Welcome back to the Vermont House Appropriations Committee. It is still Monday, January 9th, 2023, little bit after one o'clock we're just had lunch. We're gathering back in the room. We're going to hear right now for a bit from our JFO, our Joint Fiscal Office to walk us through what is the letter of intent that the previous Chair of Appropriations and the Senate Chair of Appropriations in, I think it was June. So yeah, June 30th, this letter is dated that after that said, by the way, could you take a look at this when you come back? And so Sarah is going to walk us through this. Great, thank you. So for the record, Sarah Clark, Joint Fiscal Office. My colleague, Maria Bellovo is here to assist, if needed, if we have questions, so. And so my goal today is to walk everyone through the letter of intent document with an eye towards discussing items that were included in the budget adjustment. Governor recommend language that we received on Friday and that commission regression just briefly walked us through about half of it. So items that were included. And if there are areas where it's not included, make a note of it for all of us so that we can follow up with commission regression and his team. So with that, I think everybody should have a hard copy at your desk. As well as the link, it's actually, it's online. I think Erin will be seeing it on the House Appropriations Committee webpage. In addition, it resides on the Joint Fiscal Office website in the FY23 budget documents. And so one of our orientation items is to do a little walkthrough of our website as well. And so, but it's located in both places. So I think you can flip to the page numbers on the document but on the second page, which should say at the top sections B105 and E105.2, subsection C. And what this indicated in the letter of intent document is that essentially no special fund appropriation from the Technology Modernization Special Fund were included in the FY23 budget. And that's because that was a contingent appropriation, meaning that it wasn't going to be made unless at the close of State Fiscal Year 22 there were general funds available to make that transfer. And so this language is saying essentially that in the FY23 budget adjustment, if those funds are available, an amendment will be needed to establish those appropriations. And so that was included in the language and Commissioner Greschen and his team have discussed that. So great, I had a question from somebody and I just want to make sure that where earlier today that B, I think Representative Brennan had brought it up that the B105.2, is it? I think you were sitting in here. 11. Oh, 11. So 11. Maybe I'm in the wrong place, sorry. 11.01 B on this long sheet and in the explanation sheet it's 11.02, I just wondered if there should be a line. Anyway, I thought it was this one 105 and 105.2. So at some point we'll check that out. Okay, yep. Thank you, Maria. And we're still, you know, we are as an office reviewing all the language and information we received on Friday. And so we, you know, are gonna continue to scrub and make sure everything aligns and is as it should be. But please, as you see things, point them to us. So for the first item, it was addressed in budget adjustment. If there's any further questions at this time about that section. I'm just making a note in BAA already. And it was, it's in BAA and I don't know if you had a chance to take a look at the two. Is it the way, is it in BAA the way that the letter of intent wanted it to be? I wanna reserve the- Exactly. Analyze, I think it does accomplish the goals laid out in this letter of intent, but I think being very thorough to make sure it's exactly what they intended and you know, and that what this committee would support as well. So the next section is sections B-225 and B-225.2 which are appropriations in the agency of agriculture, food and markets. Thought this after it was too late in terms of the session had adjourned, $250,000 was appropriated for the conservation districts appropriated to the wrong appropriation. And so this was indicating it needs to switch from the budget adjustment. And they did do that in the submission that we received. And that's, that looks good. That looks good. The next item in sections B-502 and B-505 has to do with education, special education formula grants and the adjusted education payment. Essentially, there is a true up that should happen in the big bill after the local school bus, local school budgets are passed at town meeting in March. And so the appropriations should have been updated before the budget was passed. They were not last year. And so those technical amendments have been included in the budget adjustment. We are reviewing those updates now, but hope and anticipate that it is as it should be based on last year's information. Excellent. So in BAA, but you're reviewing for the detail. Okay. The next section is section C-102, which was clarifying and you really want to flip to the second, the next page because what this was doing was clarifying that some of the transfers and appropriations that were on the contingent list, essentially meaning if the funds were available at the end of state fiscal year 22, these transfers or appropriations would occur. And the language here in the intent document said, if needed, there will be an adjustment proposed in the FY23 budget adjustment. I believe, and so this is another area we want to make sure that the transfers and appropriations were made as intended. We do know, for example, within the agency of digital services that those amendments, and that's one that's included on this list, that those amendments have been included in budget adjustment. In my quick review, I do believe that we should be all set in this regard with those changes, but we will, we will confirm that. Oh, yeah, Scott. Oh, yep. Please go right ahead, Representative. Do we maintain such a list or contingency list for situations as you just described? And where do you find that? So last year's big bill, I think it should be in section C102, did lay out what those contingent appropriations would be. So that if the general fund closed in a surplus, as was anticipated, that these were the items that would be funded. First. Considered first. Yeah, that's right. So, yeah. Just flipping in this very helpful big budget book we all have now. But yes, that is where it was laid out. Thank you. Yeah. If it's helpful, we have a spreadsheet as well that consolidates it that maybe for ease of viewing, you can see all of that laid out. It's page 102 of this. Okay, good. Thank you. C102 on page 102. Ready? Okay. The next item in the letter of intent document is section C112, which is referring to a one-time retirement system appropriation that was actually made in Act 74 of the previous session, which was the big bill FY22 budget bill. This language in the intent document was just providing additional guidance to the Department of Finance and Management on how and when to make the deposit associated with this appropriation for the Vermont State Employee Retirement System. It's not something that needed clarification in the FY23 budget adjustment. So we should be all set there. That we, I'm sorry, can you repeat that? It did not need clarification in the budget adjustment. It was just providing additional guidance to the commissioner of finance and management. So sometimes items in the letter of intent could need further clarity in budget adjustment. And sometimes it's just providing additional guidance to the administration to bring clarity to how they carry out a program. Okay, so guidance, no action required. Correct. Do you know if they carried out that guidance? My understanding is yes, but we will confirm. Yeah. Okay. The next item, section E334, is also providing additional guidance to the administration related to language on a report that will be due to the legislature on February 15th related to home and community based service provider rate study. So no action was needed in the budget adjustment related to this, but it did clarify that part of this study should include an examination of alternative payment methodologies, such as a bundled rate for the adult day services portion of the study. So it was just providing additional guidance to the administration. We should know the report will be due to us in February. So we'll validate that at that point. So last year, there were a lot of bills outside of the budget that had appropriations in it. And so in this letter of intent, you're going to see that the remaining pages actually have to do with other bills that had appropriations where additional intent was needed. And so we'll walk through that. So Act 83. So okay, this first Act 83, which was the budget adjustment for FY 22, section 46 was basically just adding the clarification that if the funds were not expended, this $25 million that went to the agency of human services, that the balance if still needed would carry forward and from 22 into FY 23. Again, no action needed in the budget adjustment, but it was providing clarification that those funds would carry forward. And if they weren't needed, if the agency of human services determined that those funds weren't needed for those purposes, they would be identified for a reversion. And I don't believe there are any of these funds that have been identified for a reversion on the list that we received. And this $25 million was to address emergent exigent circumstances related to the COVID-19 pandemic. It was part of the administration's recommendation on the budget adjustment last year. So no action needed there. And continuing in Act 83, section 48, this actually did require action in the budget adjustment or it was laid out here if an amendment was necessary, it would come forward in the budget adjustment. And so this was included in the budget adjustment materials that we received on Friday, which was basically some technical corrections updating the reversion amounts associated with the legislative IT appropriation and the Sergeant at Arms appropriation. These are areas that the Joint Fiscal Office identified for correction and it has been updated. And updated, okay. Moving right along, is there a questions? Anybody? So Act 114 was the act relating to amending various public pension and other post-employment benefits. The first part here, the language in this first paragraph, at the end of the session, the Department of Human Resources identified some issues that perhaps would require clarification related to the creation of the new group G within our pension program. And there were, I'd say, a few relatively minor technical updates that the administration had expressed wanting to update in the budget adjustment. In my read of the materials we received on Friday, these were not included in the budget adjustment. And so it is an area that we want to follow up with the administration to determine if, you know, if there's a reason for that. Yes, yeah, representing. I'm gonna do them, but it's a little flower. German. I'm assuming that we will learn what G is. Yes, yes. Yeah. And it has to do with the different groups, and I'm not, and perhaps there's a legislator that has some more expertise in this area, but the different groups refer to the different units of state employees in terms of what their pension benefits are. And I just ask a quick follow-up. I'm sorry that just going back to Act 83 and Section 46, that $25 million appropriation, if I remember right, that really was intended to provide a bridge between the VRAP program and, you know, transitioning folks off of emergency housing assistance. These funds are actually not related to the emergency rental assistance program. This $25 million has more to do with, I think, provider stabilization efforts. And you know what I can do is get for you that language from budget adjustment that described what that program was. Okay, thank you very much. You good? Representative Harrison. So, Sarah, I just want to make sure I understand EHR had recommended a change in the contribution rates and the rest of the administration didn't take them up on that. We know it's a oversight miss or whether they disagreed with that recommendation. Yeah, we think, I don't know enough yet to answer that. I think they did, the administration did identify to us some technical things that may need to be updated in the budget adjustment. It's not included in what we received last week, but we need to follow up to understand why and perhaps there's another plan for that. So, we will get more information on that. Why I wanted to go through this number one so that you could hear it. Number two, so that we could identify just this highlighted piece of like, oops, something that may end up on the floor by accident. Okay, great. So, the next section in the pension bill as well, Section 28, laid out some specific intentions around how finance and management would effectuate the deposits associated with the $75 million that was appropriated as part of the plan for the Vermont State employees. And then this continues on to the next page. It talks about the same language with the state teacher's retirement system as well as with the health and medical benefits language. This language is calling for what would the figures in the big bill itself are slightly different than what was there last year. And so, this was saying it would basically be trued up in the budget adjustment and that language has been included in the materials that we received last week. Okay. I'm just writing in BAA, details under review, right? Yeah. But I believe we are all set there and we confirm with the analysts that works on pensions. Great. So, the next act that has some intention language is Act 138, which is an act relating to tax reductions and other aid for Vermonters. In that bill, there was an appropriation to the Aid to Age Blind and Disabled Program, AABD, which was calling for a supplemental payment for beneficiaries who are not living in nursing care facilities. The budget itself addressed the personal needs allowance for these individuals in nursing care facilities, but it allowed for either a January of 2023 or January of 2024 implementation to increase the personal needs allowance depending on capacity to administer within the Agency of Human Services. If necessary, there would be a clarifying amendment in the budget adjustment. There is no language in the budget adjustment. And so, I think I could make assumptions but what would be my next step is to follow up. Well, Agency of Human Services will likely be in here this week and this will be one we'll want to follow up with them to understand what their timeline is for implementing. What that's about, okay. That's a highlighted one then. Yeah. Not here, so that could be okay, but we wanna... Why? Yeah. Was it by choice? Was it by thought? Was it by accident? Yeah. And there's someone in the room that I know that's taking really, really good notes from the administration that I'm sure will be there. That will be very helpful in making sure that they at least have an idea of what we're thinking. Okay. The next one is in Act 158 which was an act relating to regulating licensed small cannabis cultivation as farming. And so, this language basically indicated that two positions were supposed to be transferred from the Agency of Agriculture, Food and Markets to the Cannabis Control Board. There was not language included in the budget adjustment that we received on Friday that called out this transfer of positions. However, there is a mechanism where the administration is able to transfer positions amongst agencies and departments outside of legislation. And so, this is on my follow-up list to understand if those positions have been transferred. So not in BAA, but may have occurred regardless, right? Correct. No, Jay, here I ask- Oh, sorry. Quick question here. Are those existing positions, are the responsibilities for those existing positions related to this cannabis cultivation at farms? Or are they just generic existing? I think that they were specifically created for those purposes and they were just moving them with the purpose that they were intended to the Cannabis Control Board. Thank you. Yeah. Okay. The NEST is Act 172 which is an act relating to the Municipal Energy Resilience Initiatives. So, this act created positions. I think it did not specify the type of positions they were. And so, when Commissioner Gresham was in earlier, I think him or his deputy referenced like the ways in which you create new positions and you need to be very specific. And so, this is just stating that these positions should be classified limited service positions. There is not language included in the budget adjustments that clarifies this, but it's an area for us to follow up with the administration to understand how they created those positions and to confirm it was as classified limited service. So, that is on our list. Okay. Who is that? I believe those are at buildings and general services. That's okay. All right, I'm gonna look right at. Okay, then the next item, turning the page is Act 182 which is an act relating to expanding access to safe and affordable housing. The first section has to do with the manufactured home improvement and replacement program. And this language was indicating we needed to be more specific about the source of federal funds. And so, the intent document was stating, it should say from the American Rescue Plan Act recovery funds consistent with how we handled similar appropriations in other areas. This language has been included in the budget adjustment. Yes, perfect. Senator Harrison. You have to learn to do your writing, but also look at. I know, I need like eyes. Well, you also will eventually have your right hand back. And so, I'm gonna look at. That's true. All right, Sarah, can I assume this relates to an exchange of emails that some of us got this summer from the chair? And so I can check this off. I guess. Super. Well, I remember that email house. Yes. Is that to me? All of self-interest. I have this as follow-up and I keep. Okay. Okay. I'm gonna put down your Jim interest. Not because it's a conflict, but because I know who to go to if I've got deeper questions, right? I know him too. Anybody else? Questions? Okay. So the next item in this bill, section 28, also was request for further clarification that this appropriation for the municipal bylaw modernization grants that the language be changed. So it indicated the allocation was up to $650. Excuse me, $650,000. And that was also included in the language we received on Friday. So we should be all set in these two areas. Okay. Moving on to act 183. Which was the act relating to economic and workforce development. The first in section 16. This is related to CTE construction and rehabilitation program. And some appropriations, one time appropriations that were made with education fund dollars. We needed to clarify that we needed to add the notwithstanding the existing law in relation to the education fund appropriation wasn't included in the act at the time in the bill at the time. So that has been included in the language that the administration sent over on Friday. So NDAA and CTE is Center for Technical Education? Yes, sorry, I should have cut out. Okay. Go ahead. Is that the section related to the Mount Housing Conservation Board? No, I don't believe that it is. Okay. Section 47 has to do with the Vermont Economic Development Authority, VEDA, short-term forgivable loans. This language, it was included in the budget adjustment. So let me say that. So it has been addressed in the language we received from the administration. I think the language that is proposed here, if you look down at the bottom, I can't really tell it's to be the bold language is what the eight requests to be included. And that has been included in the language that we received, which is basically I think allowing for more broad appropriate basis of comparison to determine eligibility. Okay, I'm getting through it. So the next item, if you flip to the next page is still in the same act 183, it's section 53. Which it was this language was included in the budget adjustment that we received on Friday. It's basically updating when the bill passed last year, we thought there was 25.5 million dollars that could be reallocated for a different purpose. And that's one of the ways that they funded some of the activities in that act. But in reality, there was only $25,042,000 available. And so they are updating that amount available for reallocation. And they have done that in the budget adjustment. Okay. Sometimes the agencies and departments are spending, it can spend more than we are aware of. So we have to catch it up. The last act is act 186, which is an act relating to the system of care for individuals with developmental disabilities. Section four is language that was included in what we received on Friday. And again, it's language that is expressing the intention that this position, a residential program developer is intended to be a classified limited service. And that the funds for this position are going to come out of the global commitment, federal medical assistance percentage, home and community based services plan funding. And so that is another topic for orientation in the committee. But essentially the home and community based services enhanced FMAP was an opportunity that the federal centers for Medicaid and Medicare services made available to states that has allowed Vermont to have another avenue of funding to make some investments in our home and community based services system. And so I think that that would be a good item for future understand what that is and how the state of Vermont is using those funds. Cause it was a couple hundred million dollars that was made available and that the agency of human services is in the process of carrying out that program and plan. That be normal? You know, it may be one that we wanna actually have the team at the agency of human services because it is pretty detailed. It can be relatively complicated and they I know they've been preparing some briefing materials for other committees. So Nolan will have a high level, yeah. So I'm gonna do this like pivot call my friend over here and make a note of that that we can, that we'll, you know, to get a whole of, to see the next week of the FMAP. Okay. She gets this little side list of things that we think of. And at a weight page. How many different funds or services are under the global commitment whole lot? Yeah. So, I mean, so the global commitment is one fund and it is unique in state government and that it's actually a blend of state and federal dollars in the global commitment fund. So it pays for a variety of programs within Vermont's Medicaid program, which in Vermont, the way we administer our global commitment waiver or Medicaid program, it pays for services from healthcare services to supports for children in custody, mental health supports, a wide variety of items. Nolan is actually, Nolan Langwell, my colleague will actually be here tomorrow and provide some more information in this area, a good foundation for everyone to understand that. And this program that's referenced here is a very specific kind of offshoot. You good? Okay. Sometimes I have a tendency to jump a little quick. So I, and the person may be still in the middle of questioning and I don't want to cut you off. Oh, sure. All right, we're doing this at record pace. Record pace. Great, so the last item here is at the Department of Disabilities, Aging and Independent Living, DALE. And it has to do with the development of a housing and residential service pilot planning grants. This language was included in the budget adjustment, so it has been addressed. And basically the clarification that was needed was just indicating that this program is being funded by this Enhanced Federal Medical Assistance Percentage Home and Community Based Services Funding Plan. There's a lot of acronyms associated with what I just said out loud, but I'm trying to be good at saying all of the words and then we'll get to acronym level pretty soon. All right, so that gets us through the letter of intent. Just ask a question. And when I hear like the funding, should be allocated to the global, it's a part of that FNAP. That's not just the bump, but that's the actual FNAP, right? So it's not like, oh, it's our intent that when the bump goes away, this would go away. No, no, this is like, it's all related to this unique funding opportunity that CMS, the Center for Medicare Services, provided to states that allowed states to kind of draw down a 10%. So to confuse things further, it's a different enhanced FMAP amount. It's 10% as opposed to 6.2%, but it was only to be drawn down on home and community-based services. You reinvested in related expenditures. AHS has a very detailed plan that was discussed with the legislature last year in terms of how they're gonna spend those dollars. And that's where we want to have them come in and provide an update to you in terms of where they're spending and how it's going. And this was clarifying that this particular program would come from that fund source. It needed, I think it wasn't as clear in the original language that was drafted. Nice. All right, so we've gone through that. Lickety split, because we've got 20 minutes to spare. I know. Wow. So, I know, let's go play basketball, sir. Thank you. So, I did have a break built in at like 2.15.  And to tell you the truth, we had a whole list of opportunities. So I don't even actually know what order it's all gonna come in this afternoon. Are people ready for that, or should we take a minute? Why don't we take a minute and we can, and we have a plan, but let's take a minute to talk about it, and then come back.


Hey, this is Brett and this 2021 Jeep Wrangler Unlimited Sahara Altitude is stock number 24J238A. I am here at Summit Automotive in Fond du Lac, Wisconsin, near New and used Jeep and Jeep Wrangler headquarters. This 2021 Jeep Wrangler Unlimited four-door Sahara Altitude has the two-liter turbocharged four-cylinder engine. It's paired up with the eight-speed automatic transmission. This Jeep has been fully safety and inspected by our service shop per the state of Wisconsin inspection process. It has a fresh oil and filter change. All the fluids have been checked and topped off and it is 100% ready to go. I'm going to go all the way around in this video. Inside underneath, start it up, take a look under the hood, show you all the options and give you the most accurate representation that I can of the vehicle. Sarge green clear coat is the color. I shoot all my videos in 4k. If you like the video, subscribe to the YouTube channel, click the bell notifications, get updates on the videos I do each and every day as well as having access to one of the largest catalogs of vehicle and specifically Jeep Wrangler Walk Rounds on YouTube over 550 Wrangler videos up there and stay current on our ever-changing and vast Wrangler inventory here at Summit Auto. This one comes with the 18-inch gloss black painted alloy wheels. Those are part of the Altitude package and it comes with Bridgestone Duler AT tires. These are 25570R18s. I would say they have right around half the tread left on them. Frame and underbody is very clean on this vehicle. This is a one owner clean title history, clean car fax from right here in Wisconsin. Do note that you get the painted fenders and hard top on this one. Fenders in pretty nice shape. Has the LED running lights here, the LED headlamps and the LED running lights there and the LED fog lamps. You also get the gloss black bezels around the fog lights and in the seven slotted grille part of that Altitude package. No major dents or dings or scuffs or scrapes on that front bumper. The grille is in excellent condition as well and the hood is in really nice shape. I didn't see any major dents or dings on there. Passengers side front fender, very nice and clean. Passengers side front wheel, no major scuffs or scrapes on there. And as you go down this side of this 2021 Jeep Wrangler Unlimited Sahara Altitude, take note of how clean the body is, how reflective and mirror like that paint is. I take these HD videos so if you are far away or even if you're close by and you just cannot make the trip down but you're still interested in purchasing the vehicle, you can see the vehicle, hear the vehicle and have confidence in what you're looking at before you even get here. So when you do get here there's absolutely no surprises and you can make a smart and informed buying decision from wherever you're at. Now if this video helps you make that buying decision let your salesman know that you saw the video that it was helpful and that Brett sent you four wheel disc brakes on the Wranglers and the back tires have just as much tried as front tires. Underbody for being a Wisconsin Jeep looks really good. Very little to no corrosion. It does come with the nice factory step bars. I'm going to show you the door hinges here. They are in pretty nice shape. You always got to check these to make sure that they're not corroding badly. These all look pretty good but I always like showing those in these videos. You get the LED tail lamps as well coming around to the back. You get the backup parking sensors, the towing package with the receiver hitch four pin and seven pin wiring. You also get a toe hook back here. Back storage area. This is your case for the front hard top pieces and we actually did a demo on how to take your hard top off and utilize that case. That's in the upper right hand press screen. This one does have the Alpine premium sound system. You get the storage bin under here as well as holders for your door hinge and roof and windshield bolts. And speaking of that hard top there are four bolts on each side. Two quick disconnects. Look they've already had it disconnected. They must have had the hard top off recently. We'll get those connected back up and you also have the insulated hard top here which is a really nice thing. Seven slots on the back door. Two door four door overall length and wheel base on this badge back here and overall width and water folding. But very nice and clean back there. Coming around to the driver side just as clean as that passenger side. That hard top looks like it's in really nice shape. Back fenders in nice shape as well. And for full disclosure this back wheel no major scuffs or scrapes on there. And down the rest of this side doors look really good. And once again I'm going to show you the hinges here. We did a demo on how to take your doors off your jail wrangler as well if you want to check that out. That's linked in the description below and in the upper right hand part of the screen. Take a quick look at the back seats. Back seats are in fantastic shape. No rips or tears back here. It does have the latch child safety system for any child car seats. You get the all-weather topographical floor mat back here with the red Jeep lettering. I really like that. 115 volt 150 watt plug-in and you do get two USBs. Two USB C's back here as well. These seats fold down almost completely flat which is really nice if you have to haul a bunch of extra stuff. The other thing I like is that these headrests stay down for better visibility if nobody's riding back there. Child safety locks on the back doors in the inside and bottoms of the doors all look really good.  Now you do not get the Sahara stitched into the backrest because this one is an altitude so you don't get the stitching in the backrest but you do get the driver seat height adjuster and lumbar there. All weather floor mats up front, auto headlamps, power locks and power mirrors, tilt, telescopic steering wheel. We'll hop inside check out the miles radio and everything that this one has to offer on the interior. You can see this one has 49,029 miles. You do get the digital 7-inch display there, digital spinometer, compass display, you can change all those corners to read pretty much whatever you want. Instrument cluster is very nice and clean, comes with the heated leather wrap steering wheel, cruise controls on the right, Bluetooth and information center controls on the left and audio controls on the back of the steering wheel. This one has the 8.4c radio. You get AM, FM and Sirius XM radio capabilities as well as Bluetooth, AUGS and USB hookups. You get your heated seats and heated steering wheel controls here as well. That's where your backup camera shows up and that is HD now.  This one does have the factory navigation system. There is highway 41 so that is working nicely, always something to check on these radios to make sure the nav system is working nicely. This one is. Here are all your different apps. You do get projection management. You can project your cell phone to the screen via Android Auto or Apple CarPlay and then you get your off-road pages here as well. They take a second to load. So while they're loading I will show you down here the more tactile volume tune and climate controls including your push button start, dual climate controls, heated seats and steering wheel controls there as well. Start, stop capabilities, stability control, parking sensor, speed select, crawl control and you can turn the screen off if you want. Down here your power windows four auxiliary up-fit switches. That's part of the tow group AUGS USB and USB-C hookup four by four shifter on the floor and you get the eight-speed automatic transmission there with the Jeep logo in there as well. You get the switchblade key with the remote start. Nice chunky always like those. Here are your off-road pages and you can see you get latitude, longitude and altitude on there.  So as I turn the wheel you can see those tires actually move and the steering angle changes as well. Latitude, longitude and altitude and your accessory gauges and pitch and roll as well. So one of my favorite parts of the altitude package is this dash. You get the granite crystal finished gloss finish dash. So I think that looks really good. It's got metal flake in it of course and really a cool looking dash. Passenger side floor mat and seat are in excellent condition as well. I don't think this vehicle's ever been smoked in. You get the crushed eggshell finish looking hard top pieces as well as the inserts. It's kind of like foam wrapped in like a carpet material. Assistant SOS buttons, auto dimming mirror and your home link buttons for your garage door security systems and lighting systems. Let's start it up. Take a look under the hood and check out all the LED lights in the front and you can see you get the outside temperature display on there as well and like I said you can change those to read pretty much whatever you want. I would personally like to thank you for checking out the video today and hopefully from this HD video you've been able to verify the quality, condition, options and of course cleanliness of this Jeep all the way around inside and out. Under the hood we have the two liter turbocharged four cylinder engine. 270 horsepower engine base very clean runs very smooth and once again this Jeep has been fully safe and inspected by our service shop as a fresh oil and filter change all the fluids have been checked and topped off. There is the emission sticker and this Jeep is 100% ready to go. I would highly recommend it from a quality and condition standpoint. Check out those LED lights just how bright they are all of them working very nicely and like I said from a quality and condition standpoint one owner clean title history clean car facts I would pretty much ship this one anywhere very nice Jeep very good looking color very nicely optioned out on the inside as well and to see more pictures of this Wrangler or one of our other 550 new and used cars trucks, SUVs, minivans and Wranglers go to that website right there at summitauto.com full pictures and descriptions of every single vehicle all at summitauto.com. If you want to check out more HD videos you can go to youtube.com slash summitauto click the bell notifications get updates in the videos I do each and every day as well as having access to one of the largest catalogs of vehicle walk-arounds on youtube and stay current on our ever-changing and vast Wrangler inventory here at summit auto so you do not miss out on gems like this one in fact in a second you will see a link to subscribe to my youtube channel the upper left a link to all the wrangler videos I've ever done in the upper right link to this vehicle on our website and lower left and a link to one of our latest youtube videos and lower right click those check us out we're super excited to help you with this ultra clean 2021 Jeep Wrangler unlimited sahara altitude in sarge green clear coat thank you so much for checking out the video remember to like subscribe and share on the youtube channel I really appreciate it thanks again and have a great day


Hi, this is Leo Bordelon, NDSU Extension Cropping System Specialist, and I'm here today to talk about cover crops in soybeans. Soybeans is our number one crop in North Dakota right now, so based on the value of the crop and acreage, but we have seen a lot of issues on erosion after harvest the soybeans. So erosion is a big problem for us, we are losing our most important resource in an environment which is the soil, because the soil is the foundation of every production in the world. So cover crops can play a very important role to do two important things. One is to protect the soil and to stop the erosion, and the second one is to tackle a very important issue we are having in North Dakota, especially in the western part of the state which is weed control, especially coacia. So we can have or we can build a win-win scenario putting cover crops into soybeans to address these major issues, but how can we do that? So one option is we can broadcast or intercede in cover crops into standing soybeans. So there's a lot of research in North Dakota, especially in the eastern part of the state, where we know right or some broad leaves like canola or wiener canola or wiener camelina are successfully used as a cover crop. There are some pitfalls in doing this. One is the timing, so typically we should do the broadcast cover crop into standing soybeans at the R5 stage or R6, which is when the leaves start to drop. Why we do this? At least we can have cover crop growing before the first frost. If we are moving towards our western part of the state, which our moisture is more limiting compared to the eastern part of the state, we still can do it, but the moisture is a little tricky. So sometimes the best part should be regulated by two things. One, the crop stage and the moisture available. So it's not that easy to do, but it's possible. And as much as we can, we have to protect our soil to improve our soil health. And one option is broadcast cover crop into standing soybeans. Thank you for your time. And if you have any questions, please reach out to NDSU Extension for more information or questions. Thank you.


This is the second half of the morning of Thursday, January 13 and the Vermont House Human Services Committee, and what we are going to be talking about and learning about this morning is what, what could what should and an overview sort of a public health response to COVID-19. This is something that whoever would have thought that two years ago more than two years ago we would still be wrestling with something, and we need to figure out if there's something we can do but we also need to learn more about it and what what are the elements and so thank you very much. Thank you for coming and talking with us about it. Appreciate it. Thanks for having me I'm looking forward to the conversation. Well, first I just wanted to say it's it's great to meet everybody and I wanted to start with gratitude. Throughout this pandemic, lucky to live in Vermont where the leadership has been really careful to try to balance the very best cutting edge science with the interests of the state's businesses with our Vibe as a tight knit communities and has been good about communicating how those balancing acts are being navigated. And so I felt lucky, not only that the burden of disease in Vermont has on a per capita basis been less than in other areas of the world, but to see that healthy legislative process happening. The collaboration between the executive branch and the public health department and the clinicians around the state. That points to rhetorical challenge that I have today that I will need your help with which is I can offer medical information and public health information, but I'm acutely aware of the fact that the scope of my expertise does not extend to public health policy enactment so that's, you know, the job of elected officials like you and the people in public health and so I want to make sure I sort of do a good job of not going outside of my reach but but empowering your efforts in that regard with good information. Thank you. I'm thinking that along those lines, a way to think about this moment we're in now in the third year of the COVID pandemic is to think about what is unchanged and known in a stable fashion and what is evolving right in front of us. So we've all have this, this wild sense of just enduring change you know as soon as you think you know the rules. You know COVID has a way of changing them right underneath you and I think that creates its own stresses it's, it's hard for every single one of us in our personal lives. You know, from the standpoint of the scientific community to to have sort of, you know, just the scientific facts changing on a regular basis as we learn more with what has been the most volcanic outpouring of scientific brilliance that I've ever seen. It's difficult from a policymaking standpoint to know you know sort of when has enough changed happens to take a different tact and and and yet I did want to highlight the fact that primarily in January of 2022. The story is the same as it was in January of 2021 that most things are the same even though there is important change we need to grapple with. And so I thought it might be helpful to frame ideas that way, and I'm going to be relatively brief so that I can make sure that I hear from you about the questions that you're hearing from your constituents and that we sort of align to the need that is really there. So what is the same. We know that COVID is airborne, and we know that it spreads from person to person, most easily inside when we're unmasked and when we're unvaccinated or otherwise don't have immunity such as we might get from being infected previously. That leads us to the common sense measures that we've all been using in our lives for years now that still work and are still I think really important to kind of blow the dust off of and help our communities connect to. So we know, I think that probably for me at least the biggest challenge of this pandemic has been the massive impact on our social lives. You know we know that gathering together inside unmasked to eat together, as is natural to do is probably the most effective way to spread COVID-19. And that so my love for my parents and my other loved ones that brings me together with them can be the thing that endangers them. So we have to own that curtailing indoor gatherings is a key piece of this, but we're all looking forward to when that's no longer the case because it hurts. We know that wearing a mask inside can really dramatically cut the risk of that sort of transmission. The mask is better than nothing but it's quite clear that surgical masks are better than cloth masks, and even better masks like KN95 and N95 are better than that. So that has led to the a bit of confusion about, you know, sort of when do I wear what. And so I thought it might be helpful to clarify that I have not worn a cloth mask for well over a year, because I think that equally comfortable equally aesthetically appealing equally available surgical masks are better. And we always were almost always were one of those. There's no data to suggest that any variant is more likely to get through a mask than any other. And we think they still work quite well, despite, you know, for instance, Omicron being more transmissible. I mean, when I'm going to the grocery store and I know everybody else is going to be masked when I'm seeing patients in the inpatient setting who don't have COVID, sort of not zero risk I'm not just home with my wife and my pets hanging out. I'm out there exposed to other people but it's pretty low risk I wear a surgical mask. And seeing a patient who has COVID-19, when I'm in, when I cannot avoid being in a public public space where people are unmasked, then I wear a higher quality mask like a KN95. I have been calls for higher quality masks for everybody. And I see the motivation of that, and I think it's safer to call for that than it was when we had overly limited supplies of KN95 and then 95 masks and we were trying to save them for healthcare workers. But I'm not convinced that that is necessary for every person to wear that kind of a mask. And so when I see somebody in the grocery store wearing in KN95, I kind of think, yeah, they're taking an extra measure of precaution and that's fine. But I think some people find them uncomfortable and sort of, you know, a little hard to breathe in for long periods of time and they don't really want to and I wouldn't want to feel obligated to push them too hard. But I do think the message that surgical masks are really important and comfortable and better than cloth masks is important. I'm going to ask a question and zoom a show and tell. Is this a surgical mask? Yeah, that's sometimes also called a procedure mask, but that's a surgical mask usually comes in light blue like that. Yes, okay. I wish I had a KN95 with me so that I could do a show and tell of my own but I think right where I'm sitting I only have one. Oh, that's not true. I do. I thought my briefcase would contain a whole bunch of masks. It's kind of ridiculous. So here is a KN95 mask. Sometimes it has a little bill to it or sometimes you'll see them horizontal. And then a N95 is that circular one that sort of really holds on your face quite tightly and I don't have one of those with me. All right, so curtailing gatherings indoors with people outside of our households is important, but only for a finite time we have to get back to living as humans. Wearing a mask when indoors with people outside of your own household is important. Before actually talking about vaccines, I wanted to talk about one context that is easy to forget that and that is it's so natural to get together and eat food together. That sometimes people will be super careful about wearing masks and lots of context but then get together to share a meal together with people they love inside without masks because I find it difficult to eat with a mask on. That's a really high risk transmission time. I've dramatically cut that down in my life but in certain special occasions I've been really careful and I'll talk about that in a second to do that but I think it's important to sort of say routinely doing that is quite high risk. And of course has massive impacts, particularly in the hospitality industry that we really have to wrestle with. Excuse me, Dr. Leahy, we have a question from representative McFawn. Yeah, happy to happy to take that. Thanks, Madam Chair. The surgical mask. That's a single use mask is it not. The question you know I think early on the guidance has been that many of these things were single use but we're learning that that they still work quite well for over.  And so usually what I'm doing is I wear a procedure mask. If I'm wearing it all day long like when I'm seeing patients all day at the hospital, and then I'll use a new one the next day. But if you're sort of selectively using a mask in some circumstances in a day but other times like this on a video call and don't need one. It works perfectly fine to keep the same mask over a period of days so that it's a cumulative day long of use that then you say, getting gross, let's get rid of it. So I would say that you know over weeks that I'm not doing intensive clinical time and I'm doing video calls like this or teaching like at the med school this morning like it was on video, it may take me a week to change my mask out because I've really only used it an hour a day or something like that. Yeah, and can you sterilize the surgical mask in like we have a sterilizing machine that sterilizes with oxygen. So is that work. Yes, it does and that's been also helpful for in 95 masks that have much better supply but but sometimes they've been in tight supply and that's how we've been able to keep them going for multiple uses. Most people don't have that sort of sterilizing but if you have access that does work. And Dr like we have a question for another question from representatives small. Thank you madam chair and thank you Dr Leahy. I've come accustomed personally to where those cloth masks one because they have those fun designs on them. So wondering why has the guidance shifted away from cloth masks and towards can 95 and 95 or the surgical masks. That's a great question me and I think I think cloth masks are a little bit more comfortable and you're absolutely right that just the ability to make a fashion statement with one of those boring blue masks is really hampered and that that's hard for me to. I, you know, get high quality four ply black ones so you can't even see it because it's so fashionable, but that's not enough. The guidance has shifted because there are sort of two levels of evidence that suggest the cloth masks aren't as good as the surgical masks. One is sort of basic science stuff where people in the lab have looked at how well particles of a certain size can cross through those things. They can virus size particles and have them cross through a cloth mass it does help, but it's about 20 30% less likely to stop the that particle than a surgical mask, probably because the weave of the fibers of the surgical mask has fewer holes in it. The same thing has been true in epidemiological studies there have been a few out now looking at mass requirements, showing that they reduced the community incidents of disease and showing there was a big study in Bangladesh in particular showing that surgical mass were clearly better. I think the mask that you can wear is better than nothing and so I think some people are going to find the surgical mask unacceptable and so I say hey go for the cloth mask. I think the solution other people have found is to put a cloth mask over a surgical mask so that it's that extra layer of protection and also they can have the logo or whatever they want shown. Wonderful. Thank you.  Okay, so transitioning from masks to vaccines. We in Vermont have led the nation in vaccination and it has made a massive difference in our hospitalization and in mortality rates. The likelihood of being having severe disease from covid in vaccinated people is around 25 to 30 times lower than it is in people who are vaccinated. I think one of the communications challenges in the pandemic is that that protection from infection is not perfect from vaccination. And so I think sometimes people can struggle with why would it still be worth getting vaccinated if I can still get infected. And I think the most important message is because it will save your life that people who get vaccinated are far less likely to have more than a cold. One challenge is that not only are our hospitals primarily now seeing severe illness and people who are unvaccinated, but it's also true of people who are vaccinated but have medical reasons not to have an ideal immune response to the vaccine. So if you are older than 65 and your immune system is not quite as strong as it once was or if you have a medical condition that leads to immune compromise or some other vulnerability, the virus can get around that that vaccine. It is still much less likely for that person to die but they can sort of get some disease if they're unlucky. That means that a vaccine only approach to containing COVID-19 is sadly not enough and thus we're still talking about vaccines and masking and other measures. But I think it's really important to say that places like Vermont where the vaccination rates are high, the death rates have been quite low. I feel incredibly thankful that the age of vaccination is dropping and so now we're getting down to kids who are five and older and studies are ongoing and younger kids. Every age category must have proof of safety and efficacy before they get vaccination because we don't want to be experimenting on people. And I've just been stunned at how effectively scientists and clinical investigators have shown that these vaccines not only are incredibly safe with very rare side effects that are serious, but also they do stop people from getting infection and most importantly they save lives. This is true of people of all ages and I hope it's true of kids under five and I hope they get access soon although it will be months. Importantly, we've learned that booster vaccinations do enhance protection from deadly COVID-19 compared to just getting the original series. And so I anticipate in time what fully vaccinated is is going to include for most of us a third shot. We are certain that this is the case for people over 50 and people with medical conditions and it is likely that not as well proven for younger people that a booster shot is helpful. We also know that boosting helps immunocompromise people. So that's who it's most important to boost. For me, if I was picking which one intervention I would do, which is of course not the right solution in the COVID pandemic, I would pick to get people newly vaccinated over people getting boosted. It's your increase in your benefit of finding that unvaccinated person and saving their life from the initial vaccination than there is from boosting me. But we can do both and we are and that's what we should do. Omicron has changed the vaccination story a little bit in a way that really hasn't changed the masking story to the best of our knowledge. We think that Omicron is more transmissible and more likely to therefore reach any of us, but there aren't data yet that it thwarts our surgical masks. Vaccines, it's a little more complicated story where it is clear that even vaccinated people can have breakthrough infection more frequently with Omicron than with the Delta and other variants. What's also still true is that vaccination remains incredibly protective against hospitalization and death, even against Omicron. So if I'm vaccinated and boosted, I would not be surprised if I got it because protection against infection is lower. But the vastly most likely outcome is that I'm going to have the snipples for a few days. It's going to be really inconvenient. I'm going to do my best to avoid spreading it to somebody more medically vulnerable and then I'll be fine. That means that giving a booster shot to the people who are most at risk of severe disease is incredibly important. It can save their lives. So important to residents of lunch and care facilities, people over 65 and people with medical conditions. And so that's why that's important to do. I think really importantly, we need to be clear in our messaging that even that drop in protection from infection doesn't mean it's something that we don't want to do. It's still the most important way we save lives. The last technology I just wanted to highlight is testing. So fortunately, in the last several months, we've now got the ability not only to do a PCR test, such as we've been doing in the hospital since the very beginning of the pandemic, but a rapid antigen test that you can do at home in 15 minutes. What we know is that the rapid antigen test is not quite as sensitive as the PCR test. And sometimes in medical settings, that's a problem. But actually with COVID, it's quite helpful because we know the PCR can detect people who are probably just have fragments of the virus left over in their body after infection but aren't transmissible. Whereas the rapid antigen test is a pretty good gauge of whether you're contagious or not. So that leads to two really useful ways to use the rapid antigen test. One is before you're going to see somebody and one is after. So I mentioned that I have not gone out to eat with my friends, much as I love to, is hardly at all over the last couple of years. We basically get together outside for a walk in a snack or do it by zoom. But for a very, very special occasion, a couple of months ago, I went out to dinner with some friends inside. I tested with a rapid antigen test right before we met up. They tested right before we met up. And that's how we made sure that we were not contagious at that moment. And for the next several hours, we could still have picked it up from the few other people who are in the restaurant at that moment. But at least I knew I wasn't going to be the one who transmitted to somebody else. But since I was in that restaurant and could have been exposed to somebody who, you know, was there but didn't know that they had contagious disease. At five and seven days after that exposure, I tested again so that I knew the next week I could work on the clinical service and not endanger my patients. So testing right before you want to see somebody on that very rare event, you're going to see them indoors unmasked. It's really useful in checking at five and seven days after exposure as a way to get out of quarantine. Or if you're infected, it's a way to help ensure that getting out of isolation is safe if you wanted to get back to work after a case of COVID. There have been, go ahead. I was going to say in terms of timing. When my family got together in August, we, we, we tested. But some of us, myself included, tested the day before. Because then I was going to drive my whatever. So is that the wrong thing? And is it, or is it naive to think that, okay, I tested, you know, I tested myself that, you know, the night before or the day before, the day before. And they said, okay, and you're good. And then so I got in my car and drove down to, to the Cape so I could be with my family. So should I instead have tested in the parking lot of where we were staying? Yeah, it's a great question. I think lots of people are asking this. The difficult reality is that a negative antigen test gives you a handful of hours of confidence that, that you don't, you're not contagious now and you won't be for a little bit. It is unfortunately possible that you, you know, sort of recently acquired infection were not contagious in that moment you tested, but the next day than the amount of virus rose in your body and you could become contagious. So for instance, my in-laws live in Massachusetts about three hours away.  And then if they stay overnight with us, we'll test serially to make sure that I'm not transmitting to them most importantly because they're older than I am. But they'll do the same just out of consideration to me and because I work in the hospital. So yeah, unfortunately testing the day before doesn't give you enough assurance because the virus can change that quickly. So speaking of change, I've been highlighting where Omicron is not changing things and where it is. So it does not change as far as we know, masking guidance, although it does make me that much more careful if I'm in a place where there are not masked people to make sure I wear a good mask. It doesn't massively change the vaccine story, but it takes the edge off an infection, but it's still vaccines are incredibly important. Testing, there was a rumor that Omicron maybe made the rapid antigen test less useful. That's still being evaluated scientifically, but the latest studies suggest that it's actually equally good at testing Omicron. We think that the disease of Omicron sort of comes on faster and goes away a little bit faster. And so this stuff that we were just talking about about timing of testing it might be that, you know, maybe that window that you need to retest again gets a little shorter and how long you're going to be contagious gets a little bit shorter. But it's early days and I think the take home messages the tests we thought might work differently with Omicron, really not the case, still a really important tool to use. I did want to mention one other aspect of testing which is population level testing. We've heard a lot of stories about the CDC guidelines about going back to work after you've had a case of COVID-19 or school contact tracing. One, I think clear message that can be helpful to get out there because there's a lot of confusion about this is that while it's helpful for me to test right before I do a very special high risk event or to test after exposure at a population level, it's becoming much less useful. The reason for that like in the hospital we're stopping doing contact tracing. In most cases and the same you know as the case in schools, the reason for this is that there are just so many cases of Omicron out there that each of us is so surrounded by people who are positive that doing contact tracing is one overwhelming because there's so many cases that the people that are doing it can't do it all. There aren't enough people to do it. And what they find is you're surrounded by people and so it's not even clear what you're going to do with that information it's just like you're surrounded. And so the so there's a disconnect there that we can help clarify for people which is the tests are great for individual personal use, but that's the reason why they're not being used in schools and workplaces to the same degree because it becomes infeasible. I see representative Wood has a question. Thank you. Thank you, Dr. Leahy. My question relates to. So now that we see that Omicron is the dominant virus. Does it actually replace the Delta variant or are they both sort of like they're out there at the same time. You know, all we hear about is Omicron we don't hear anything about Delta and so I just wondering from a public information perspective, has it replaced the other or is it just now more dominant. That's a great question. As of now we think that Omicron has replaced Delta. It did so with incredible speed much faster than Delta became the dominant virus it really only took a couple of weeks for it to do it but now by far but but nearly all viral isolates around the United States including a Vermont or Omicron. There are a couple of exceptions but it's Omicron. One important for some of the reasons I've highlighted is also, I guess a side light that's more of sort of a clinical thing that maybe is less important for public messaging. But we do have available treatments that are actually quite effective, both outpatient and inpatient, and that replacement of Delta with Omicron has taken some of those things off the list because they don't work against Omicron. Additionally, we do have oral pills that work we do have IV treatments that work and so we do have a miraculously better number of arrows and our quiver against this virus. Thank you Madam Chair. Doctor, there's been some discussion about a second booster shot. Is there any evidence that I mean scientific evidence that that's a good thing to do for a person that's over 65 with a an underlying problem. Not not for most people yet. It's it's a you know one of the big questions and during through the pandemic has been are we going to get this every year or are we going to get done with three and call it good like with a hepatitis B series and and really for most people the answer to that hasn't been answered in big studies. There are some small studies looking at people who are very immunocompromised, suggesting that they can get up to normal vaccine responses with that extra dose. And so currently we're just targeting folks who are quite immunocompromised for getting that extra dose, but I'm not routinely recommending a second booster until better evidence shows that it's necessary. Representative Rosenquist. Oh sorry representative McFawn did that answer your question. Yes, thank you. Representative Rosenquist. Thank you Madam Chair. I'm just curious. You just started talking about what I guess people refer to as therapeutics drugs or treatments that can treat people for this disease. Once they have it, whether they're vaccinated or unvaccinated, but there seems to be quite a bit of dispute over whether some of these are effective or not. And there seems to be very little information out there on what are the effective therapeutics and I guess further to that would be, would it be useful for people to have some of those therapeutics at home to take. So they don't express or get to the point where they have to be hospitalized. So I was wondering if you could answer that obviously there were some that were considered were derived from veterinarian type products and people were concerned about that, but presumably they have made a human version of that therapeutic. Thank you. Yeah, happy to help out. You know one of the, it's been really quite remarkable to think that there have been illnesses like HIV and hepatitis C that it's just taken us decades to develop effective therapeutics for but for coven given the worldwide need. It's been remarkable that we now have, you know somewhere around a dozen effective therapeutics that have been proven effective for sort of a spectrum of disease we have a monoclonal antibody called a view shell that can help. Very high risk people stay protected from getting infected. We have an oral drug called packs low bid that is currently an heavy shell this being used in Vermont, the oral pill packs love it is now in Vermont pharmacies and limited supplies and can treat people who are at high risk who have active coven and leads to about an 85% reduction in death and hospitalization. We also have an ID drug for people who can't get packs love it called Citrovimab that can have has a similar reduction and hospitalization and death. There's a drug called remdesivir, which is more controversial and use and severe disease but clearly reduces death and hospitalization when given to people who have sort of just the beginnings of disease, now being used in hospitals. The oral pill called malnupiravir that can, if you can't access any of those can also be helpful, although it only reduces hospitalization and death about 30%. So it's not as good and so not preferred. And then if you're unlucky enough to end up in the hospital and sicker there's an array of drugs that have also been proven and randomized clinical trials like those others to work that includes the steroid dexamethasone, the immune modulator which is a map. Some people think remdesivir helps some don't. And then there are a couple of other sort of niche products, bear a sit nibs another one that we use. So we have sort of this array of drugs. There's also been interest in lots of other drugs such as you alluded to and sadly those would have been great because we already had them available and the evidence was really pretty bad for it. There was, I'd say an internet based enthusiasm for them that I'm hoping fades away, because I think it was largely born of desperation and suspicion of the medical establishment but when you have an array of really proven effective therapeutics that we all think work that desperation goes away and I think we can just agree hey doctors will choose what's good and, and they do and it saves lives and thank God for that. So yeah it's been great and I think one of the challenges is going so fast that it's difficult for me focused on this in my career on infections in my career to keep track of it all there's so much information out there. It's very, very difficult for primary care physicians to keep track of it because it's moving so quickly, and even more so for the for the general public because of course they're paying attention to other stuff to. And so, but fortunately we've put out guidance for the clinicians all around the state about which to pick first which to use seconds and lots of sites out there including from the NIH and the infectious diseases Society of America that for anybody who wants to go into the details can kind of tell you which study and all that stuff. So I hope that helps I know I went I geeked out a little bit into the details but I thought it might also make a point that man there are lots of difficult to pronounce words out there in case some of your viewers are feeling artificially expert in the topic. Thank you very much it certainly was quite an array. Can I ask a follow up or not. It says to do with vaccination of children, let's say less than 12 years of age or what have you. There seems to get probably because of the Internet you get conflicting information. There are a number of people that believe it you're more at risk to have kids vaccinated than your than not because of some of the adverse reaction. Children especially get to the vaccination that might not be an immediate thing might be further down the road. The, what's it called the swollen heart that's not the right term but I mean that it's something that affects the heart that people been talking about. I'm curious at what point do you equate the risk of the vaccine versus the chance of being badly affected because we also know children at least up to this point have been very minimally affected by the virus. So, at what point do we make that decision and vaccine is worse than the disease. Thank you. I think lots of parents, including me grapple with us. The way I think of it is this one the impact of COVID-19 on on children is massive and it partly has to do with how it impacts their parents and partly how it affects the children themselves. It turns out that around the United States, because of the massive death toll of COVID-19 now exceeding 840,000 people, that means that somewhere around 130,000 children have lost a parent. So vaccinating those parents is really critical but of course, there's a benefit, a little bit of vaccinating the child and protecting the parent, but we would only vaccinate the child if it really benefits them personally. And the other thing that we've really learned is that although children are definitely less likely than adults to end up in the hospital and have severe disease, they do have huge medical impact. So actually currently we're in the middle of an unprecedented surge of hospitalizations from children with thousands upon thousands of children in the hospital right now in the United States. I should clarify, I'm not talking about Vermont. And so it's a huge impact that isn't as big as the adult impact, but one that we really want to minimize. It's a much greater threat than other vaccine protected diseases. Also, it's a pain to be a child and get a non-life threatening version of COVID-19. And so I figure if we can protect them from that, that would be great. But all those benefits have to be better, bigger than the downsides. And there are downsides at vaccination. They're quite uncommon in anyone, including in children beyond a sore arm and a fever for a day or so. But they do sometimes happen. You mentioned myocarditis that has shown to have a slightly elevated rate in adolescent boys only. That's an important side effect. Fortunately, that has been self-limited and not led to enduring disease and the vast majority of the young boys who got this. But would I want my teenage son who did get vaccinated to get that? No. Did I talk with him about that? Yes. Did I think that it was worth it for him to get protected from hospitalization and loss of parent and all that? I think on balance it did. I think that balancing act has to be rethought with each age area. And so when we look under five, same math has to apply and we have to make sure it's worth it. Because it has to be good for the children to do it. And so far it is. But I think it makes sense for parents to hear that scientists are weighing those pros and cons and to watch the public CDC hearings where those data are weighed against each other so that they can trust that people are really thinking hard about it. Thank you very much. Sure. Dr. Leahy, we have lots of questions. And before I let folks loosen the questions, I want to know, because we have about 15 more minutes of your time. If there are things that you want to make sure that you get out first and then we'll ask our questions. Thank you very much for that opportunity. I guess there was, I had one semi-medical semi-personal point that I wanted to just to make today beyond the importance of curtailing indoor social gatherings, wearing a mask when you're indoors with people outside of your household, getting a vaccine and using testing wisely. And that is, it relates to the gratitude that I talked about at the beginning. I think it's a piece of pride and I think also a guide for the future that Vermont pulled together to debate where we should to consult the data and to set it next to other considerations like the economy and our social lives and weigh them thoughtfully as a community. And largely we have not have the same level of divisiveness and public denigration and negativity that we've seen in other contexts. And I think that is partly why we have done so well. Partly for me that like all of you I'm sure the pandemic has been a very hard time for my family and for professionally, but I have gotten solace from knowing that my neighbors are thankful and they are caring for more for me and they deserve to be protected. And I've been thankful that our state leadership has at all levels worked hard to protect us and I know that that professional adult caring tone that does allow for debate, but it's healthy debate not calling each other names and throwing out misinformation has been partly why we've been able to save more lives. Because people have been less confused by disinformation.  So I just wanted to say thank you to you for for the way you've contributed to that to the thoughtful way our elected officials have made decisions and, and I hope it's something not only that we can lead the world continue to lead the world and doing, but also that we will continue to save lives until we get to the end of this damn thing. Well, thank you. Thank you for that Dr lady and thank you for your work in terms of doing this. Thanks. And for your educating us and in that continuation vein, we have at least three questions we have one from represent Whitman, who probably was geeking out with you about those chemicals that you can't pronounce because he can pronounce them all. Thank you Madam chair, and thank you Dr lady for all this information really appreciated as well as your message. I just wanted to ask my question was actually the same as representative Rosenquist about therapeutics. Those chemicals, but I did want to just follow up on one thing that you said, which was that some of the outpatient and inpatient treatments aren't as effective against Omicron. Am I getting that quote correct and did that kind of applied to all of those therapeutics that you were listing. Thank you. Thank you for asking that clarification and also you reminded me there was a piece of representative Rosenquist question that I didn't address about whether these treatment should be in people's home so let me try to address both of those. The treatments that I did mention are the ones that retain strong activity against Omicron. And so it's sort of nice that we have an array of three or four effective outpatient treatments and a similar number of inpatient treatments. What has been unfortunate is that we have lost some of our treatments that did work against Delta so for instance there was the intravenous monoclonal antibody. And also the combination BAMLA, NIVMA, MAB and EDA7MAB these were medications you may have heard that President Trump received when he had COVID-19. They did have efficacy against the prior versions similar to what the monoclonals were using now use, but unfortunately those no longer work and so we've stopped using them, but kind of through the luck of the draw, one of those is the Trova Mab still does work and so that's the one we're using exclusively. And so that one challenge throughout the pandemic has been shortages. We were worried primarily about shortages of ventilators and it turned out that in some states that was a problem but in Vermont that is never, we've never had to ration ventilators. But shortages of staffing is something that we could talk about today and the threat of health care collapse I guess is something I haven't touched base on if you wanted to. But the related to your question, shortages of medicine is a real issue. So it turns out that there are something like 60 doses of Pax Lovid each week available for the entire state of Vermont. Something like 100 doses of Satrova Mab for the entire state of Vermont each week, 500 doses of the less preferred drug Malnupiravir available each week. And unfortunately those numbers are just not nearly enough to meet the clinical need. That means that we have to be really thoughtful about the way we allocate them. And so partly clinicians are given guidance about who's the highest risk people who should be given it. And partly when we're using those intravenous medications, we are rationing them in our hospitals all around Vermont. Currently, we use criteria put forward by the NIH to figure out who most needs it who's most at risk. But sadly that means that there are people who really I want to be able to dose I want to be able to protect them from hospitalization and death, and I can't there just aren't doses. But at least keeping them centralized that makes it so that at least we can make those determinations whereas we chat about home it would just be rich white guys who would have it and I might not need it as much as somebody else. But hopefully that will change I know that the big drug companies are being encouraged to ramp up production. Oh no. My, my puppy I think just got attacked by my cat, but my wife will look into that. But anyway, so right now we're in a time of rationing of those resources that I hope is temporary. Thank you for that. Thank you representative Bromstead. Thank you. Thank you. Thank you, Dr. Leahy for being here. I, my question is around variants. And I think we all are weary of the next variant and get nervous that we might get excited that we're getting close to the end of one variant and only to hear that a new variant is jumping in. And I, I think of all of the people right now who go out and say, Oh, this one, you know, I'm a cron isn't that serious, I'm going to, I'm not so worried about it but the more and more people who get it, though, at least what we've heard in the past is the more chance for a new variant but then also that really variants come from everywhere in the world and so if we can just vaccine and get vaccinations out to the rest of the world, then we can control variants. So I'm confused and wonder if you could help. This is I think the multi trillion dollar global question right now. And I think we all know that the more transmission there is of the virus, the more variants can happen. And so anything we do to reduce transmission will help you may hear of a Wall Street Journal op ed to the contrary which is utterly false. I would say it's just utterly upside down more transmission more variants is the story. That's accompanied by this other pattern that you alluded to which is the more people who are vaccinated or who have been previously infected the more immunity we have in the population. The more that's a mild disease for for the average person. And so the sort of the societal importance of all those cases starts to shrink. So the hope is that at a certain point. We will stop caring about coronaviruses in much the same way we didn't care about coronaviruses in 2018. We knew that they were there but who cares it's a cold. That's the hope that we'll get back to that because we'll have enough people in the population who are in some way immune. We won't have so many cases in our hospitals, and we'll say you know what we still have some cases if you're unlucky, but it's it's not so many that it makes us have to take special measures as a society to protect against that. So when do we cross that threshold I think is essentially a another way to address your question. And for me I think it boils down to not the case counts which are becoming increasingly irrelevant. But how the, the number of cases of severe disease are impacting our society and impacting the ability of the health care system to address them. I think if we get to a place where the rates of hospitalization and death from COVID disease not incidental, but directly related to the disease are low enough for our health care system to be able to manage them. And if it's low enough so that we as a society sort of feel and this is where elected officials come in, that's kind of like influenza and its level of impact, we should flip back to living life as we used to and feel thankful that vaccinations and other measures are there. And then you know hey if it mutates in some new way we can always put our mask back on but we shouldn't expect that we'll always be doing it. When will that come. Gosh you know anybody tells you they can predict the future well that's lying to you right. It looks like Omicron is already peaking in South Africa in New York City and in Boston and so we're hoping that that wave is short and that perhaps that time we've all been waiting for is going to show up in March. But it's too soon to tell because what about the next variant and will that affect hospitalization. So for me, I try to zoom back a little bit and not focus as much on which variant it is and all that.  We should still have special precautions. Are we having an unacceptable toll of loss in our over 65 and medically compromised people. If so then we must still fight as a community against it, but if it gets to a place where it's perhaps more than we were used to but not that much in our healthcare system can deal with it.  Thank you. And I think my household thanks you because that is my evening question. Daily basis. Say hi to john for me. Representative Rosenquist. Thank you. I'm just curious about antibody testing. I know my wife when she finally got vaccinated back in May I think it was anyway, she didn't get any reaction at all and she always gets quite a reaction just to enable even the normal influenza shot in her arm as well should get be get very hot and all that. So he had no reaction. So she went ahead and got, presumably, an antibody test, and it was negative. So obviously that concern her because, you know, presumably antibodies would have been created by, by the, by the vaccine. But I'm just curious, maybe why there isn't greater emphasis on testing people to see if they have the antibody, and would not need further vaccination or booster or what have you. Maybe comment on that. Thank you. Yeah, be happy to your point to an unmet scientific need. And maybe the best way to think about this is to, to make an analogy to antibody testing for hepatitis B. When I test somebody for to see if they're immune to hepatitis B I can tell because there is more than one antibody that I test, whether they are immune because they've been infected, or whether they're immune because they've been vaccinated or whether they're immune. Unfortunately, in COVID what we have now is just one antibody test and all it can tell me is whether I've been infected. We know that people who have been infected have some level of protection from future disease. We know that that protection is much less than the age of Omicron. But one of the things we don't have clinically is a good antibody test that can tell you if your vaccination took. And that's a real hole. I would love to be able to distinguish between those two. I expect that will come. You know, it turns out in a research context, investigators have shown that certain kinds of antibody levels do correlate with protection. Those antibody levels are different from the antibody levels that you can check in the clinical context. But what I hope and unfortunately that assay is super complicated and the kind of thing that a normal clinical lab cannot do.  But unfortunately, that's for the future. Thank you very much. Um, doctors, thank you. This has been an incredible hour and a half and informative wish you could perhaps foretell the future, but I appreciate that you can't. All I can say is just invest in plastics. That's my big advice to you. Sorry, that's an obscure reference to the graduates, right? That's all right. That's, you know, that's all right. And on some level, some of us have been looking for something different than the common sense responses that you talked about and the fact that yes, we're all getting tired. We're getting tired of being alone or the social isolation. We're getting tired about not eating and being inside with our friends. And some of us at the whole boat load of very attractive face masks that now we will have to figure out something else. The, the, what you talked to us and, you know, about the science, but also about the testing and then the importance of testing and the immediacy. And then the immediacy before you do something if you want to be safe with this group and then the importance of testing five is now is it both five and seven or five to seven days. Yeah, the ideal thing is five and seven. I think one of the practical realities is that tests are expensive and sometimes they're hard to get nowadays. We hope that the 500,000 free test of the Scott administration and the 10 million tests that the Biden administration are putting out there eases that difficulty in which case ideally it would be five and seven days but like if I could only get that one test from the government and probably use it at seven days to say good. Okay, great. And before we wrap up, we have one last question from representative Rosenquist. Yeah, I'm sorry if that's so many questions but great at answering all this information, but I was I read someplace and I can't remember where I was. There's something about that the PCR test the current PCR test was after December 31 was no longer authorized under the special Protection Act or whatever. And I was just curious was that incorrect or has it been reauthorized or what happened. Yeah, that was a it was a quirky piece of information that I think led to some confusion so it turned out that that PCR testing is something that we use on a daily basis and clinical medicine for a number of things it's pretty old technology and they just adapted it for COVID-19. There was one time limited company specific PCR authorization that did expire on the 31st. But there are multiple PCR platforms and use and very highly reliable and, and so that was just kind of an administrative detail that didn't really speak to the efficacy of the test. So we use that every day in the hospital to detect cases and people who have symptoms. Thank you very much. Yeah. And again. Thank you. Thank you so very much for being so informative and for taking time away from your practice to to be with us this morning. It's very much appreciated. It's good to see you and thank you for your work too. I really appreciate it. Thank you. And thank you committee. 1145 and it's this this morning's testimony is over, and we will actually have some more expert testimony around COVID-19 this afternoon starting at 1.