Vermont Legislature SmartTranscripts:

[Rep. John O'Brien (Member)]: When we were on here in November,

[Rep. David Durfee (Chair)]: we heard at least from one, maybe two witnesses about the Bridges to Health program, which has been sort of off of my radar, I think off of this committee's radar. The health committee spent some time, I think, learning about it over the past few years. Was new to me, and I'm not gonna try, I'm gonna leave it to our witness to explain a little bit more about that program and also why she's joined us this morning or asked to join us. So good morning and welcome.

[Anore Horton (Executive Director, Hunger Free Vermont)]: Thank you so much, Chair Durfee. Thank you, members of the committee, for fitting me in last minute. I am Anora Horton. I'm the executive director of Hunger Free Vermont. And I'm here today to express Hunger Free Vermont's strong support for including $167,700 in the FY 'twenty six Budget Adjustment Act in support of Bridges to Health. And what this funding is specifically for is to allow Bridges to Health, the Bridges to Health program, and I'll say more about what that is in a moment, to transition from its current home as part of UBM's extension program. But UBM is no longer willing to house the Bridges to Health program. And so a number of organizations have been working in support of finding a new home for Bridges to Health. And Hunger Free Vermont is one of those organizations. And that is why I am here today. And I'll explain a little more about the connections there as well. But Vermont's free and referral clinics have agreed to re home the Bridges to Health program. And this funding is really critical to make that transition possible without an interruption of Bridges to Health's critical services. So Bridges to Health is a health outreach and care coordination program for migrant and immigrant workers and families across Vermont who are not otherwise served by existing programs. So this is the first really important point that I want to make. These are non duplicated folks. They would not have anywhere else to get connected to health care and other critical services that include things like transportation access and food access, which is why Hunger Free Vermont is really, really concerned about the continuation and the continued existence and strong functioning of this program. So Bridges to Health ensures that essential immigrant workers and family members in agriculture, the building trades, and the service industries have timely access to needed health and health related supports. There are eight regionally based community health workers who staff Bridges to Health, and they meet a wide range of needs that are identified by these immigrant and migrant worker communities that they serve. They engage well over 1,000 individuals a year, and they work one on one with families and with households to navigate an increasingly complex and complicated health care system. Bridges to Health community health workers have trust and rapport with their clients, employers, volunteer drivers, volunteer health providers, and community based organizations. And that includes food shelves and food pantries and congregate meal sites and making sure that children in these families are connected to summer meal programs. And again, these members of our communities who are not eligible for many of the federal food programs. But they are, we know from our research and our own community outreach through our eight regional food security networks, we know that this community is the community most at risk of experiencing severe hunger of all of our different vulnerable communities in Vermont. So these are kind of trusted relationships that have been built over time and connections that directly address systemic and individual barriers to care and ensure that as many people as possible can access needed health care services. And I think it's also really important to note that if these thousand plus folks, adults and children alike, don't have a trusted way to get connected to free sources of health care and food that are safe for them to use, then they're going to end up ultimately in a hospital emergency department that's already overstretched. And or they're going to be too afraid to access those services and they're not going to get care at all. And both of those outcomes end up being extremely problematic and extremely costly for our communities, our farms and our state.

[Rep. David Durfee (Chair)]: Sure. Representative O'Brien, do we

[Rep. John O'Brien (Member)]: know how many children are in the community?

[Anore Horton (Executive Director, Hunger Free Vermont)]: I think that Bridges to Health may have that data, but I do not have it at my fingertips this morning.

[Rep. Richard Nelson (Ranking Member)]: Representative Nelson. I always thought of Bridges to Health as being more of a health care. And I have limited experience, all positive for bridges to health and I have limited experience. I always thought that ate pretty good, because they make their own, I mean, but anyway, it surprises me to hear about the hunger issue. Is that a smaller percentage than the health issue? The health issue was very concerning to us, and I understand, and I won't say why that's changed, but we know and I support it. I was surprised to hear the food part of it.

[Anore Horton (Executive Director, Hunger Free Vermont)]: Well, I think that's a really good question. And yes, I mean, within this group of folks that Bridges to Health serves, I think there's just a wide range of experiences. So not everyone who makes use of Bridges to Health's connection services to health care is also experiencing hunger, but some are. And just in general, we know that Vermont's immigrant and migrant population is a population that is at very high risk of experiencing hunger. And I think this is a point that Hunger Free Vermont and a lot of other organizations in our food security coalition have been making. So you've heard it before. But when a family can't have all of its basic needs met at the same time, then they are immediately going to be at risk of hunger. Because if you can't find a way to get yourself connected to health care that is free or that you can afford, and you're spending more money for health care, for example, where that's going to come from in your basic needs budget is your food budget. That's the thing that is flexible. We don't have a lot of negotiating power around a lot of our other basic needs, but we can reduce what we buy at the store. We can buy less nutritious food. So health care for us is a hunger issue, always.

[Rep. John O'Brien (Member)]: I may have asked this in November, but do all children, migrant children included, have access to Doctor. Dinosaur and schools?

[Anore Horton (Executive Director, Hunger Free Vermont)]: Children Universal School Meals. Yes. Right. Yes. So all children who attend a Vermont public school have now, thanks to you all, equal access to universal school meals, breakfast and lunch every school day. And the same is true for after school meal programs and summer meal programs. And I believe that there are different requirements related to citizenship for accessing Medicaid, which is Doctor. Dinosaur. Let me see. Did I have more? Right. So I think I'll just reiterate in closing that Hunger Free Vermont, we are particularly concerned about ensuring the continuation of the Bridges to Health program, because it provides not only direct health care support, but also assist connecting to a lot of other resources that all are necessary for this really important population for our farms and the food on our own tables, honestly, right? To access transportation, to access food, to access other vital services. And so we are respectfully requesting that this committee include $167,700 in transition funding for Bridges to Health to be able to continue its services uninterrupted and move to a new home in the FY '26 Budget Adjustment Act.

[Rep. John O'Brien (Member)]: Thank you. Just budget stuff. So last year, what imprinted to have their budget, or how much came from this body?

[Anore Horton (Executive Director, Hunger Free Vermont)]: Oh, I don't know the answer to that question. Sorry.

[Rep. Amy Sheldon (Member)]: Amy Schromberger, for the record. So there was funding allocated in H-ninety one for Bridges to Health. When H-ninety one got to that money was not appropriated, and that's did not go to British for Health, so they have not received state funding, but they have, and they were going to close in January because they needed that funding, but they have since negotiated with UBM, and UBM has stepped up and provided funding for the six month period that they will stay there, but then once they leave, that funding is. And so they will also have an FY27 request, but this is really to get them over the hump of that transition, because it happens right when the fiscal year begins. Yeah, I thought I remembered us voting a few years ago to provide healthcare for pregnant women and children from migrant communities, and it was a small number. I remember it was like 48 people a year or something would fall into that category. And I actually just looked it up. And according to the internet, they say that we do through an immigrant health program. So I think that they do actually, they are eligible for healthcare programs.

[Rep. David Durfee (Chair)]: Thank you.

[Rep. Richard Nelson (Ranking Member)]: This all stemmed from federal with you being, I believe nervous about their appropriations from the federal government and where their money goes and how they use it. I've heard the backstory right.

[Anore Horton (Executive Director, Hunger Free Vermont)]: I don't know the details of all that went into UVM's decision, But certainly, the level of uncertainty and changing rules and changing eligibility rules for different populations to access different federal programs that has happened and is continuing to happen at the federal level has made all of this much more challenging for every everyone involved.

[Rep. John O'Brien (Member)]: Okay, just a follow-up. So the majority of the funding then used to go through UVM or UVM extension to this. Is that how it flowed? Yes.

[Rep. David Durfee (Chair)]: You mentioned eight community based health workers in the program. Do you know where they're located in processing?

[Anore Horton (Executive Director, Hunger Free Vermont)]: I don't.

[Rep. David Durfee (Chair)]: And recognizing that you're here in your role as the Honduras Vermont spokesperson. And my understanding is that we're happy to hear from anybody, I should say. My understanding is that there isn't anybody here today who would have maybe more detailed information on the health care pieces. Thank you for coming in, unless you want to correct me.

[Rep. Amy Sheldon (Member)]: Amy Sheldon again. Yeah, they weren't able to come, this was all very last minute, we really appreciate the committee taking the time. I just wanted to clarify that my understanding is that Bridges to Health does not provide healthcare,

[Rep. Gregory "Greg" Burtt (Member)]: what

[Rep. Amy Sheldon (Member)]: it does is it helps people get access to healthcare. So it's really the go between, especially for folks who might be worried about just walking into an emergency room because of their status. They really help to make the connections so you can get care safely and get access to anything that might take for this role. And I think

[Anore Horton (Executive Director, Hunger Free Vermont)]: what you just said, representative, about migrant workers who are pregnant, there's a program to provide medical care. But somebody has to know that there is that program and somebody has to connect the person who needs that program to that program. And that is exactly why Bridges to Health exists. So that's a really good example.

[Rep. Richard Nelson (Ranking Member)]: Thank you. Helped facilitate the vaccination program during COVID, I believe.

[Anore Horton (Executive Director, Hunger Free Vermont)]: Yes.

[Rep. Richard Nelson (Ranking Member)]: It came directly to the farms and volunteer medical staff. Wonderful program. And they also identified clinics where they can bring the migrant population of workers to get health care, know, free or reduced price, and they help facilitate that. For those of you who don't know, it's a it's a truly a great service. I speak more to it, but I hesitate.

[Rep. David Durfee (Chair)]: Representative O'Brien, do they help with housing at all?

[Rep. John O'Brien (Member)]: Because that's sort of what you said, like that's another one of those.

[Anore Horton (Executive Director, Hunger Free Vermont)]: Yes, Yeah, absolutely. That's another one of those critical basic needs that if you're not housed, you're not going to have good health and you're certainly going to be experiencing hunger. So yes, these community health workers are just really, really knowledgeable about all of the different kind of programs and options available. And I think they really work to connect people with the network of whatever people might need, with each case, of course, being kind of unique and different. And that's what makes it so valuable. And that's really what our vision is about how we're going to kind of all get through this current really challenging period that we are facing with the decisions being made at the federal level, which is that we've got to have people who are really, really skilled at listening to what basic needs are missing for people and being able to connect people in a holistic way, in a one stop shop kind of way. Because that's what's going to keep people healthy. And so it's going to keep people connected to employment and connected in their communities. And it also is what's going to let us leverage the most federal dollars and be most careful and thoughtful at how we're expending state dollars possible. And that's, I think, really important for every community and every population in Vermont, not just this one we're talking about today.

[Rep. John O'Brien (Member)]: So did you explain how they came up with this specific number? Was it essentially this is to replace loss funding? Or is this going forward, they said until we can get to FY '27, this is what we need to keep the lights on.

[Anore Horton (Executive Director, Hunger Free Vermont)]: Yeah. There's just a there's a very specific budget of, like, where the gaps are between when their period where UVM is willing to continue housing them ends, which is the June, and the need to transition over to the Vermont free and referral clinics without having any interruption in services. So they have a kind of a very specific budget of to get to that number.

[Rep. John O'Brien (Member)]: You feel like getting half of this is really detrimental, right? Yes. This is just the minimum.

[Anore Horton (Executive Director, Hunger Free Vermont)]: Yes, this is the bare minimum to really keep the program operating. And then there's going to be some costs for them associated with this transition. Because being housed at UVM, Bridges to Health had access to secured servers that were valid security for health records, for example, which is a very high level of security that is appropriately required. But now they are going to have to acquire that kind of secure server. Know what I'm talking about here. So there are certain expenses like that that are included in this number that have to be funded somehow if they are going to be able to continue properly operating and properly providing health referral, health care referral services.

[Rep. David Durfee (Chair)]: Safe to assume that you or somebody has also made this request directly to the preparation committee?

[Rep. Amy Sheldon (Member)]: To see if this was even something that could be pursued. And although obviously she didn't make any commitments, said that we could make the request. And

[Anore Horton (Executive Director, Hunger Free Vermont)]: I'm also providing testimony to the House Committee on Health Care later this morning.

[Rep. David Durfee (Chair)]: Any other thoughts or questions?

[Rep. Gregory "Greg" Burtt (Member)]: Representative Burtt. Thank you, Chair. I have two gentlemen from Jamaica that work for me through the H2A program, I was trying to look back through emails, couldn't remember exactly who the point person was or what their department was, but I know this doesn't affect necessarily your farm or folks' farms in similar situations, but with the H2A program there are some folks that come onto the farm and then make sure they speak directly with our workers and let them know about opportunities that they have and their rights as farm workers. So I'm just trying to look through specifically on if they have had information about house care and opportunities. Just want to at least point out that at least through the H-2A program there are also this is Juan Lopez who's hired by the state of Vermont to do this work essentially.

[Rep. Richard Nelson (Ranking Member)]: They're a tremendous asset for our farming community.

[Rep. Gregory "Greg" Burtt (Member)]: So I just wanted to at least point out that in H2A, there are other mechanisms.

[Anore Horton (Executive Director, Hunger Free Vermont)]: Yes, yes, that's absolutely accurate.

[Rep. David Durfee (Chair)]: So this may be even more of a need for farmworkers, not just farmworkers, but immigrants who don't have access, who aren't here on an HOA fees or one of the other visa programs. I

[Rep. John O'Brien (Member)]: just wanted to ask these two, since you both have migrant workers. Is there sort of a prescribed, one of your workers falls out of a tree and breaks an arm, know, on emergency stuff, what does healthcare look like? Mean, I if there's a path that says you can

[Rep. Gregory "Greg" Burtt (Member)]: Yeah, I would contact the company that I work with. Your workmans comp, workmans comp, pretty similar with h two a. You know, it's just similar to

[Rep. John O'Brien (Member)]: what you do. So you're like

[Rep. Gregory "Greg" Burtt (Member)]: a workforce. Yeah. Yeah. But I would definitely contact. If we have one network with a

[Rep. Richard Nelson (Ranking Member)]: Right. Or run over by a cow. We we know, we've gone through that, and absolutely care is not refused, and care is covered, and they all have work which comp. They do. But it's two things. It's the they got the flu, the vaccinations that were provided during COVID, the English language teaching that UVM Extension did, it was all really, really, really great service.

[Rep. Gregory "Greg" Burtt (Member)]: I will say that, you know, my employees letting me know that they have a problem that's ongoing, that they can hide, right, and if they have fear of just going into a public place, I didn't, they did express that to me, I was like, why aren't you doing this this crazy? Because I was like, I'm sorry. You we used to go to do stuff over at Lake Champton, there's a migrant worker recreational group in Vermont, which is great. Just, you know, he went mountain biking for the first time. He went sailing on Lake Champlain, you know. So it's a great program. Didn't do that last year. And let alone just tell me about a Tuesday.

[Rep. John O'Brien (Member)]: Like Dennis, Dennis will speak.

[Anore Horton (Executive Director, Hunger Free Vermont)]: The level of fear that people have, what you're speaking to representative, just escalated a thousand fold.

[Rep. Gregory "Greg" Burtt (Member)]: Whether it's founded or not. Yes. Right. Yeah. Vermont is something, obviously. But even if, I mean, Vermonters are extremely welcome to the minor community, but there is a reality

[Rep. Amy Sheldon (Member)]: there. I

[Rep. David Durfee (Chair)]: know Representative Bartholomew spoke to this the other day when we were going around the table, and I think we all recognize the reality on the ground and that if there's something that we can do as a committee to react that is meaningful. We can talk about it, we can complain. We need to

[Rep. Richard Nelson (Ranking Member)]: declare independence and create our own H2A program that works for everybody.

[Rep. David Durfee (Chair)]: Yeah. Maybe we could draft something and send it to Washington. But in the meantime, this seems like something that we could do that's tangible. As And somebody just said, I don't I don't think this is in the governor's budget or BAA proposal. Money is So Dollars are tight, has to come from somewhere. I have not heard, actually.

[Rep. Gregory "Greg" Burtt (Member)]: We can get their own education.

[Rep. John O'Brien (Member)]: They're giving money away.

[Rep. David Durfee (Chair)]: Maybe a multiple committee letter to approach it. Yeah, so I think we just heard that the healthcare committee is also taking testimony. But yeah, that might be an approach having the same language coming forward. We do have more testimony scheduled at 11:15, so I think we could take a break now. I would suggest that if our next witnesses get here early, we might get started early, because I think there's probably a lot to hear about. Why not? The Land Industry Viewport. Yeah. Oh boy.