SmartTranscript of Senate Health and Welfare - 2025-04-10- 9:00 AM

[Chair Ginny Lyons]: Alright. Good morning. This is Senate Health and Welfare. It is April tenth. And this morning, we're taking a look at our for the budget areas for which we're responsible. We've got joint fiscal here to help us go through what is what is currently in the budget and stated some of the asks that are in the budget that haven't been funded, some of them that have been funded. And then tomorrow is a it's a bigger day when we look at all the [Member Larry Hart]: some [Chair Ginny Lyons]: of the folks who would like to request of us their support. I'm gonna turn it over to two of you. Do you know everyone in around the table? [Witness Emily Byrne]: I don't know. I know. I know. I know. It's not a problem. [Chair Ginny Lyons]: Not at all, babe. So I think you Senator [Member Larry Hart]: Hart from Orange County. That's [Chair Ginny Lyons]: me. Yep. [Witness Nolan Langweil]: I'm senator [Member Larry Hart]: from Orange County. Yes, sir. [Chair Ginny Lyons]: So good. So go right ahead, and we'll look at our spreadsheets and listen. Great. [Witness Emily Byrne]: I'll just do I'm Emily Burton. I'm a deputy fiscal officer for the joint fiscal office. I spent most of my time at the appropriations committees, hoping to work on the budget. And Nolan, who you all know Yep. I'm here as, like, support. No one's gonna help. [Witness Nolan Langweil]: Keep my reinforcement. [Chair Ginny Lyons]: You are our support. [Witness Emily Byrne]: Turn it over to Nolan. [Witness Nolan Langweil]: For the record, Nolan will have joined this call office. What we're gonna share today is a snapshot of the sheet that has been used in the Appropriations Committee that just sort of shows the difference in some of the governor's proposal, what the house did, the difference of them is. Some of these, we can go into detail, but because I know about them. Some of these, I don't know what they are, and I I can't provide the detail. And I would recommend if you want more information that you have, the department, the agency, the advocate, the whoever, then so to the best of our knowledge of what we know what it is, I will explain it to you. But if I don't, differ. So let me share my screen. This is on the website, and there's two fish it's two pages. So the first page is Art Base, Fund Appropriations, and the second page is OnePath. So the first thing you'll notice on all these these are all so this I'm not not to go into it with the how the budget is laid out in your a section, b section, c section. But the b sections, the what you need to remember is the three hundreds. And every one of the three hundreds are agency of human services. And then the Green Mountain Care Board, and you have some other small things. But usually, that's where you find all the health and human services related things. The large version of the sheet, which Henley has over here, is, like, every section one hundred through five or six hundred. Forget it. [Member Larry Hart]: Nine hundred. [Witness Nolan Langweil]: Nine hundred. We're just gonna do three hundreds because that's the area of your jurisdiction. So I'm gonna walk you through the sheet. Like I said, the best of my knowledge, I can explain each of these. Most of them I can. Some of them I can't. But this is really more to highlight, like, what's in the budget? What are they up to now? The other thing I wanna point out is that if it's a dash and so the the changes are always changed from base. So on the left side, if you see the governor prints the first slide, you see the governor added twenty nine million dollars. That's off of the current base line. So he's proposing additional, you know, twenty nine million per we'll say, GCPenex. The house, as I see, concurred. And so there's zero difference from the governor. Whereas the next one, without going into detail at the moment, you can see the governor didn't do anything, and but the house proposed adding four million dollars. Just to give you a sense, and then the far right shows you that's different from the governor recommendation. This is just to help situate you so you understand how to read this particular sheet. It's kind of like an what we call the ups and downs. This isn't the ups and downs, but in a similar format of up or down from base. [Witness Emily Byrne]: Base meaning the FY twenty twenty five outcast budget. Okay. Yeah. It's the starting point for building a ton of expense budget. [Witness Nolan Langweil]: And then the second page is one time. So that's just so those are not things. Those are just with revenue, the extra money in the budget to be able to pay for things that would be just for this year alone. [Chair Ginny Lyons]: Okay. So we're, I guess, zeroed out. Doesn't mean there's no money. It just means there's no additional money from us to Correct. [Witness Nolan Langweil]: If we were to tell you every work where the money is for everything, we would be here for weeks. That's what the appropriations committee does. They talk about here's what's in the budget. Here's what's in the base. They go in detail about what their base budgets are, what's in them. We're not talking about we're talking about the changes. And so with your committee, I think with the vision, I assume, is here is to to get a sense of what were the new proposals the governor proposed, what did the house do in terms of doing it or not doing it, and then the final thing of what are you gonna do? What are you going to recommend to the Appropriations Committee? And you may recommend things that aren't on here, and that's your priorities. And that'll show up as and when it goes onto this sheet, it'll be a a dash in the gov, a dash in the house, that add in the senate. So so with that context, I will start. So the first thing is and then and I will tell you what the acronym is in the beginning. So AHSCO stands for Agency of Human Services central office. And this first thing, global commitment metric. This is what everyone calls the mix and bold. So throughout the ups and downs and the new additions, a lot of them are global commitment matched. And so as a result, this is where it gets matched. Not to go into detail of how global commitment works, but it'll show up in the other departments often as gross or [Member Larry Hart]: Yeah. [Witness Nolan Langweil]: These are all general fund. This is just the general fund share. But then that's where it gets matched with the federal balance. So if you change the top below, then that that the global commit match would change to the extent that that is global commit matchable. [Witness Emily Byrne]: And for this this first one, this twenty nine million dollars seems like a big number. The majority of that number is really just the changes in caseload and utilization that are projected in the Medicaid program from FY twenty five to FY twenty six. So it's really there's a consensus process between the joint fiscal office and the administration to determine, like, you know, there's it looks like Medicaid trends are showing there's more kids in the program. There's fewer, you know, people in this category. It looks like services are growing here. It's sort of we go through all of that and try to project what Medicaid spending will be in the future. And so that twenty nine million dollars is really just a reflection of what we think increased caseloading utilization. And then this year, it's mostly increased utilization, will be in the Medicaid program in f y twenty six. [Witness Nolan Langweil]: So the next one is the the federal it says MASH, so that's the general fund share for the FQHC rating fee. So the house to the the governor did not propose any changes for rec UHCs. The house heard testimony from five state that they wanted a rate increase, and so the house gave them a four point well, it's ten point seven million dollar increase, and that's four point four two in general fund. The next one also is [Member Larry Hart]: I I [Chair Ginny Lyons]: jump in on the [Witness Nolan Langweil]: second one. [Witness Emily Byrne]: So one thing on this one that we've heard from the agency of human services might be something for this community to explore is whether or not this needs to apply to both FQHCs and RHCs, the rural health centers. Mhmm. And my understanding, and I think this is good thing for the committee to find out, is that it has to apply to both. It can't just apply to one, And we've heard sort of conflicting information. So that's something that should be clarified and then the senate and be ready [Speaker 4 ]: to figure that out. But I [Witness Nolan Langweil]: think that this number actually includes the rural health centers. [Chair Ginny Lyons]: I think it does. So it's [Witness Nolan Langweil]: it's just which should say, say, match for FQHC and rural health. RHCs. Yeah. RHCs. Thank you for the clarification. The next one is rate increase for family planning e and m code. So the e and m stands for evaluation and management. This is, as you know, hospitals use or providers use different codes for the specific services that they provide. So this would be a rate increase specific to this family planning d and m code. This is an app from planned parenthood. It gets a ninety ten match. So it's eighty six point o nine. It's eighty five thousand dollars because it's rounded, and that would draw a total of eight hundred and fifty thousand dollars global commitment. So the house decided to do that. Next one is home and community based service rate study. So this was there was a study in twenty twenty three done by Dale that looked at a lot of the choices for care home and community based services, and and it was to to show how much money would be needed to bring those rates for those particular providers up to the twenty twenty three levels or twenty twenty four. I can't remember. And so they decided to fund that particular piece test. The ones that are in there are ERC, which stands for [Chair Ginny Lyons]: presentation. [Witness Nolan Langweil]: ERC stands for enhanced residential care, and then there were some other choices for care providers that were in there as well. So that's those are the folks that are getting that. I don't know what that represents in terms of a percentage rate increase. They this came from human services committee, and it was this is how much money would be needed to bring them up to that level. Alright. So which one are you talking about? Talking about the home the [Chair Ginny Lyons]: Community providers rate increase. The one above the FedEx side increase. Yeah. I don't I don't know what percentage that is either. [Witness Nolan Langweil]: Yeah. I don't know. So but it it's grosses up to about six point eight million dollars. It's two point eight million dollars in general fund. The next one, the community rate providers, is a two percent increase for specific well, it's most of the home and community based providers, but not all of them. So there's this is where it gets a little confusing. There is a little overlap between the folks who are gonna get the rate study and the two percent. But, mostly, this is the this was a group of non home health agencies, I think. No. Remember who got this. [Chair Ginny Lyons]: I think of we're the we'll we'll probably be dealing with that down in appropriation, but I think they left out adult day. [Witness Nolan Langweil]: No. Adult day is in there. It's just that the question is whether it captures all adult day. The way we have it in the budget Yeah. Is that it goes through sections of the budget. So this this actually is in multiple sections. You can see it's a b three zero one, three fourteen, three thirty. That's because we have agencies that provide this here. For instance, DAs and SSAs, There's they they provide services to mental through the Department of Mental Health. They have stuff through Diva. They have stuff through Dale. So they go across multiple parts of the budget. So in the budget and the ups and downs when you're going through it when in the or down the hall, you're gonna see a rate increase in the one section. Now the rate increase, this goes across multiple sections, but this is the total rate increase across all those. And it didn't it does include I'm right here, actually. ACCS, which is assisted community care services, that issued the providers, substance use disorders. We have DAs, SSAs, adult day, AAAs, SLPs, which stands for shared living provider, TBI, which is for traumatic brain injury, personal care services, homemaker, respite, etcetera. So those are the different providers. Actually, the last one I think it's the other one. Anyways, those are the providers that are covered. I know I've spoken with Jill Olsen. I know she had some concerns that there were some groups that may be left out. [Chair Ginny Lyons]: That was what I read last night or this morning, and I think she thought adult day was out. So right. [Witness Nolan Langweil]: Adult day is in. The question is whether all the adult days Not all. Things are in. And that's a I would recommend if there's if there's somebody left out, I recommend that if you talk to Jill or other advocates to help understand that. But this is [Chair Ginny Lyons]: We are not gonna talk with anyone. We've been listening to who we've been presenting. It is normally Got it. Got it. That. [Witness Nolan Langweil]: Okay. Thank you. Now the next one you have is the two one one increase. This is for the global COVID three hundred thirty two thousand. It's a hundred and forty thousand dollars. General fund, I actually don't do you know what two one one one? [Chair Ginny Lyons]: It makes it twenty four seven. Thank you. [Witness Nolan Langweil]: So the next one was, the governor recommended these recovery campus. It was, one point five million, total gross and six hundred and twenty thousand dollars in global commitment. The house felt that they didn't have enough information. They felt that the agency did not provide them with enough detail to understand what it was and it didn't meet their priorities. So they chose to take it out. That's why you see it's neg why you see there's nothing in the house and that's negative six point six two. So that just shows that's the difference from the coverage. Right? [Chair Ginny Lyons]: So there's actually a total of one point five for all of this? Some of it's base and some of it's one time? [Witness Nolan Langweil]: No. One point five is the total. That's total. Federal. [Witness Emily Byrne]: There is fake one time money as well for [Chair Ginny Lyons]: There is one. Oh, that three hundred thousand. Okay. [Witness Emily Byrne]: Okay. But But it would have it's we'll come in that manual, so it would have drawn in federal by law. [Chair Ginny Lyons]: I did ask for language on this, and I'm gonna take that language into appropriations for the discussion. I think this committee has always been supportive of having expanded services. We did x thirty six, and we understand the need for some mid level recovery residences. So we'll we'll take that and look at that. Thank you. [Witness Nolan Langweil]: I'm gonna skip this next one if we go to aftercare navigators only because that is tied, minus things, that's tied to the recovery canvas. Yeah. So I believe that it's a separate line, but it's tied to that total initiative. And that was that's again, that's why that one was taken out as well. And then the right above it, the reengagement beds withdrawal management Alright. They just matched the governor's recommendation on that. Next, we have DMA, Department of Mental Health, and it's alternative to emergency beds. Again, the house concurred with the governor's recommendation for three hundred and sixty thousand dollars for that. The next one is the Howard Center commute next two, actually, are Howard Center. The community center outreach, and then the embedded clinicians' first call. So the governor had reduced spending for this by a hundred and sixty I think a total of four hundred and twenty thousand or thirty thousand put in two of them. And you could see that the the house Put it back. That's why it's dashed. So the dash means that they that the house actually put that back in. So it's not an increase from base. It's it's just getting rid of the elimination of it. So the house chose to add back the reduction for that. And then for the embedded clinicians, they added some of it back. Add back two hundred and fifty thousand. So it's a twenty thousand dollar reduction versus the total two hundred seventy five dollar reduction from the governor. So they added back again, they added back to Howard Center, and they added back most of First Top, not all of it. The next two are CCFAP, and this is tied to this gets complicated, and Emily jumped in to help me explain it if needed. But, basically, there's a sense that the the caseload so we we built projections of what we thought the CCFAP. This is the childcare program that we passed two years ago, but now and we made estimates on how much on how many kids we thought would be in the system and what the spending would be. And tied to that is payroll tax. So what happens is is that in the the the projections or consensus, it's based on its time was based on less not having experience of what actually actually happened or what's happening on the ground. So last year, I think the the utilization was off even more than it is this year. We're still trying to dial it. It'll take about five years for us to really kinda figure out what that kind of utilization could do. So you have case load savings of three hundred and three point five million dollars, which means we the case load's a little bit less than what we thought could be. And there's multiple reasons, but I won't get into that. But we concur JFO concurs with those estimates or believe that they're reasonable. We have no issues with that. So what they've done the next one is is it this is it's we have it as a a fund shift. So, basically, as a result, there was extra money from the payroll tax. And, by the way, we always knew that the timing of the payroll tax would be different than the timing of the rollout of the programs. So we always knew in the beginning there would be excess payroll tax because of the timing of when you put a payroll tax in and how it comes in versus the expense. There will be a point where it does this or at least, hopefully, does this. But right now, it's doing this. And so what the administration proposed was, since there was extra payroll tax, let's use the they want the proposed use the payroll tax to pay for the program, bring up general fund. Because right now, CCDF is a mix of payroll tax and general fund. So they backbilled the general fund with payroll tax to pay to to free up general fund to do other initiatives within the program. [Witness Emily Byrne]: And I think the the payroll tax can only be used for child care to the extent the state is collecting those dollars and they're sitting in that special fund. The proposal, and the house accepted most of it was to utilize those dollars that are being collected rather than have them just sort of sit in the special funds, put them to work. So the nineteen million dollars was the administration's proposal in terms of and the, payroll tax number is adopted by the emergency board as part of the consensus revenue forecast. So it's Some water. Consensus revenue number for that piece. And the change that the house made, they decided that to invest some dollars into infinite toddler rates to increase them by four point five or five point four point five percent. Yeah. What? So that means we have to put a little bit more general fund back into the program. So they propose to take nineteen million out. We're not gonna take we're or to shift the full nineteen million. We're not gonna shift the full nineteen. They need another home it's this number actually is off a little bit. If the senate agrees with the house is proposed, it will have to increase the number slightly, to about five hun five point one million dollars. But that was that's the sort of there's a couple things going on in [Chair Ginny Lyons]: that line item. I'm assuming this is the source of the rash of form letters I've been getting over the last twenty four hours stopping the governor's systemic defunding of child [Member Larry Hart]: care. Right. [Chair Ginny Lyons]: I I can't think That's a so, yeah, what else it would be? [Witness Nolan Langweil]: The advocates would like to see the money going to a special fund and be used there. And sit there and be I wouldn't use that terms, but be used in the future [Member Larry Hart]: Yeah. [Witness Nolan Langweil]: For needs or rate increases or specific to the child care program? [Chair Ginny Lyons]: It's not just the advocates. I think that there's some strong sentiment on the part of the appropriations committee members that the childcare fund not be rated on a regular basis. That would be nice. But this would be a onetime event in doing that. Yeah. [Member Larry Hart]: Thank you. [Witness Emily Byrne]: Well, I think, you know, it's important to what's happening with this [Witness Nolan Langweil]: Right. [Witness Emily Byrne]: Meet like, the program is still fully fund. So they're Yes. [Chair Ginny Lyons]: We got it. [Witness Emily Byrne]: Resources needed to fund. Like, program that exists in statute today is funded with what the how the house's budget. [Witness Nolan Langweil]: One of the compromises that happened in the house, though, is rather than create a a special fund a new special fund to put this into, they changed the language around the caseload reserve to be able to be used for childcare as well. That was sort of the compromise they found time because there was still a need for within their initiatives to find a general fund. So but there was no new special fund created specifically as a reserve or there's no reserve created for CCM. The next is OEO. I don't remember Office of Economic Opportunity. This is the HOP grants. So this is part this there's some overlap with h ninety one. This is this goes towards housing and shelter and temporary housing. The governor proposed an an increase of three point three five. The house concurred. Conflict and free case management. Again, governor proposed one point two nine at the gross, that's six hundred forty thousand in general funds and the house concurred. Same with Pathways for partnership. The cost concurred with the GovRec. Vermont the VBA sends Vermont's veteran home, and there's a rebase in the budget at five point seven one. Again, cost concurred with the governor recommendation. The last one [Witness Emily Byrne]: On that one but the veterans home has had to have some pretty significant budget adjustments in the last couple of years. The hope is that by making this adjustment and putting this money into the veterans home, that they won't need that budget adjustment going forward that this will sort of reset them to a more sustainable level. [Chair Ginny Lyons]: When you're talking [Witness Nolan Langweil]: about budget adjustments, are you referring to infrastructure costs? We've we've been discussing a lot of why institutions from the. [Witness Emily Byrne]: No. They're they just need a budget adjustment for their operating Operating costs. Yep. Okay. [Member Larry Hart]: Okay. Gotcha. [Witness Nolan Langweil]: The last one on this page is is the expansion for a head. This is basically the Green Mountain Care Board had saying that they need five positions in order to implement the head model. And in the budget, the governor or the governor proposed three positions. So you have more positions in your h one s one twenty six. But that's what this is, three hundred thousand rupee for three positions with agreement with CarePoint to implement the head file. Oh, yeah. Good. [Member Larry Hart]: Alright. So So and and [Chair Ginny Lyons]: just FYI, there's been a lot of conversation in appropriations on many of these things here. So if you have a specific interest, you should bring those up tomorrow. Other but I think a lot of the conversation will continue down the hall upon these as they came to us. [Member Larry Hart]: And the the last [Witness Nolan Langweil]: thing on this page, sorry because I haven't spoke that way. They left money in the budget. So the h ninety one, which is in this committee now, the emergency temporary housing temporary emergency temporary shelter bill passed after the budget, but they left ten million dollars on the bottom line to fund the one time appropriation that's in h ninety one. That's the money that's gonna go that's in the budget to go to caps. And I know that this committee will discuss what that appropriation should be within our bill, but the house left ten million on the bottom line to fund this bill. [Chair Ginny Lyons]: And we heard yesterday from the caps that it could be it might be six point five. So we don't know. [Witness Nolan Langweil]: K. So now we're gonna move into one time. And all the one times of the are in with all the eleven hundreds. And then the e or the f, that's just how they're numbered in that section. The business model where all the one time funds are. [Chair Ginny Lyons]: So, you know yeah. And the base funding is important, but it's also a balance of moving things around to keep the base budget neutral as much as possible. Now our I think our our most of our interest is here on the ground time page Yeah. In this one. [Member Larry Hart]: Okay. [Witness Nolan Langweil]: So first one is so the governor's recommendation had ten point eight million dollars for blueprint and SASH, and this is basically to backfill the loss of Medicare's participation. So when the all payer model ended under the all payer model as part of the agreement, we were get the the federal government was Medicare was contributing blueprint payments to primary care practices. And so the end of the all payer model and beginning of ahead assuming that whatever head agreement would allow for the continued payment of participation of Medicare. But in that gap, which is how many months if if that had even happens at this point, there's at least a year gap. And so they proposed backfilling the loss of Medicare participation with state dollars to kind of keep the flow moving to help those practices. Now in this, it's one time, but I believe we're using full recruitment investments. So we are navigating federal match, but I don't believe that is the long term plan. The plan, obviously, would be now if ahead doesn't happen, that becomes a conversation for next year, what do you wanna do around those credit and cash. But that's what this proposal is in the house concurred with the double d recommendation. So, again, this is actually ten point eight billion. That's four point four five general. Oh, this one shouldn't be here. Fire after. [Chair Ginny Lyons]: I know. That was that was in the last one. So it was true. But we'll just we'll just look at it and say, isn't that interesting? Yeah. [Witness Nolan Langweil]: I when it went I went through the one time, so I tried to delete all of the nonones that would be here. This was a a null and error. So Okay. [Chair Ginny Lyons]: But it's a fun thing. We're gonna get [Witness Emily Byrne]: a fire you know, proposal to give the FPR a fire apparatus. Yes. [Witness Nolan Langweil]: There's a fact for [Member Larry Hart]: us to go on. [Witness Nolan Langweil]: There's governor recommended four hundred eight thousand dollars per PCB testing at [Member Larry Hart]: the health [Witness Nolan Langweil]: department, and the house reduced that by fifty percent. Again, we have a pilot this is a one time cost associated with the pilot recovery. This is five hundred thousand. Again, the house had eliminated the whole recovery campus setup. This was one time start cost. [Chair Ginny Lyons]: Oh, we went we went right over PCV, but that really I it is in the Department of Health, and there is a lot of discussion going on down the hall with education folks and others. So we'll just we'll put that one aside for us in here, but it is I know that it's important to folks in [Member Larry Hart]: the room. K. Right. Next, we [Witness Nolan Langweil]: have empty arms. I believe this is to help bereaved parents who lose newborns. They heard the house I'll prepare her testimony, compelling testimony, and they had been asked for forty thousand dollars. So they the house had it in. We have three hundred thousand dollars for recovery residences. I will flag that there's also three hundred or three hundred and fifty or six hundred, I can't remember, in h two eighty one, which is the opioid bill, which is in this committee. So there may be some overlap between here and there. So just flagging that, I don't know. I [Chair Ginny Lyons]: I don't know whether the money for these are coming if if this money is coming from the settlement fund or not. [Witness Nolan Langweil]: This is not. This is Yeah. This is general fund. [Member Larry Hart]: This is [Chair Ginny Lyons]: all general fund. And I know there's been conversations about that. [Witness Nolan Langweil]: Yeah. My point is that Yeah. It's in the bill, which is settlement fund in two eighty one, and it's here, which is general fund. So it's in twice. Now I I can't tell you [Member Larry Hart]: what [Witness Nolan Langweil]: the difference is on that in two different places, two different appropriations, the same thing. Good to know. Two million dollars for shelter capacity expansion that the the house concurred with the government recommendation. The next one is very much tied to h ninety one. This is the thirty point five million for the GA emergency housing. So politics, I know there's been all the conversations around BAA. This the governor's recommend is the current program. The current program that we have for twenty five with the adverse weather conditions and the eighty days and eleven hundred beds that was in the current year as per policy absent the executive order. The proposal was the same program for twenty six, and the house concurred with that with the idea that they were going to be doing h ninety one, which focuses on fiscal year twenty seven. So the idea was okay. They're they didn't touch it in the in the in the budget. They addressed it in h ninety one, which is not focused. The only thing in twenty six is the ten million dollars to have to help the task move into the new program, which was starting twenty seven. So this is the thirty point five million dollars, and it's one time. But even though it's every year, the last couple of years, it's still considered onetime and not base. [Chair Ginny Lyons]: And I [Member Larry Hart]: never mind. [Chair Ginny Lyons]: Say it again. Bye. [Witness Nolan Langweil]: The next one so I keep looking up Linda because my stepdaughter took her driver's license today. And I could see them far sitting over her top [Member Larry Hart]: of the tree. [Chair Ginny Lyons]: Okay. Great. [Witness Nolan Langweil]: And I and I just got a I just got a text that she passed. So I'll just switch over That's that's the first one. That that gold one. Anyway [Chair Ginny Lyons]: sorry. Nice work. [Member Larry Hart]: So I've [Witness Nolan Langweil]: been kinda watching all day. I'm gonna fly and be sitting right here. I can see it. Alright. The next one is Indeeda, Department of Vermont Health Access. This is comprehensive payment reform. I actually do not remember what this is. Do you, Emily? [Member Larry Hart]: Yep. Okay. [Witness Nolan Langweil]: I've been light Fisherman [Chair Ginny Lyons]: Primary care. I think we're gonna hear about this tomorrow. We're we're good with it, I think. But it is important. And this is is this general phone match? [Witness Nolan Langweil]: No. This is Yes. Just general fund. It's a good question. [Chair Ginny Lyons]: Well, we will have match. [Witness Nolan Langweil]: It probably is matched. Not in this letter. I assume it would be. I don't have it on this sheet. My other sheets, it was held. [Chair Ginny Lyons]: I have the sheet on it. Okay. [Witness Nolan Langweil]: Then we have the OneCare primary we have the OneCare primary care transition. This is to sort of help primary care practices. As OneCare sort of winds down, I believe this is tied to blueprint dispatch now. [Chair Ginny Lyons]: Well, Blueprint is up above. [Witness Nolan Langweil]: No. No. But there was more [Chair Ginny Lyons]: There but well, there's a whole there's a whole need because OneCare is going away. They're just payment from OneCare. Pay for the year of twenty six before a head comes into place. So we're sort of doing a transition and covering the loss of funds from OneCare. So it's like a ten million dollar primary care total. Gotcha. Gotcha. Gotcha. [Witness Nolan Langweil]: Yep. This last one is for HomeShare. I don't know anything about HomeShare, but the house funded two hundred forty thousand dollars with that in the governor directly, [Member Larry Hart]: which is a neat program. [Witness Nolan Langweil]: And then the last one is that this day, there was h four seventy two. There was additional positions at the secretary of state's office around executive office of mental health professionals, but it would cease in the future. So I think this is a new bill. And what happens often is that when you start a new program, it's just for the secondary state's office, there's new fees, but the fees don't come until later. And so this is to help them pay for the the the work they do in the first year, and then going in the future, the fees will actually cover the cost. But they don't get the fees right away, so they have to have some money upfront to be able to do the work. We do this all time with secretary of state's office when we do things. We'll fund them and put general fund for the first year to get it off the ground. And then going forward, they're able to use the fees to pay for the state. [Chair Ginny Lyons]: Did this bill go through go up? So is that bill has that bill gone through anything here? [Witness Nolan Langweil]: I don't actually remember what bill this was. I was told if I was [Chair Ginny Lyons]: h four seventy eight. [Witness Nolan Langweil]: No. No. I know that. I don't remember if I worked. [Chair Ginny Lyons]: Oh, no. I I don't [Witness Nolan Langweil]: think I worked on this bill. So I don't [Witness Emily Byrne]: I know. [Chair Ginny Lyons]: Yeah. I know. [Witness Nolan Langweil]: See, I didn't work on this bill, so I don't remember. Yeah. [Member Larry Hart]: I had a couple. Okay. [Witness Nolan Langweil]: She's similar to her, [Member Larry Hart]: but he [Witness Nolan Langweil]: doesn't know about the bill, and he's on the bill. [Chair Ginny Lyons]: We'll find out. Yeah. It'll [Witness Nolan Langweil]: be come up. And that's what we have on our sheet. [Chair Ginny Lyons]: I have comments. Oh, good. You want me if you wanna hear [Member Larry Hart]: them? Yeah. [Speaker 4 ]: Okay. Mhmm. [Chair Ginny Lyons]: But one moment, last question. So we're gonna save our anyway, go ahead. Save our anger and ire for another time. We're gonna let them do [Speaker 4 ]: this right now. Can can y'all speak to why the PCB testing money was cut in [Member Larry Hart]: half? No. [Speaker 4 ]: Okay. Well, then I I need to say that I completely oppose this. The PCV testing was a program put in place by the legislature. They had the opportunity to pause it multiple times and refused. It has been very deleterious to school districts to have to navigate the testing, which was not only problematic to the functioning of the school and the teaching of the children, but has cost a lot of money. So the money that is not paid that is rebates in here will be on the backs of the [Chair Ginny Lyons]: districts, which will be on the ed fund. [Speaker 4 ]: And we're trying to do education transformation, and this is really problematic. And I'm sorry [Chair Ginny Lyons]: I'm looking at you. Yeah. I really like [Speaker 4 ]: I I tell I wanna [Chair Ginny Lyons]: I wanna I wanna assuage her concerns that this is a conversation that, senator Bruce has also brought up in appropriations. And I think that you will we should we can talk further, but I think that you will be fine with the final output. We're gonna [Speaker 4 ]: ask the schools to do things we need to support them. You got it. Otherwise, we shouldn't do it. [Witness Emily Byrne]: I think for context, at least, some of the conversation in the house that I heard was that they had asked the administration for some additional information in terms of how many schools or what this what the money was gonna buy, and I don't think they ever got an answer. [Member Larry Hart]: Okay. [Witness Emily Byrne]: So I think part of this was also prompted. What you know, it would be good to know, you know, how how many schools and how many tests. Like, all of that sort of detail was not, I think, presented to the satisfaction of the house preparation side. Okay. They changed [Speaker 4 ]: the number. I'm all good. Thank you. But I I stand by what [Chair Ginny Lyons]: I said. Well, this is an important message that I can say when we're done. [Speaker 4 ]: Thank you, senator. I appreciate your loyalty. [Chair Ginny Lyons]: Okay. Now excuse us for a minute. We need to take a break. No. No. It's Javier. Where is it? Oh, the car. [Witness Nolan Langweil]: They're just standing outside the car. I think I bet she's taking pictures. [Member Larry Hart]: Should we [Chair Ginny Lyons]: all stand in the bottom of the window? It's really embarrassing. [Witness Nolan Langweil]: No. She can't hear us. We can all go out there. [Chair Ginny Lyons]: We can all go out. [Witness Nolan Langweil]: Sing to us. So love that. Sorry about this. It's good news. [Member Larry Hart]: Watching family [Chair Ginny Lyons]: real time. Okay. So Well, fantastic. Questions for our joint fiscal. Yes. Well, I know it's for joint fiscal. I was told that I think it was buildings and general services had paused all the testing in face of doing education transformation because we weren't sure what buildings would be open. So I don't know. That's several steps down the line, and maybe they restarted it. Okay. But my source is one of the companies that's doing the testing. Oh, what was Well, my thinking at while we're doing money, just the event that I think there is testing going on, and there's certain certainly funding for it currently in budget. Yeah. So the budget need to speak further. Right? And that it's it's kinda not our jurisdiction, but it's our jurisdiction because we all have schools that have these problems. And it is a public health issue. [Member Larry Hart]: Yep. We don't but it [Chair Ginny Lyons]: would just be nice. It would be nice to know it while we're appropriating money if they're actually You got it. Spending. [Member Larry Hart]: That's [Chair Ginny Lyons]: what and I think that senator Dulick would probably agree with you that this is not too [Member Larry Hart]: all coming. Alright. Attention. I'm trying to take pictures. It's too far away. Sorry. I'm taking attention. [Chair Ginny Lyons]: Any other questions for Nola and Emily? So appreciate you're going through it. And and so it's it's a lot. If you're if we if you haven't heard this before, it is a lot. And there are a lot of things, looming parts right now in the big old discussion down the hall. I think our goal tomorrow is to look at what are the one time requests and then how do they fit in with our priorities. So and I that's where we'd be spending our time. And if you have something that you feel strongly about on the base funding piece, we can follow-up with that. I know, obviously, GA program, h ninety one, that's in here big time. We'll be looking at that together. And then we have s one twenty six, which relates to the Greenmount Care Board request for for positions. And then AHS is also in one twenty six. So when we look at our one time and our priorities tomorrow, I think we should probably include the bills that we passed out that have funding because they that sets a priority when you go to bill. [Witness Nolan Langweil]: And two eighteen, understanding if they're [Chair Ginny Lyons]: And then we have a two eighteen, which is a [Witness Nolan Langweil]: Shift of recovery presidents during the one time also. Yeah. [Chair Ginny Lyons]: So we'll and we're gonna we have that on Alright. Agenda today. Yeah. So we can and I'm hoping we can look at it and told it out. Should I? Yours. Yeah. [Member Larry Hart]: I think you have an [Chair Ginny Lyons]: We'll at least walk through it and vote it out tomorrow. I'll vote it [Member Larry Hart]: out tomorrow. I think we'll just work out. Yeah. You know, Alright. [Chair Ginny Lyons]: Other questions? So just as a reminder, and and, like, Nala and Emily can help with this. One Care is gone. And we so we are between Mhmm. Payment reform models from in twenty six. So there's a loss of funding in particular for primary care during that time. So the loss of what? Is it ten million dollars total or something? Two million dollars. For in the gap the gap year called the gap year between [Witness Nolan Langweil]: Well, it's dependent from what? From one pair, there was the four million of you or whatever? [Chair Ginny Lyons]: Right. So I'm thinking primary care, but there are gaps in there that are embedded in the in the budget and trying to cover those gaps so that people don't lose the services that they need before if and when a head model goes forward. Oh, that's important to us. [Speaker 4 ]: Are we good? Great. Thank you. [Chair Ginny Lyons]: I really appreciate the work that you've done to bring this to us. Very helpful. And so tomorrow, I hope they're doing more work for us. Mhmm. I know. Okay. We'll see you tomorrow. Why don't you take a little break until ten?

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