 So we're back, and we're continuing on 611, and welcome to Jana. You would state your name, you need a run change, and all of that. Yeah, thank you. My name is Jana Claire. Thank you, representatives, serving on the House Human Services Committee and others present for receiving testimony from service providers and participants as you consider H611 legislation for an Older Vermonters Act. I'm pleased to see this bill making progress, along with the continuity of the Older Vermonters Caucus that meets Thursdays at noon this session. And I'll just mention that myself and a couple other senior center directors will be at the caucus on March 12. We're looking forward to that. My name is Jana Claire, again, and I work for the City of Montpelier as director at Montpelier Senior Activity Center. I served on the Older Vermonters Act workgroup that made recommendations for H611. As I was in the workgroup, I'm here today representing many of my colleagues who work at the dozens of senior centers and meal sites around the state. We established the Vermont Association of Senior Centers and Meal Providers, also known as VASCAM, about five years ago with the mission to provide senior center and meal providers advocacy on a statewide level, promote the growth and quality of all centers, and strengthen the professional skills of their staff and volunteers. VASCAM has no staff, budget, or office. Those of us who are involved are volunteering our time for it. It does have a steering committee of members committed to continuing the advocacy and building on professional development and networking opportunities. We've created in recent years with some great support by Dale, including most recently from Angela Smith-Jing, who's been a great advocate. We've also had several opportunities to work with Janet Hunt of V4A and the AAA directors, though there's inconsistency in how that looks around the state. Senior centers are not part of the Dale funding stream, and if the Older Vermonters bill ended up being limited to supporting services funded or administered by Dale, then senior centers would be among the VAS network of vital community-based services not adequately included in the important broad-based work going forward. We all rely on a strong system of interconnectedness as individuals and as organizations, whether private or public. Vermont senior centers are on the front lines of supporting socialization and engagement and preventing isolation. They are essential in the state's effort to support healthy aging and to prevent or delay institutionalization. They are the ones who provide meals, activities, and lifelong learning opportunities for little or no cost to participants. These include classes, health clinics, trips, educational initiatives, multi-generational initiatives, technology training, and so much more. Movement classes are among the most important services offered. Senior centers play key roles and are essential, in fact, for successful outcomes for the state of Vermont's plan on aging, and they are also the sites for most senior nutrition programs, including production and distribution of congregate meals and home-delivered meals on meals. Additionally, many of the state's fall prevention efforts rely on senior center located and managed programs, such as Tai Chi for fall prevention and arthritis and bone builders, strength training and exercise classes. Many people are surprised to learn, and so we are compelled to raise awareness that Vermont senior centers receive no state funding or that funding they receive from their local communities is inadequate. While centers do receive Federal Older Americans Act-funded reimbursements through AAA contracts that cover a portion of senior meal costs, only about a third of the actual costs at some sites and some meals being totally unfunded and unreimbursed, all centers struggle to raise money to maintain and meet the demands of their nutrition programs and other services offered. These include meeting the expenses of staffing, facilities, insurances and more. Capacity and sustainability of senior centers and meal sites, especially with growth in older adult population and demand, is stretched. Unlike the area agencies on aging, there's no state or federal funding that goes directly to senior centers or meal sites for operations or administration, and most rely on small, often unpaid or underpaid personnel to fundraise and meet operational expenses. 65% of senior centers serve between 3 and 10 towns and a quarter serve over 15 towns. With an average budget less than $100,000, many senior centers are hindered in their ability to reach more people and provide more services. We have evidence that those centers who are better staffed and funded by their local communities and skilled fundraising efforts are able to do more and serve more, including the examples of Thompson Center and Woodstock and Montpelier Senior Activity Center. Only four centers in the state are municipal departments, most are tiny nonprofits, and many have staff who will be retiring in coming years without succession plans or adequate budgets to attract skilled workers. Indeed, some are staffed entirely by volunteers. For Vermont seniors, for Vermont seniors entering... Sorry, I've got a little typo here. For Vermont senior centers to thrive into the future and continue to help Vermont meet the goals of its state plan on aging, senior centers and meal sites need to transform and evolve, but they cannot do this alone. They need more support to build capacity, so our ultimate goal is to have senior centers receive better recognition and additional funding support for the vital and valuable role they play in supporting healthy aging, keeping people in their homes and reducing social isolation. More works remains to be done at a state level to understand and support the needs of senior centers and meal sites. Please pass the Older Vermonters Bill, as it includes so much we need to be thinking about and addressing, and please be sure to include in it the comprehensive network of community-based centers and services like senior centers that are vital to older Vermonters and to successful outcomes for Dale, the AAAs, and the state plan on aging. The Older Americans Act gives great recognition to the importance of senior centers and other community sites. If H611 only supports the work of Dale and the AAAs, it will miss the mark on hundreds of community-based services like senior centers. We all strengthen each other and are making great progress in serving older Vermonters, and more remains to be done. Please ensure the Older Vermonters Act reflects that well. So, do you have specific suggestions about how the Older Vermonters Act can be more reflective of Vermont's network of senior centers? There has been some dialogue of how it could be supportive for Dale to commit to supporting further study of the needs of senior centers. Well, we can all recognize current funding and budget realities are what they are. We think it could be a good use of a small pot of money, perhaps, or an intern through Dale or something like that to do some further study into the budgetary and professional development needs of senior centers and perhaps create a plan for the coming years. And we don't feel that's adequately happening now nor do staff like myself that work at the centers have time or budget to do that on our own. One of the things that the Older Vermonters Act and the Older Americans Act call for is this state plan on aging and calls for the AAAs to do essentially a needs assessment looking at their communities that they serve and incorporating recommendations for the state plan on aging. So do you feel like that process that happens once every four years is reflective of the needs of senior centers? I think it could be improved. Another area that we're really interested in seeing better supported is when Older Americans Act funding increases have happened for senior nutrition, there has not been transparency with the meal sites about how those increases are distributed to the sites. There's a lot of inconsistency in the five agencies across the state about what happens, what kind of increases do or don't happen. It's very inconsistent across sites. There's a real inconsistency in support provided to the contractors and I think that's an area that we'd like to see change, as well as just greater recognition that what the centers are doing is part of health care. I know there's some progress in discussion of medical meals. Truly, I think as many of you are aware so much of the home-delivered meals, meals on wheels that are delivered are results of discharge planning when people are coming out of the hospital and so they're receiving perhaps physical therapy or occupational therapy or other services at home and they're told to get meals on wheels and the sites make it happen. They just make it happen. They raise the money to make it happen because the reimbursements are not enough. All of those other discharge planned services are reimbursed through health care and the meals are not and the Older Americans Act funding helps a little bit, but it's not enough and it only covers a small portion and doesn't help the sites with their operational and administrative costs. So we would like to see greater advocacy for changing that and supplementing the federal funds. Carl. Should funding that you might seek would it flow through the area, the area of agencies on aging or not? Would it come straight from the state? Yeah, well currently the Older Americans Act funding is funneled through the area agencies on aging. We think there's potential for direct funding to the centers. I think there needs to be study about how that would look. Centers come in so many different shapes and sizes and what they offer. Whether it's a capital for capital based thing or a grant program there's a lot of unknown about the best way to do that but I think there could be some greater efficiency and more direct funding. So does each of the centers work with their area agency? Each of the centers who serve meals or have transportation services that are funded through federal dollars has a relationship with their local AAA but I just want to emphasize this huge inconsistency about what those relationships look like. And they're very strong and effective in some cases and from what I hear less so in some cases. Jenna, is what you're saying that there's I've heard you use the word a lack of transparency in the meals reimbursement aspects of that. So are different rates to different senior centers depending upon which AAA that they are affiliated with? Yes. And some have received increases in recent years and some have not. Thank you. And I think we believe that needs addressing. Carl. You're not in this particular area but I understand our senior centers up there in a way from getting meals through carry on the aging and I don't know how they're going in on their own but anyway do others have that same problem? I heard there was another senior center that's had the same problem. I'm probably not the best person to respond to that but I have heard cases of some communities going outside of what's available for federal reimbursements. I think that might be a question for Janet who works with all those to try to get a picture of what it looks like statewide. So that would be all the best reason. It's my understanding for my senior center that for the meals that are supported by the older Americans act that only not even suggest a donation but they only ask for donations because they can't like say you know we have little placards so for any site receiving those reimbursements there's lots of hoops to jump through in terms of meeting nutritional requirements and so forth you cannot charge for the meals so for folks 60 and older you can suggest a donation and as I understand across the state there's a group on average far below the suggested donation so often many people are not in a position to donate at all and the meals are there to help those people and others some people donate the full suggested donation and very many less or nothing and sites who serve people under 60 can be charged for those meals but there is a great challenge in fundraising and so sites are doing a wide variety of fundraising efforts whether they have the skills to write grants in some cases do events do appeals it's a tremendous effort for many of them to raise enough money and in particular at sites where there's no paid staff or staff who have the training to do fundraising and so the way that it's a state last question from Jessica it seems to like I used to visit senior centers for work that I did for a US senator and it was very different in the price and what they put out is how much to donate and also how much the area agency and aging was involved in the center like gay but all of the different things that they did depended on where you were which was hard on some of the seniors in some of the more rural areas where they needed the most health and that's I believe because I looked into it because this was at the beginning of the Over Americans Act and that was really just because the older the agencies didn't have as much ability to do as much in some of those communities either because of their support but this is a I am grateful that you came and talked to us about this because this is something that I haven't even thought about in all these years it's a tremendous effort for sites to pull off the programs including nutrition, the movement programs the hosting drop-in groups of all kinds and as you mentioned groups that donate cleaning and so forth senior centers are a really great example in so many cases of bringing community together so many other small nonprofit community groups congregate as a hub to integrate with senior services being offered whether it's cleaning organizations CSAs the local health agencies offer a lot of their services the hospitals in many cases do stuff many sites serve as facilities where lots of other groups rent space for meetings and activities they have in many cases become and in other cases have great potential to be community hubs and places where people of all ages can come together we need to we're already turning the site to get to your bill so your choice yes I will answer use the phone bank to get it some sites do not all sites do thank you very much thank you for your time I really appreciate it so folks we're going to shift gears totally here remember to take out H635 regulation of long-term care facilities and we have not only Ledge Council but Ledge Council has a special assistant today No way no way No way Yay No way for punt though you may get him back again and less alright H635 Go look at that right Jennifer Kari legislative council this is H635 It is a short form bill, which means it has only the statement of purpose. It doesn't have the rest of the bill making the actual statutory or session law changes or provisions. So introduced by Representative McFawn, and the statement of purpose, I think, kind of explains what the proposal is anyway. Would propose to make modifications to some laws around the state's regulation of long term care facilities. First, it would authorize the Department of Disabilities aging independent living to take immediate enforcement action to eliminate a condition that can reasonably be expected to cause mental harm to residents or staff. Under existing law, the licensing agency is authorized to take immediate enforcement action when necessary to eliminate a condition that can reasonably be expected to cause death or serious physical harm through residents or staff before the condition can be eliminated. This would also expand that to be a condition that can reasonably expected to cause mental harm, so not just death or physical harm, serious physical harm, but also mental harm. Would also add a definition of insolvent to be applied in the context of regulation of long term care facilities. So under existing law, a complaint requesting the appointment of a receiver can be filed in the superior court when the facility is insolvent, but there is no definition of insolvent. And so I think the proposal from Dale, if it hasn't changed, would be to potentially use a definition that exists already in our law that's based on the Uniform Commercial Code for the insolvent. And then third, the bill as proposed would prohibit any actions that are taken by a court-appointed temporary receiver from being used by a long-term care facility in support of its opposition to the department's request for a receivership. And I'm sure you'll hear more about this, but my understanding is it has sometimes come up that the court appoints a temporary receiver to start managing the affairs of the facility, pending a hearing on the merits of the complaint request from the department for a receiver. And so if that temporary receiver does some things to stabilize, for example, the long-term facility, the facility should not be able to point to those actions by the temporary receiver in support of saying, we don't need a receivership. See, we're already turning things around because it was the temporary receiver who took those actions. So you'll hear, I think, more about this from people who have been involved in the process. But that's what this bill would do if you choose to turn it into a long form or put it onto something else. Since it doesn't have any real words. Yeah, that was it. It does have a title. But that's it. I suggest that we be here for witnesses before we question the judge too much. Welcome to Goal for the Love Law, representing about holiday and true spirit. And see you tomorrow. We are revamped for as mentioned from Essex Town. Nice to meet you. Carl Brooks, representing the town of Georgia. Jessica Bromstead, representing Shelburne and St. George. Sandy Hoffman Rochester, also representing Gufford, Stockbridge, and Pittsburgh. Paul McFawn, representing the very town. Theresa Wiss from Laudervere, also representing Golden Beale Square in Paiton. James Craig-Bortfair, Peter Fletcher, and make us food. Nice to meet you. Kelly Payella, London Dairy, Weston Strat, Jamaica, and... Great, thank you. Nice to meet you all or see you all again. So my name is Jamie Renner. I'm an Assistant Attorney General at the Vermont Attorney General's Office and Chair of our Office's Elder Protection Initiative. I'm also a member of the Attorney General's Trial Team that recently represented Dale in asking a Vermont court to appoint a receiver or interim manager over the Pillsbury senior communities, which are three residential care homes that house and provide care to over 200 Vermonters. I mentioned my participation in the Pillsbury case because in the process of that lawsuit, my trial team and Dale identified a few places where our long-term care statute can and should be amended to help clarify and strengthen the state's ability to seek receiverships over long-term care facilities when that's necessary. The purpose of this bill is to bring about those amendments. So today my plan is to share some brief necessary background on the Pillsbury case itself, and then I'll turn to the proposed amendments explaining each of their significance in light of that Pillsbury experience. In terms of the Pillsbury case, and this case may be familiar to you by virtue of its presence in the media in the past couple of years, but by November of 2018, Dale in my office had learned that the owner of the Pillsbury facilities, or the then owner, had stopped paying for critical services like electricity and food, leaving the facilities residents in imminent danger. To be clear, the facilities had received electricity shut off notices, meaning that their heat, computerized medicine management systems, and oxygen nebulizers were all about to fail. The facilities food service company had stopped delivering the facilities food. Kitchen staff were dipping into their emergency food reserves and scrambling to local stores to buy protein sources and fresh produce using their personal credit cards for the facilities residents. And all of this was occurring against an otherwise ominous backdrop, which was that for months, and with increasing frequency, the owner had been failing to pay all vendors in a timely manner. For months without any explanation to his staff or the residents at the facility, the owner hadn't invoiced or cashed any of the resident's rent checks. And with significant staff attrition, the facilities were experiencing severe nursing shortages. And the facilities owner to boot was increasingly in communicado with both his staff and the residents about all of these issues. He was also increasingly in communicado with the state. Given these circumstances, residences were experiencing extremely high levels of mental stress. They worried about a total collapse of their home and their care. So in November of 2018 to address these increasingly dire circumstances, and after Dale had already attempted an escalating course of corrective approaches with the owner, we took the extraordinary step of asking a Vermont court to appoint a receiver over the facilities. So to be clear, a receiver stands in the shoes of a facility's owner. Their job is to write the ship, to safeguard the residents, and to either return the facility at the end of the day to the owner or more likely sell the facilities to a new responsible owner. Along with our lawsuit, which I'll refer to as our complaint, which was the actual legal document we filed requesting the receiver. Along with that lawsuit, which we knew would require a trial, we asked the court to also immediately appoint an emergency temporary receiver, which Jen referenced, to run the facilities during the course of the trial to safeguard the residents in the meantime. And the court granted that request. So after a trial that stretched over November, December, and January, the court ultimately ruled that a receiver was merited. So for the last year, the receiver has been managing the Pillsbury facilities and preparing them for a sale to a new owner. And in fact, the facility recently sold, and that sale I hope for the residents' sake is closing sometime soon. So with that as some background, let's circle back to H635. Like I mentioned at the start, I'm gonna explain the significance of each of the proposed amendments in light of our Pillsbury experience. And just as a warning, the proposed amendments are fairly technical. So as I sort of walk through the rationale for them, please bear with me and feel free to ask any questions as they arrive. I'm just gonna jump in for a minute, so you're reading something, and I hope that we're gonna get it in something. I'm happy to provide it. We don't have it now, okay. Yep, I'm happy to provide it. So I'll start actually with, if we look at the short form items two and three on the short form bill, because they most squarely relate to receiverships. And then I'll circle back to item one, which relates to strengthening Dale's long-term care authority more generally. So let's start with item two, adding a definition of an insolvent to the long-term care regulation. So one of the grounds on which the state can seek a receivership is that a long-term care facility is insolvent. However, the long-term care statute, and we're talking about Title 33, Chapter 71, doesn't define insolvency. Big picture and law, there are two definitions of insolvency. The first is that a business can't pay debts as they become due in the ordinary course of its business. That is, it doesn't have the revenue to pay for its accruing debts. The second definition is that a business isn't paying debts as they become due in the ordinary course of business. Never mind whether they can or can't. So the first definition looks to a business's resources. The second definition looks to a business's behavior. The Vermont Uniform Commercial Code, which is consistent with Black's Law Dictionary and other legal sources, already defines insolvency as being both or either of these two things. It's just not defined in the receivership statute. So why does this matter or why did it matter in the Pillsbury case? Well, in the Pillsbury case, we had substantial proof that the owner was not paying the facility's vendors like the utility vendors, the electric vendors, the food service providers I mentioned. As those bills were becoming due, the owner of the facilities argued though, well, that doesn't matter because I'm well resourced and therefore you can't find me to be insolvent. So the question of whether the court could find him insolvent ultimately turned on how the court would decide insolvent should be defined. And at the end of the day, the court did find that the Pillsbury owner was insolvent in line with definitions in our commercial code and Black's legal dictionary and in line with the definition that we argued then and we're urging for now. But we just wanted a flag that going forward, and this is the rationale behind the proposed amendment, long-term care facility residents will be better protected and we at the Attorney General's office will spend less time litigating the meaning of insolvent. If the long-term care statute simply defines insolvency to mean the same thing it already means in our state's uniform commercial code. So simple cross-reference. Can it be done with a simple cross-reference in the statute? I don't see why I couldn't though. I guess I would defer to legislative counsel on the best approach. You're a lawyer sometimes. You don't have to do that. I am. I am. For better or worse. You would have to do two if you did that. It's defined in two places. Well, well, well, well, we'll let Jen figure that out. Yeah, so that's item two. So in terms of item three on the short form bill, this notion of essentially preventing the owner of a facility to benefit from the work that a temporary receiver has been doing, I can back up and explain where this came from. So at the start of the Pillsbury trial, to our surprise, the court announced to the parties that it was going to judge whether a receivership was needed by the facts on the ground at the Pillsbury facilities at the close of trial, not at the start of the trial or as of the time of filing of our complaint. And this approach was unusual and presented us with various concerns. So first, as we read then and read now the receivership statute, that statute envisions a world in which the state files a complaint that makes allegations that a receivership is needed. It then has to prove those allegations at trial. And because those allegations invariably regard conditions at the facilities at or before the time the complaint was filed, proof of those allegations that's put forward at trial is always proof of past conditions. Also, sort of setting aside the logistical challenges of trying to prove to a court in real time evolving facts over the course of a two to three month trial that in and of itself, I think, is unworkable as an approach. This approach also risks leading to undesirable results. So for example, and this was flagged, if an emergency temporary receiver who's tasked with fixing the problems at the facility actually fixes all the problems at a facility during the course of their temporary receivership and the state therefore can't prove by the end of trial that a receivership is still needed, then in theory, a receivership wouldn't be granted and our concern is that would mean that ownership would revert back to a bad actor. And so our view is that shouldn't be able to happen that a receivership should be appointed if the complaint alleging that a receivership is needed is proven and then there's already a separate statute that provides for how a receivership is terminated. And basically it says that any party to a receivership preceding the defendant, the state, Dale, the receiver, him or herself can say to a court, we're done now, we don't need this. And that goes forward as a court proceeding. So in our view, that's the intended process for ending a receivership that the state has proven to be deserved. So one clean way to approach this might be that the legislature clarify that a complaint seeking a receivership should be judged by a court based on the merits of the complaint as of the time of the complaint's filing. If a court always does that, we're never in a position where a court's having to look at what did the temporary receiver do during the court's trial and what does that mean for the outcome? So that's item three. So lastly, let's turn back to item one. And I can speak a bit to item one, but my hope is that Pampota will be able to put me on the bones of this as well. So Dale has a range of tools it can use in addressing long-term care facilities of concern from simply requiring corrective action plans to imposing fines to banning the admission of new residents to revoking licenses to seeking receiverships. But generally before it takes or undertakes any of these actions, and this is by statute, it has to provide facilities with the opportunity to correct the problem at hand. But what happens, and we encountered this in the Pillsbury case, when there's no longer time or no longer reason to provide an owner of a facility opportunity for corrective action. And what if you're at that stage, but a receivership might not yet be needed. There's one statute that allows Dale to take what's called immediate enforcement action where Dale can use its enforcement tools, but it can just do so without giving the facility the opportunity to correct the issue in question. Dale can only do that where it's, and I'm just reading directly from that statute, necessary to eliminate a condition which can reasonably be expected to cause death or serious physical harm to residents or staff. So we as a trial team and Dale noticed back then when we were grappling with deteriorating situations at the Pillsbury facilities, and also in reflecting on the statutes now, that this statute that authorizes Dale to take immediate enforcement action doesn't reference mental harms as a valid basis for emergency action. And this is out of step with the needs of long-term care facility residents. So in the Pillsbury case, aside from the looming physical danger, the majority of actual harms the residents experience were mental harms. They were anxiety, profound anxiety and fear and uncertainty. The residents were so profoundly stressed by their circumstances. And as a window into that, I'll just share that when one member of our litigation team, this is Bessie Weiss, arrived at one of the facilities to announce that a temporary receiver had been appointed, she received a standing ovation. So Oliver Munner's requiring long-term care should not be in a position of cheering at freedom from anxiety. And in fact, one of the grounds for receivership and temporary receivership that we proved was in fact imminent danger of mental harm. So it's already in the receivership statute. And in the Pillsbury case, we relied on and won on those grounds, among others. So in item one, Dale's proposing and we support Dale in proposing the addition of mental harms to the list of legal bases for Dale's immediate enforcement powers under their statute. That would broaden Dale's tools and flexibility in addressing concerns at long-term care facilities. And again, I would leave it to Pam Coda to give more examples about wearing how that might come into play and be useful. So that was the only testimony I had prepared. I'm happy to answer any questions. And you are gonna submit that to Julia for us to come. Thank you. That was very helpful. Okay, great. So I have notes. Monica, and just of note, Monica's testimony is mislabeled as H611 when it does address this H635. So just for your clarification. So Pam Coda, licensing chief of for the division of licensing and protection within Dale. And honestly, Jamie laid the stage so well that all I really have to say is that we agree with Jamie. And to expand on the first item, that definition or the adding mental to why we can impose immediate enforcement action is important when we consider and contemplate how we're gonna approach various situations moving forward. So this Pillsbury receivership worked well because the facilities were making money. So receivership companies were willing to come in and take over. And write the ship. Yes, and they were, you know, they're profitable facilities regardless of whether they're collecting rent or not. So as the department and my division contemplates how to move forward with receiverships when the facility is not financially stable and doesn't have any capital to pay out of state or a firm or a company to come in to assume control. We're contemplating taking immediate enforcement action instead and so there have been situations where we have sought receivership in the past and it was pretty complicated because the facilities weren't making any money. So basically people volunteered their time because they were good natured people to come try to save these facilities. But moving forward, we need a different model than that. The state ended up having to pay for those receiverships prior to Pillsbury and so we're contemplating how to address these situations moving forward. And one of them actually did involve mental harm. So the residents were being verbally and mentally abused by the manager and we didn't have a way to seek immediate enforcement action because we didn't have the physical harm or risk of death piece. So it does get in the way when we're not allowed to seek immediate enforcement action when there's mental harm, which I could argue is just as important as physical harm in many aspects. So when we're dealing with a situation like that where we have a facility that is, where residents are being tormented mentally, but no, not physically, it would be very helpful to have this tool so that we can explore different options moving forward with facilities that don't have the financial resources to support a firm coming in and taking over through a court ordered receiver. And it's also certainly much less resource intensive when we're not seeking receivership through the court where we can take our own action. Now all this being said, we do not take immediate enforcement action lightly. Up until this point, we really haven't had to use it. So it's there, but it's not like a tool that we are using all the time. It is for very extreme circumstances, which hopefully don't happen very often because hopefully our homes are being run well with our current oversight. So that's really where the mental harm is needed. Not only does it give us a little more basis for the receivership action itself, but if we choose to not go the receivership path with a facility that is putting their residents at great risk via mental harm, it does give us some tools to use to try to either improve conditions very rapidly or to assist with transferring the residents successfully to somewhere else where they won't be in danger. It also got a little bit in the way when we were contemplating the Pillsbury receivership. I can remember sitting at the table and saying, wait, we don't have death or serious physical harm here. Can we even do this? When we knew that people were suffering and we knew that they were experiencing mental harm, I had to kind of put the brakes on and say, wait, we have only have authority to take immediate enforcement action when we have risk of death or serious physical harm. So it did get in the way. It didn't stop the process, obviously, as you know, it played out. But it was a barrier and a barrier that we really had to address as a team moving forward. So that's really all I wanted to add to Jamie's testimony. It was just a little more clarification on the mental harm, but I'm certainly happy to answer any questions. And looking at Monica's prepared, that has your suggestions for language for the bill itself. So if people want to look at that, it's under Monica and the list. So this is, obviously, we're going to spend more than 30 minutes on this bill, going forward, and if we are going to go forward. Any quick questions for Pam? I suspect you'd be willing to come back. I just have one statement. The definition of mental harm is going to be consistent with the mental health status. What do you mean by mental health status? I'm sorry. I'm just asking. Oh, yes, yeah, yeah. Of course, we'll try to make it consistent with any other state definitions of mental harm. I'm actually looking at it and it says mental harm means dot, dot, dot. So I think we still have some work to do here. There is. There's no one definition. So I'm kind of... I was trying to, I know at lunch, just speak to the whether you need to define mental harm at all. I don't think you need to define mental harm. The phrase already exists and is working in statute. It's already a grounds for receivership that we proved and won on. We went before the court, argued like you do for physical harm. It's just a term of our, and you have to prove it. So we said to the court, there was mental harm here. And the court said, okay, prove it. So we put on witnesses. We put forth evidence. And then it's ruling the court said the state proved mental harm. So it could be a really complicated radical to wander down and try and define that into the sense of the goal of the committee and the legislation and the policy of the receivership statute is to be as much probably protective of the residents as possible. I would recommend considering being open. Okay. Yep. I would agree with that. Yep. Thank you, Jamie. That's fine. Okay. I'm ready. One, two, three. I'm ready to go. I'm ready to go. I'm ready to go. I'm not a lawyer, so... Neither am I. Is there any chance that mental harm can be one person feeling mental harm or the whole place being mentally harmed? So is that written somewhere so that you're not getting calls or you can dale it saying, I'm being mentally harmed here? So that would certainly be, and we would take all of this into consideration. We wouldn't, so of course we take complaints about one person being mentally harmed. That's taken care of through our normal enforcement processes. We'd go out and investigate. We'd cite. We'd allow for correction. When we're talking about immediate enforcement action under the part of the statute that we are looking to change, it is about the whole facility. So if there's a practice where a majority or a great deal of residents are at risk for this serious mental harm, it wouldn't just be one person unless there was some extreme circumstance I can't dream of. I was just worried that you could end up with people saying, hey, I'm being mentally harmed. Yeah. We wouldn't interpret it under this part of the statute. We would use our normal processes for that. Thank you very much. Yes, thank you. You're very welcome.