change, but if it's all local for everything, then I'm not gonna, you know, but if it's something that the state board of education or whatever has done uniformly for everybody else, every other thing, I'm not gonna go, well, what are we doing for this? I think there's also local control for when a child turns three and can be in a public school setting. In a public pre-K? Yeah. I think we did hear that there were some two-year-olds attending. I know, the problem is in my mind. And I don't know if they were all attending public school programs or if they were also getting doctors to be in privates, but there were two-year-olds who were a part of the. Well, let me take that question away. I'll come back to it. Okay, thank you. Okay, that's good. Difficult pre-K education has unchanged. Okay, and then we come to where we had language about pre-qualified and now we're kind of striking through where we're moving away from the concept of pre-qualification. But now we have a definition of just a private provider and that is somebody who's either regulated as a center-based child care program or a family child care home. Okay, and then we have a definition of a public provider, which means a provider of pre-K education that is a school district that meets program quality requirements under a section we're about to come to shortly. So let's put this in your view. Thank you. To me? Okay, sorry. So this is the same, nothing's changed here. So in terms of 35 hours per week, 35 weeks a year, the tuition payments work, all the same as before. So again, the district of residence will pay tuition to a public provider, a private provider as a parent's choice. That student will be enrolled in the district of residence program only for purposes of if they're being paid away for purposes of the ADM count, that hasn't changed either, it's still 0.46. So all of this mechanics are all the same in terms of this area here. No good question. Yeah, yeah. I'm sorry, I got a little lost. So I live in Rochester, I'm taking my kid to Randolph. So the school is paying for Randolph. Is my kid counted in the ADM for both schools? No. One's paying and one's receiving. No, only the home district. The home district is getting the ADM credit. Okay, so Rochester gets the ADM and Randolph gets $3,000, $4,000. Correct, correct, is that correct? So actually, okay, what value plus or minus to Rochester is getting the ADM? That's the question we were talking about earlier. The values of Rochester is a 0.46 count for ADM. Which will always be in Rochester. I'll think the equal. It'll be in Rochester. So you would like that, just send all of your, we have a great pre-caterer, we're at King Rockton. Yes, but don't you want lower taxes? No. No, I'm trying to catch you. No, I'm trying to catch you. I'm trying to catch you. Good, good. I'm trying to catch you. I'm trying to catch you. See how clearly we don't quite have any funds trying to ship you back to the administrators. So if, this might just be a nuance, so in Sandy's example, let's just presume that the student was going into a public provider, now not a public school program, public provider. They still only get the $3,400 from the ascending school district. Okay, so that's regardless of whether it goes to a public provider or a private provider out of district. Correct. Okay. Correct, correct. There's some changes in this, simply as before we hear, the original language in law now, contemplates it might be a lack of supply of providers. So this talks about how you deal with a lack of supply and that kind of partnership with building right futures. That's been taken away, I guess in the view that there's enough supply. The language law says nothing in this section should be construed to require the state or district to begin or expand pre-K education program to satisfy demand for pre-K education. And then it says if a district plans to begin or expand a public pre-K education program, it shall, not less than 30 days prior to the date of commencement or expansion of the program, notifying and writing the public and private providers with which it has contracted to provide pre-K education. So the idea of being this notification to people locally or people you've interacted with that you're about to expand your program or start one. So next to subsection C, which had been pre-qualification, you can see that language is struck through. But then on 19, we have the new leading language being provider qualification and the question came up downstairs. What is the difference between pre-qualification and just qualification? And I think that's a fair question. And the best answer we have is we base this off the AOE and AHS proposal that came over two years ago. So that was the basis of where we were drafting from. Regardless, this section deals with the qualifications that we had been speaking about with regard to the existing law. And on the top of page five with regard to the private provider, we still say that the private provider shall meet the minimum program quality by having the NACI accreditation, so same as the existing law, or at least four stars. Similar to the existing law, except we're striking through that we have to have two points in each of the five arenas. So that specificity is gone. Instead, it's just having four stars. And then you'll see that subdivision C, which was the three stars with the plan to come into compliance, or I hate to say compliance, come up to the fourth star, that goes away under this particular proposal. And then we have an AND in subdivision two. A private provider shall also employ a contract for the services of at least one teacher to provide direct instruction to a pre-K student who is either licensed and early childhooded or special ed, or has a Montessori Early Childhood Teacher Certification. So two things there. First, the language on line 18 about the Montessori Early Childhood Teacher Certification, that is new from the previous draft. The previous draft didn't include that. The previous draft just had licensed teachers with either early childhood or early childhood special education license. And then the second thing that is worth pointing out here is on line 15, there's the phrase that the teacher is to provide direct instruction. So if you remember from the existing law when we went over it, we talked about an option for training and supervision and there wasn't language about direct supervision. So this draft as written would require direct supervision. However, at the very end of this draft, there's a standalone section that says that it takes, it gives private providers three years to come into compliance with this so that they wouldn't have to have a teacher licensed as specified providing direct instruction for three years. Instead, we'll look at the language with more specificity but it allows both direct instruction during that three-year period but also coaching from a licensed teacher. So that's a change from the previous or from the existing law. So the addition of, I'm just curious about the addition of Montessori and or I can tell you that probably everybody here about the same letter I did about the Walmors, and I'm just wondering if there was discussion about that. Yeah, can I answer that one? Yes, there was. And while there wasn't any vote on changing the language, it kind of, after the last discussion landed at maybe we should just stick with licensed teachers. Yeah, I don't need that idea. That if you just stick with licensed teachers because if you name one specific philosophy of education that has a certification process, there are others. Yes. So there was discussion about that and that was where the last discussion landed but the language hasn't been changed. And I mean, who knows if and when it will be but that's where the last discussion. Will the court have that? Yeah, not yet. No, I just would concur. I wonder why that had been pulled out as a new example. So I got to visit a couple of programs and when I said, so when are you doing pre-K and when are you just taking care of kids? They said, we're doing everything all the time. And I'm leaving at the bottom of page five during the hours in which Christian Der Garten education is paid for with publicly funded children. So at 10.30 you do, but at 9.30 you don't. I mean, they're doing the same stuff. They're playing their building things. That's right. I don't mind driving in the city. You can't speak to what the conversation is so much, right? You're just being the one. So there's also a bit of conversation about that, although no real acknowledgement of it being a challenge. So aside from the fact that it's going to take time to have any enough workforce to have every private provider even the ability to hire licensed teachers, there's also a question of if that's the expectation those licensed teachers are likely going to need to be paid more. Because they'll be working after school. Right. After school activities. So if we're going to pay them more, it is likely going to lead to an increase in tuition rates at private providers. And then there's a whole domino effect, what that looks like in terms of the voucher amount as well as what childcare subsidy amounts because that's all rate based, which then leads to more questions about affordability for families who need both the tuition and the subsidy to be able to send their children to high quality programs. So I would say that's been brought up, but not thoroughly discussed. We already have an unequal system because we the taxpayers already subsidized the public school costs for Pre-K completely. And in a situation like this where the tuition payment or whatever it's called doesn't increase, then that's unequal access to Pre-K for those selecting a private provider. Yes, so I was handed, thank you, and I don't know if this is something that I can keep and should probably share. Okay, how that tuition dollar amount is arrived at, which is helpful to look at. And maybe it would be helpful to hear some testimony about that. So as rates go up, presumably the voucher amount would also go up based on what I was reading about that process. But it adds to the overall cost and I think clearly creates some issues around access and equity too. So, yeah. As a process, I believe things are always changed, but I believe similar to the bill about lead, we will actually came to us so that we got more than a drive by, but the committee came to a consensus about it, that we would actually get this bill to do things. The idea, part of my idea of having to run through now is so that we can see what our questions are so that perhaps we can have some conversations with the three people who were putting doing most of the work on it in the years, in terms of where we are, so that the two committees aren't necessarily, at least from the same path. We may not necessarily come to the exact same conclusions, but let's just know where our pass for work are. Or where our questions are. You ready? Ready. Okay, so we were on the language that talks about the direct instruction, either employing or contracting with the services of a teacher. And then in Roman numeral one, the private provider that's regulated as a center-based program. The hours that are publicly funded are the 10 hours, whereas at the top of page six, the private provider that's the family childcare home, the teacher is required to be there for at least three hours per week. So, yeah, thank you. Okay, and then we'll come to the program quality requirements for a public provider, so a school district. And on line six it says employing or contracting for the services of at least one teacher who is licensed and endorsed, et cetera, to provide direct instruction to pre-case students during the hours of operation of the program. So just to contrast that, so if you're in a public program, you have to have a qualified teacher there all day for the entire of the program. And as Katie mentioned, if you're a private program, 10 hours for center-based and three hours for home-based. So the difference is there obviously in terms of the requirements to have a licensed teacher. And two, the public provider has to meet safety and quality for the adaptive by the State Board of Education. We'll come back to that because later, you'll see that those rules have to be aligned to the rules by age us, so we'll come back to that. Oh, you're right, yeah. Okay, in subdivision two A, this directs at the Agency of Human Services is to maintain and post on its website a list of private providers that satisfy all the program requirements that we just went over. And that the private provider that, a private provider who no longer satisfies one or more of the requirements is required to notify in writing AHS within five calendar days of an event that would cause it not to be in compliance with the requirements. So for example, the teacher that the family child care home had been contracting with gives notice that he or she can no longer provide instruction or training than the private provider would have five days to get in touch and writing with AHS to let them know that they're no longer in compliance. And we actually had somebody testify last year that she, something happened in her private, some private providers place that made her lose a star. So she fell from four strikes to three strikes. So she would have to close or lose not be able to do that. So I may have missed it. Did what you were going through? But okay, so I'm the private provider and I have to notify AHS if something has happened. So I'm a public provider. Who do I have to notify when? I anticipated the next paragraph. Oh, you're right here. I'm just changing the line. So you'll notice that there's almost identical language in subdivision B. So this again is the idea of separate oversight. So the agency of education shall maintain and post on its website a list of public providers that satisfy its program quality requirements. So separate posting of qualified programs on two different agencies websites depending on whether they're private or public. A public provider that no longer satisfies one or more requirements shall notify in writing AOE and the public providers with which it has contracted to provide pre-K education within five calendar days after an event causing non-compliance. Can I, in terms of a public provider, my understanding is in terms of public schools, they might, just everyone who works in the building, forget pre-K, everyone who works in the building, do they have to be some kind of certified teacher? Do they ever do public schools in public schools like contract with, I don't know, a jazz musician to come in and teach jazz? I believe so because the requirements for screening applies both to employees and contractual workers. So that tells me that yes, a school can hire a contractual worker or teacher to come in for periods. I mean, I guess my question, we're just not asking the questions. Let's say I'm a public school and rather than creating my own private pre-K program, the public school contracts would be ampute childcare center to be the South Burlington pre-K program. Is that a public program? Because, and they're paying, I mean, is that a public program or a private program? Absolutely, that's a question. It can't be a, it can't be by definition in this draft. I don't believe that can be itself a public program because a public program or a provider is defined as a school district. So the school district is mine of water. So if you're bringing in a private provider, I assume that's a contract for arrangement that you're bringing in. Well, I mean, and if I'm going here on a rabbit hole that doesn't exist, you can say and it doesn't exist. But I'm just trying to figure out who are these private pre-K, who are these, what is a public pre-K program? Oh, public pre-K, that could be just a program here in Montpereur. So if the Montpereur School, the elementary school offers a pre-K program, that's a public program. And I guess my, and does it exist anywhere? And if it doesn't, I will ignore this, where a public school offers private pre-K but the way they offer it is they have contracted with me. Yeah, I think LeBow has one. LeBow has, they rent space from, they rent a classroom. They rent the old first-grade room. Right. And it's a private program. But it's a private program that exists inside a public school. Yeah. I believe, by the way, It's still a private. Private. Private. Yeah. Yeah. That exists. I believe so. We saw one in the Northeast kingdom too. And not all public programs are full day programs. So having a teacher there for the hours of the program, Some of them are full day, and some of them are half day, and some of them are. But if they're more than 10 hours, they don't get whatever extra. We only guarantee 10 hours of publicly funded. No. No, that's what it is. But if the school district submits a budget to the voters, that includes more than 10 hours, and it's approved by the voters, we as public are funding more than 10 hours. And we have several schools around the state that do that. Yeah. True. Mm-hmm. So it's, we have inequity everywhere. So the concept of universalism. What's universal time-out, sir? No, I was just sort of agreeing with her. So the subsection D on tuition budgets at ADM hasn't changed from the development through in any material way. So I won't go through. It's been much time in this section here. I think we can go up to here. This is new. OK. So 5A says that subject to subdivision B, which we'll come to, a school district that pays tuition for pre-education under this section should use uniform forms and processes developed by AOE for contracting with the private or public provider, invoicing payment schedules and payment of tuition for the hours that are publicly funded under this section, enrolling students in the pre-K program, and tracking attendance of enrolled students. And then as I was saying what I just read, a school district may adapt the uniform forms and processes developed by AOE to a circumstances in compliance with these uniform forms and processes would be unduly burdensome or cost-effective school districts. So back to my different school districts cost different things. Am I sending the same amount of money to public? I can send my kid to any provided that the district shall pay tuition for the weeks. Now, can different school districts charge different tuition? Not for the towers. The towers is set by rule by the agency. So that's the $300, $400. That's the same for everybody. So that's different than what is, I don't know what you call it. People in Georgia, right? You don't have a high school, right? Right. And so kids in Georgia can go to South Burlington or Essex or whatever and I don't fully, do they pay the exact, does Georgia pay the exact same thing for those kids or do they pay different? We pay the average of three surrounding high schools. I think they calculate. Or it is the tuition for South Burlington. I'm probably not 100% sure. But I think it's a blended state tax. Well, for this purpose though, for the towers, pre-K, it's the standard rate. I'm just trying to see what is different and what is the same. I mean, I'm just curious. It's none of my business. I have human services downstairs. But if we blend the rates for other parts of education, why are we not blending the rates for the potential and maybe that's what the 300 or whatever it is. Well, this is the rulemaking that Kay went through. I believe it allows that rate to be set regionally. So you have differences in that rate. I don't think it's different regionally. I think it's the same, but it can be done regionally by law. So some pre-Ks are all day. So I'm sending my kid to an all day. They get the 3,600. Do they get or 3,400? Whatever. Do they get anything else? Yeah, the program charges the additional hours since wherever their rate is. Even in public school? Well, that's the point. So today, for the private providers, they can charge additional money for the additional hours. For public school, you can't do that today. You cannot do that. But in this draft, which we actually drove last week, it allows a private provider now says, or a public provider, that it's not to charge additional or residence, merely to see the additional payments of the parent or guardian, only for the pre-K education in excess of the public final hours. So now this bill is saying, if you're a public provider, not the residence, if you're a mob courier and you're sending your child to a public provider in Burlington, they can charge now this draft for those additional hours. Where they're cleaning before. To the family. Completely non-parity with the private, if you will. And is that, in this draft, is the school board, can they set any number they want to for that, is there any, is there any frame around what they can do? That in this draft, no. No, we're on the private side. We have a discretion. We are, we've got two, five, A and B. Two on six. I'll tell you. Okay. So this is the board of the Supervisor of the Union that has a member district that is a public provider to adopt a monitoring policy that covers the public provider's pre-K education program that complies with state board rules. This is saying is, trying to move the monitoring function not just up at the AOE and ASF level, but down to the Supervisor of the Union level so SUs are responsible for adopting a monitoring policy of their own public pre-K programs. That's what I'm saying. And then seven it says that in school this is a PACE tuition for pre-K education in this section so we're responsible for ensuring that the provider is on the list maintained by the agency of human services or the agency of education which K went through but she'll have no responsibility to monitor the administration of pre-K educational services provided by public or private provider and she'll be immune from civil and criminal liability penalties for accident missions of the public or private providers administration of pre-K educational services. So today we have a situation where the school district of residence is contracted with let's say five or 10 or whatever other programs. In that contract there's a requirement to monitor those programs so that one school district is monitoring all these programs and another school district is saying the same programs as mine are those programs so this is saying no because school businesses have to monitor the programs that's done by the agency of education for publics that's done by HHS for privates and school districts basically are off the hook from trying to monitor these programs and because they're monitoring they can't be sued for not monitoring. Who is monitoring them? So monitoring is done by we have separate oversight by HHS and AOE HHS is monitoring privates AOE is monitoring publics. So the local school so the agency of education so state government is liable except that state government employees are immune. Right? Right? I mean I thought there was something you can't sue a state employee doing your job? They're simultaneously involved. Is this similar to what happens in first, second, or third grade? When my kids go to a specialized school because they need special things or when they send my when you send your grandchild who's living with you to South Burlington. So that's a popular question. I mean this isn't something that happens. Yeah. So the context of special needs we'll forget the special needs. We're complicated. So your question is outside the pre-K context if a child is in first grade and gets sent to So this is another thing where this is the sending school school of residence and the child is not going to participate in something in the school of residence but rather is somewhere else. Is Georgia I'm just trying to have no responsibility to monitor the administration and is Georgia immune from civil and criminal liability or penalties? I think for those lower grades they'd have to pay tuition to South Burlington. The only place where I think the answer is no. It's not similar. This is different than that in terms of the language here. So if you're tuition in town for example and you're paying tuition to civil and criminal liability there I'm not sure if there's any responsibility to monitor either there. So Kelly a question I will have Why are things different for pre-K than they are for kindergarten through 12? Whether it's this or other things in terms of this is going to be public school? So next we have subsection E it previously was just a subsection on rules and now you'll see we have language about regulatory oversight we have a new subdivision one in here and this basically is just two paragraphs this is which agency is overseeing which programs so in paragraph 1a the agency of education has sole regulatory oversight of a pre-K program offered by a public provider provided that if the public provider participates in CCFAP AHS shall have regulatory oversight over the providers compliance with CCFAP and then conversely in paragraph B DCF has sole regulatory oversight of a pre-K program offered by a private provider and then we go into the rules and the rules are still jointly made as they are an existing law so can we go back because it's public school because it's public I have to take all children who fit I can't say no I don't want to take you because you're receiving childcare financial assistance okay most of the rules are the same so I don't think I need to at the bottom of page 13 at the bottom of page 13 this is the monitoring so we're still under rulemaking that we have to have joint rulemaking and in subdivision H we now have to establish comparable systems by which AOE and DCF monitor previously was joint monitoring and they evaluate presentation of publicly funded pre-K programs under their respective jurisdiction so again comparable systems and then at the top of page 14 they're jointly reporting on the results of their monitoring even though AOE and HS are separately monitoring and another difference as we go through this subdivision H on line 7 it says at a minimum the system shall monitor and evaluate and then we have the same list that we had before the different things that are being monitored for except in subdivision 3 on line 14 the results for children including school readiness and proficiency in numeracy and literacy there's an addition of social and emotional development so that's new from the previous draft I'm just going to mention that there is a presentation of what the joint monitoring system which took many years to build and has just very recently been stood up I think it was October they started there was like a soft start to it and so there's there was a lot of concern that monitoring wasn't being done adequately by either agency or as a joint endeavor but it's because they were building a system and the system has just started to function that may not be adequate for some people but the lack of a sense of monitoring was because it wasn't being fully done I just wanted to add that to everyone's thinking about the possibility of bifurcation and what two sets of monitoring so am I correct that we're still in rulemaking so they're going to have to come up with rules for how to do this well under the existing law we have joint rulemaking authority and they've already adopted joint rules many of the rules are the same and this draft also requires joint rulemaking so to the extent they're already in place to the extent there are changes yes I think I love that we're asking about social and emotional development I wonder how you measure that a lot of this is how many kids how many programs it's pretty basic stuff and I'm assuming that proficiency and literacy and numeracy is probably done by testing or performance based but I'm just going to be interested to see what they come up with and how they measure social and emotional there's a new paragraph at the end of the rulemaking section and it basically says that in proposing and adopting rules under E the agency of education or state board of education and the department for children families are to seek to ensure that the rules that apply to public and private providers are aligned it's kind of similar language again except to the extent there are compelling reasons that are unique to a public or private provider environment that justify applying different requirements and then the F and G and H are really unchanged so F dealt with disciplining and tuition section G was the separation of powers H is the geographic limitations so it still creates a geographical region under this bill the only change is here is straight afterwards for people to qualify and then it comes to section 2 yeah it's a good thing it's a good thing you didn't wait right? I know so section 2 we're now on title 33 and this language in existing law says a child care facility a child care facility needs a license to operate or to be registered in the case of a family or child care home and then there's in subsection be a list of exceptions when you don't need a license and when we move to the top of 18 there's a new item can I ask what is a 21st century fund is that a federal grant that went away? I don't know the answer to that my understanding is a fund document that's what I've heard from local people so there's a new item on the list of exceptions subdivision 6 a public provider of pre-k education unless the public provider participates in CCFAP I'm sorry I'm a public provider and I'm participating in CCFAP and I'm also getting the $3,400 so I'm getting double well I'm getting the $3,400 plus the public providers the public providers to CCFAP their school budget is funding the pre-k program and then if they're also providing after school a longer day that isn't considered their pre-k program and they're offering child care assistance to people okay thank you but if I'm a public provider and only doing 10 hours a week and the participants families who are there are also eligible for CCFAP the public provider doesn't get any of that CCFAP not if it's only 10 hours if it's only 10 hours okay thank you I mentioned that the issue around that definition of who qualifies for a pre-k 4-5 year olds there's no section of law that is so this makes the same change with your early year another section of law is to make it conform basically pre-k 3-4 year olds and for 5 year olds if you're on an IP for a 5 year old and then section 4 is a piece of sectional law it requires that the Secretary of Education develop and publish this website the important forms of processes for attracting an invoice to the test results we talked about earlier and then section 5 says that the Secretary will develop and publish this website in pre-k monitoring policy for supervisor units to adopt so in terms of how this plays out for the 10 hours that is publicly funded pre-k there'll be uniform stuff hour 11 through 35 they turn into a child care and so then they have different monitoring forms well the uniform stuff is basically the algorithm tracking the process between the school district and the private provider oh ok ok sorry I understand can I just ask a clear thank question so that pre-k monitoring policy I'm confused is this only for the public programs ok and is it the way it's worded it sounds like it's developing a policy for supervisor unions to implement supervisor unions weren't going to have monitoring of monitoring their own programs so they don't have their own programs so basically what this is saying is in addition to AOE monitoring public programs if you have a public program in your supervisor union the supervisor union board has to monitor its own programs as well and is that an updated term supervisor union we have a unified union board we're using it supervisor unions are on top of two or more school districts ok so we have a number of those we have 51 of them in the state but some school districts are big enough on their own to be their own SCU which is what they're using right but if actually the product is one of them it's called a supervisor district so when it's both the function of a school district in a supervisory union it's called a supervisory district and basically it's by both of those functions because there's a system to do it without a supervisor Georgia are we're part of a supervisory union right well we used to be called Washington a supervisory union but now we're called union school district really it's to use school district school district not a supervisory union yeah it does not exist under a new SCU we don't pass any SCU budgets anymore or anything that's a different conversation sorry if we can handle this we've got three more pages and the last page is short so next is section 6 and this has to do with safety and quality requirements and there has been some discussion about which safety and quality requirements do we follow, do we follow AOEs or AHSs so this gives a little instruction that the safety and quality requirements that are required under this have to be adopted for public providers of pre-k education shall be aligned with CDC, CDD rules that apply to private providers of pre-k education unless, same language, there are compelling reasons unique to the public environment that justify different requirements so it's saying align public programs align with CDC regulations around health and safety except when we don't want to except when we don't want to do it except for specific circumstances it's not specific is there anywhere else in rule or guidance or state law where compelling reasons consistent with being a public school are outlined or are identified or is that to be determined anything right now I didn't notice this was an existing sort of thing that we're nearly at the end section 7 so this is the language I sort of previewed earlier with regard to teachers and how we talked about the direct instruction provided by teachers in the draft direct instruction of licensed teachers for both center-based and family child care home for the 10 hours or the 3 hours respectively and we talked about how that wasn't going to apply just yet and that there was going to be kind of a grace period where there was a little bit more flexibility for the private providers to come into compliance so that's what this language is that notwithstanding that language that we went over earlier the private pre-K provider employee that's being employed or contracted for services with at least one qualified teacher to provide direct education instruction a private provider may use the services of a qualified teacher to provide either direct instruction to pre-K students or coaching of the provider's staff or both until the 2023 2024 school year and after that private programs moved to the direct instruction of pre-K students so the coaching is the extra piece that private providers would have a 3-year window to take advantage of instead of direct instead of direct teaching, coaching and then we go on to list two different possibilities of language to define what coaching is so in the first instance we're kind of cross-referencing an AOE policy and in the second instance we're coming up with our own definition to put in law so first a private pre-K provider that uses the services of a qualified teacher to provide instructional coaching to the provider's staff shall use for this purpose the guidelines for implementing effective coaching systems issued by AOE in March of 2016 so that's one option and the alternative option as used in this section coaching means the practice of endeavoring to close the student achievement gap and accelerate learning for all students by building teacher capacity through implementation of effective instructional practices including the provision of ongoing embedded, non-evaluative professional learning Language taken from the March 2016 AOE policy So I'm looking at section 8 which is the effective dates and as it references section 7, I guess what I'm not sort of understanding and maybe just different ways of doing it we have two sections that really don't start until 2023 or 2024 so why don't we just delay the implementation what is different I guess rather than just saying effective dates and then saying whatever 16 BSA whatever that is is 2023 so so you don't have to explain the reasons of the education committee is there a drafting thing that these are actually that doesn't make sense so 7 talks about the basic basically of this for a teaching obligation and it's going to affect right now they've got three years basically to go into compliance so that takes effect on passage while the earlier sections explain the oversight takes effect a year from now it gives them time to adjust their rulemaking their rules so I guess I don't I just don't understand drafting or whatever why we couldn't just say that those two sections 16 BSA 829C1A blah blah will be in effect August 2023 and the other whatever it is or whether the adding of this whether there has to be this coaching thing I see what you're saying carve that one section out and then add it in so have a separate section that amends so then you're amending the same section twice versus putting it in session law so I mean we could do it that way what it would look like is amending section 829 and section 1 with a particular effective date and then amending it again in section 2 to have the inclusion of the language we're talking about and then put a different effective date for that so this current law does not law figure that we'll talk because I'm probably not understanding what the law is versus what we're trying to do what's different now in terms of I see what you mean so right now it talks about training and supervision instead of direct instruction and coaching okay yeah thank you wow there will not be a test there will not be a test you promise and we all oh Kelly a great deal of things for sitting down because she's going to be I mean it is quarter of five now so I don't think we have a lot of ability to talk more but maybe just if there are questions or that maybe either we bring folks up here again not questions of drafting but questions that we want to understand more about why that either we pass on to Kelly as the 12th member of the education committee around this or whatever or do we just need to regurgitate for a while Ponder yeah but I have a lot of questions providers I don't know until we have final language it's kind of hard to say so I guess my question is kind of if the bill is going to officially come to us at some point that's one thing and if it's drive by would it be more appropriate for that drive happen after make whatever changes to this language they're going to I'll try to get even more Claire my understanding when we this whole thing started was that we would just like we're going to get the recovery home bill that we will take possession that we will take possession but bringing a list of questions downstairs at this point is still helpful yeah and so maybe what I would ask folks to do is as we think of as we ponder this and think about the questions and in particular focusing on the questions about how it will we have a mix delivery system and so how how this will how these changes will impact that and and and do do good how's that for an English teacher that's pretty good for the kids I think it's so time it is so time you know why didn't anyone have our meetings today we were sorry so thank you both very very much that was very helpful because we really had to start from and thank you for starting us with what's current