Hi everyone, Joe for Jaspy's casebreaks.com, coming at you with 2021 Panini Luminance Football. Six box, pick your team number eight. Now breaks, we're doing half case breaks, so breaks seven and eight are actually from the same case, but eight sold out before seven, so eight is from a fresh case. I think that makes sense. Very big thanks to all of these folks right here for getting in on the action, and if you bought at least three teams, you'll get an entry and you'll be eligible for some break credit. All right, so there's the luminance right there, fresh case, so let's pop this open. Let's see which half we're going to do. All right, we've got three stacks of four right here. We'll take two and put it on this stack, two, put it on that stack to make two stacks of six, and we'll roll the die, or we're going to select a die, we'll select that one here. We'll go one, two, three for the left six, four, five, six for the right six, and it's four, one, two, three, four, five, six. So this we will save for random, or pick your team seven, hard to write at this angle here, but all right, so it says pick your team seven right there for those three boxes and pick your team seven on these three boxes, so we don't get them mixed up with the other half case that we have in the store. All right, so now let's pop these open and let's see what we have here. The convenience usually has pretty good photography, pretty nice stuff, three autographs and one memorabilia card per box on average. Got Baker Mayfield on there, on-card autographs in those year one signatures, some rare variations we're looking for, ultra rare inserts, including far out, radiance and more. Let's see what we got, good luck. Now all card chips as well, oh I kind of like the mix of fonts there. Once again, three autographs, one memorabilia card, so four hits a box. All right, let's see what we got. Oh, points, we'll randomize these points to someone in the break, that'll take the place of a hit. There's Mike Evans to 10, so I think the rookies are still in their college gears, but finally have their pro teams attached to it, which is very helpful for the shipping team now. Oh, nice Trey Lance autograph to 125, that's going to go to Lee and the Niners. Nice start. Pretty cool looking card right there, there's Alvin Cook, Key and now into 50, and Matthew Stafford to 99, got him in Rams gear already. And there's a Justin Herbert relic, a piece of his jersey going to Serenity, there's Justin Fields, we'll set aside those top tier quarterbacks, and there's Chris Evans for the Bengals, 60 out of 100, that'll be for Josh and Cincinnati, and this will be for the Bears, Aaron with Chicago. All right, next box, so far so good, I really like the photograph here. All right, next box. Has there been any major football news lately? I don't think there has, I think it's been a relatively, like no one's gotten like, no season ending injuries or anything like that, no one likes those. I guess nothing, nothing really, nothing really happening. I guess we're just waiting for camp to happen, there's Javen Hawkins to 50, and Baker Mayfield to 99. And we got a Marshall Faulk relic, vintage materials for Serenity and the Colts. Baker Mayfield, I'd like to see him take another step in his evolution as a QB. That would be pretty great, he looked really good last year. Could he get even better? And there is a Shee Smith 50 out of 75, and a Brady White autograph to 349. Looks like he's not associated with the team, let's see if Group Break Checklist has him attached to a team. Looks like he was undrafted. Brady White is none, so let's see if I can associate with him with a NFL team? No, he'd be a... No, not associated with an NFL team. So we'll randomize him to one person in the break. In fact, here's what I'm going to do. We'll do the name on top, we'll get the points, and the second name, we'll get the... The second name, we'll get the Brady White, and I guess we'll continue going on that way. Out of 299, Larry Roundtree III, we'll go to the Chargers, and we've got Patrick Jones II, and we'll go to the Vikings. Why is my... Why is my chat not working? That'll be for the Minnesota Vikings, that'll be for Michael Pacifico with Minnesota. I think YouTube's down. Alright, so if you can still hear me, I can't see your chat, but I think YouTube might be down, so you might not even be able to see this video. But this is being recorded as well, so we'll go directly to the recording. There's a year 1 on-card autograph. That's Diami Brown. These year 1 cards seem a little thinner than the other cards right here. Looks like YouTube is down right now. I can't pull that up. Sorry, we'll still roll. Diami Brown is a Washington Redskin. I thought I had my blue pen here. It's a Washington football team. The year 1 autograph. Alright, next box. That doesn't look good. Hmm, the video is working. I just reloaded my page, but it looks like the chat is just... The chat function is just down. We'll keep rolling. We're recording. It's Kenny Galday. Got him in his New York Giants gear. Mike Evans to 50, and a Trevor Lawrence to 299. Go to the Jaguars, of course. That's going to go to Aaron.  Going to Patrick Davis and the Lions. Sage Serrat to 35. Kind of like that teal foil right there. And for the Chargers, we got a Larry Roundtree, the third. It's going to go to Serenity and the Bolts. Harry Card to 299. And Jermard Jefferson. He almost looks like he has Justin Jefferson's autograph. To 349. That's for Detroit. That's going to go to Patrick. It's a 75. And Devonta Smith. Nice red ink autograph. I think are shorter printed. That's for the Fly Eagles Fly. And that'll be for Aaron and the Eagles. We're halfway through this half case break. The chat's certainly not working for me. My chat window crashed and I'm not able to bring that back up. So I think YouTube's having some issues there. But I think you should still be able to watch. Because I can still get video. Just no chat. I'm sorry about that. At least on my end. You could be on a different server. Although maybe not. How my video has frozen. At least we're recording this directly to our computer. So we'll still be able to upload this. Alright we've got house calls. AJ Brown to 100. And Russell Wilson to 35. And we've got a Jalen Hertz relic. For Aaron and the Eagles. Josh Allen to 299. And a Jabril Cox. 323 out of 349. Dennis with Dallas. Caleb Farley to 75. And we've got a 57 out of 100. A Jason Oah. For Baltimore. That's going to be for Aaron Billingsley. And the Ravens. And Nico Collins to 299. And Nico Collins year one auto. Right on the card. And that's for the Houston Texans. Michael Gallucci with the Texans. Leave all these numbered cards or shipping team. We'll top load all these before they go out. I wonder if... Mobile device. Yeah I don't think the chat's working on my mobile device either. I think YouTube's having some issues here. S-Box fatal memory exceeded. Is the error code on my browser? Alright next box. Trevor Lawrence to 299. Jaguars that's going to be for Aaron. Maybe the YouTube chat's working? I don't know if the YouTube chat's working either. On my mobile device. We'll keep rolling. The autograph is... Javon Holland to 100. It's for Miami. That's going to go to... It's going to go to Mark. It's Josh Allen to 100. Savage. Insert. Tray Lance for the Niners. It's going to go to Lee. Davanti Adams to 299. And that's going to reveal Justin Jefferson Relic. Baker Mayfield to 75. And for the Buccaneers we've got... Jalen Darden. 98 out of 100. Aaron and the Buccaneers. We've got Derek Carr to 299. And we've got Dwayne Eskridge. Year one autograph. From Western Michigan. Eskridge is a Seattle Seahawk. And the final box. Just enough trash can space for this break. For those of you who are watching live, I apologize for the inconvenience. Maybe on the mobile device? Does it work? If you can still hear the sound of my voice, try the mobile device. Maybe chat in the mobile device as well. I might see Aaron. Perhaps. The mobile chat. So that might be working. But not if you're watching via a web browser. Tyler Boyd to 50. Jordan Cameron to 299. And Steve Largent Relic. Okay, I see you Aaron. Aaron saying mobile is good. Mobile devices I think you should still be able to see and chat. There's Adam Thielen to 10. And a Sam Elnger. For the Colts to 349. Blue horseshoes that's going to be Serenity. How am I going to flip these around? It's going to go back the other way, isn't it? That's 299. And we've got Elijah Mitchell for the Niners. That's going to be for Lee. Trevor Lawrence base. We've got Devante Parker to 75. And a Cadarius Tony. Year one autograph. Those year one autographs of course are on card. And Cadarius Tony is a New York football giant. I wanted Daniel Hayes. Space Trevor Lawrence. And Quitty Pay at the end. And there you have it boys and girls. Thanks everyone for bearing with me through the technical difficulties. The mold device is working well but I just kind of... Alright. Let's give away some money. And those two extra things over there. The points and the Brady White card. Alright so let's flip back to this screen over here. Now you had to buy at least three. So slightly different from what you normally see. But I'm sure everybody read the item description. You got to buy at least three. First names here. Three teams get you one entry. Six teams gets you two. So Aaron bought seven. But for the purpose of promo, six count. So that's two entries. I don't think anyone bought nine teams. Daniel Hayes bought three teams. That's an entry. Michael bought at least three teams. That's an entry. Michael P bought six teams. That's two entries. Patrick Davis bought at least three. That's an entry. And Serenity bought at least three. That's an entry. That's pretty good odds there. So let's get all those names in here. And everyone gets a shot at the extra stuff. The points and the Brady White. So we'll use the same dice roll for both lists. Let's roll it. Let's randomize it one and a five. Six times for names and... Six times for these names. And then the break credit. Four, five, and six. So we're giving the points and the extra autograph away in the order that they were pulled. So the Brady White was pulled second. So that'll go to the second name. It's a little consolation prize for Michael Pacifico. And the 150 points will go to Serenity after six. Six times for the break credit, top three get $100 each. That's not bad. After six, one, two, three, four, five. And good luck. Sixth and final time. After six, we got Aaron, Patrick, and Aaron. So Aaron, you'll get $200 of break credit. I'll send that to you in one. And Patrick Davis, you'll get $100 of break credit going your way as well. I'm Joe for jaspyscasewrakes.com. That was 2021 Panini Luminance Football. Half case, pick your team number eight, which was the first half of the case, because eight filled before seven. Seven still available in the store on jaspyscasewrakes.com. Quick little recap to give you an idea of what we got going on here. I like the Relics, the year one on-card autographs. Excellent photography. These are all hallmarks of luminance. Red ink autos, different colored inks, different short prints. A lot of nice stuff. And the Trey Lance, we started off with, which was pretty cool. Thanks for watching. With us, I'll see you next time on jaspyscasewrakes.com.


Nineteen years ago, when Atul Bihari was Prime Minister, the NDA government introduced a new pension system for retired government servants called the National Pension Scheme or NPS. It was implemented in January 2004, but as you know, a few months later the NDA lost the elections and the Congress led UPA came to power. Now the Congress liked NPS so much that it implemented it in total and also nudged state governments to implement it too. Only the left opposed the new scheme and West Bengal refused to implement it. What was this NPS and how was it different from the old pension scheme? The old pension scheme, which has come to be called OPS for short, was pretty simple in design. Government employees got half of their last drawn salary as pension for the rest of their lives. So if someone earned 1 lakh rupees just before retiring, they would get 50,000 as pension after retirement every month. Now we know that government servants obviously don't get paid as much as private sector employees do but they are protected against inflation through a system of dearness allowance or DA. DA is based on the current rate of inflation as it is revised twice a year. For example, if the government announced the year 5%, then the Babu in our example would get 5% of his 1 lakh salary or 5,000 rupees as DA. What about retired government employees? Under the old system, they too would be entitled to this 5% DA. So after retirement, the government official in our example would get 2,500 rupees as DA on his 50,000 rupees pension. Not only that, pensions in the old scheme were revised upwards every 10 years or so to match changes in the standards of living in the country as a whole as a larger society. OPS was entirely funded by the government, employees paid nothing for it, NPS changed that entirely. Government employees now had to contribute 10% of their salaries towards the pension fund and the government, which was the employer, matched that contribution and sometimes paid even more. This corpus would be invested in bonds and stocks so that it could grow. Employees could choose from several different options of varying degrees of stock market exposure depending on their own risk appetite. The pension payout therefore depended on how well their corpus had performed. There was no DA nor any pension revision. At the time, the NPS was implemented. Financial experts and economists had argued that government employees would bend up with much bigger pensions compared to the old scheme because, as they argued, equities or stocks always deliver higher returns. They also argued that the old pension scheme was not sustainable anymore. It was costing governments too much and eating up a large part of their revenues, which could otherwise be used for development purposes. Under NPS, governments still do have to pay a certain annual outgo in terms of the employer's contribution to the pension corpus but the liability is much lower than what it was under the old scheme. Another feature of NPS is that it is open to everyone, not just government servants. Of course, governments don't contribute anything towards a private employee's pension fund but everyone gets tax benefits from investing in the NPS and also they get their investments managed for free. So why have five state governments, all opposition governments, gone back to the old system? The reason is that government servants are realizing that the benefits that they were promised in 2004-5 had turned out to be all blatant lies. Their monthly incomes are now dropping sharply as soon as they retire. In some cases, to less than 15% of what they were earning right before retirement. When NPS was introduced, the pundits had argued, as I said, that people would end up with much higher pensions than what they could have got under the old system. That is because a part of their money was going to be invested in equities or stock markets, depending on which option they chose and equities have historically delivered much higher rates of return, so therefore the corpus would go at a faster rate because as it turns out, real returns on NPS investments have been much, much lower. On top of that, they're fixed forever, neither are they protected against inflation nor are these pensions revised periodically. So government employees have been agitating for a while, asking for the old pension scheme to be revived. The center hasn't budged at all, but opposition states have. So now economists are saying that going back to the old system is economic hierarchy.  Many columns have been written about this and I'm sure you've read a few of them. And our estimates suggest that one fourth of what states earn in taxes is spent on pensions. In some states, like Punjab and Himachal, which have ironically gone back to the old scheme, the expenditure is even higher. So economists are saying that if OPS raises revives, states will go bankrupt. Now how valid is this argument? First of all, this is an accounting trick. A state's revenue is not just what it collects in taxes. Because states have no access to half of the taxes generated in the economy, which is income tax and corporate tax, states get a portion of what the center collects. And that is what has to be counted as the legitimate tax revenue. Along with that, states also get various grants, which is due to them under India's federal financial structure. If you add all of that, which are all the legitimate revenues of a state, pension payouts drop to less than 12% of the total revenues earned by states. Not 25%. Now it is true that pension payouts under the old system would have continued to rise because of two things. One, the first is inflation and pension revisions. And second, increased longevity of India, which means pensions would have to be paid for a longer period after retirement. But this can be covered by increasing tax revenues, especially by taxing the rich. As economists Rohit Azad and Indranil Chaudhary have shown us, India ranks at the bottom end amongst G20 countries when it comes to raising revenues through direct taxes. Almost two thirds of the tax revenues in India comes from indirect taxes, like GST, excise, duty, local taxes and customs. All economists agree that this is bad because the poor end up paying equally for indirect taxes, whereas direct taxes can be targeted at those who can afford to pay taxes. The government has easily raised more resources by taxing corporates who have been making record profits since their tax rates were slashed four years ago. Similarly, India is amongst the only big economies of the world which does not have any wealth tax, something that even big free market capitalist economies use to mobilize revenues. So as the government has the will to tax the rich, it will have enough money to pay proper pensions to its employees. But there's a bigger moral ethical argument here, one that deals with how we view citizens of the country. The discourse about the old pension scheme is dominated by neoliberal views where the state is seen as an entity that has no responsibilities towards its citizens. The market is expected to decide who gets what. That is why the words used for pensions are burden and liability. We are also told by economists that government employees are a pampered lot. Why should they get pensions all their lives when other people don't? Then why do these same economies, same pundits not fight for government salaries to be the same as corporate salaries? Why don't they want to pay market rates for the services that government employees provide to society? They'll never do that. Economists keep warning us that if the old pension scheme is revived, the young will have to pay for the old. But tell me what is wrong with that? Do human beings cease to exist as citizens once they can no longer work? Do we as a society not owe a decent life to those who work for decades for society as a whole? After all, that is precisely what government employees do. Even when they are corrupt and do it badly without the edifice of the government economy. Our society, everyday life, simply cannot function. Democracy cannot function. Retired people are not burdens. They deserve decent lives where they are protected against rising prices and are also guaranteed that the standards of living will keep pace with the rest of society as long as they're alive. The real reason why they are painted as burdens is because of pensions are made contributory. Finance capital gets access to huge corpus of public savings to deploy into the financial system for their own profits through financial speculation. And the contributors end up with nothing substantial as we've seen. That is why we must get the old pension system back, not only because retired people deserve better but also because finance capital which has already wrecked the global economy needs to be resisted and stopped in its tracks. That's the show today. If you've liked this video, show your love by pressing the like button. Subscribe to our channel and press that bell icon too so that you know when a new video drops. Until next time, goodbye.


Aloha. I am your host, Winston Welton. I'm delighted that you're joining us today for this out and about special show where every other week we explore a variety of topics, organizations, events, and the people who fuel them in our city, state, country, and world. As a disclaimer, any of the things that I say are strictly my own opinions and not connected with any organization that I might have been associated with or that I am currently associated with. That said, I am delighted today to have a very special guest, Aurelia Gonzalez, who is a master of science student of natural resources and environmental management at the University of Hawaii. Aurelia is also a member of Protect, our all-awaii watershed and president of Hawaii Streams and Ecosystems. So thank you so much for coming onto the show today. Thank you for having me. I'm delighted to be here. Well, we were just talking before the show and we've met and talked about these issues of the watershed especially and you have some special expertise and knowledge about ecosystem restoration and green infrastructure. That's correct. And we will be talking about that and I think it's in this larger context of the Protect, our all-awaii watershed group that's formed to sort of give some alternatives to the Army Corp plan that's currently being presented as this 100-year flood model. Is that... Yes, yes. So it's a little bit of a back story. There is a proposed project, the Alawai Flood Mitigation Project and that's how I became a part of Protect, our all-awaii watersheds, that working group. So the proposed plan is to have seven or six debris dams up into our upper watershed for the Alawai watershed. So that would be Makiki, Manoa, Palo Lo Streams. And then going towards the Waikiki area, there would be some detention basins. They also want to raise the flood wall for the Alawai canal. And the project has been, really hasn't been, there wasn't properly notified to the community so a lot of people and stakeholders of that area feel pretty discouraged that the Army Corps kind of passed this project and the city had the opportunity to gain some money for this project but the stakeholders weren't properly involved and I believe that the environmental impact statement could have been done quite differently. And so I'm pretty passionate about other softer alternatives and I, as a student of Natural Resources and Environmental Management, we've been taught that there are other solutions out there. But our municipalities aren't really adopting these forward-thinking solutions and we're still adopting outdated concrete infrastructure. And so I'd like to talk a little bit today about green infrastructure and how that provides not only economic, environmental benefits but also economic and cultural benefits to our community. It encapsulates it well and you said that the EIS, the Environmental Impact Statement, is maybe based on some old modeling or some outdated ideas. Yeah and I think that there is a piece also that they want to offset and mitigate for their impacts in this project. And I think they've proposed to remove some smaller weirs but actually if you talk to people who work in these streams, you know, these smaller weirs, they're actually holding back invasive species up, holding them back and so they don't go further into our watershed upstream. What is a weir for the people that don't know that?  It's a concrete wall and going across a stream. It's a barrier for fish migration and so a lot of people typically want these things removed and it's good to have them removed. But in some cases they actually retain invasive species to certain areas and so you can actually manage for invasive species to that idea. For instance here in Hawaii it's specific that we have gobies that can climb walls. We only have five endemic fish in the state of Hawaii and these are our gobies and they have sucker mouths and then so they naturally... These are freshwater fish, right? Freshwater fish of course. So there are only freshwater fish and they have a specialty to climb up waterfalls and they use the sucker mouth. So here in Hawaii weirs actually, you know, they still allow the passage, small weirs, allow passage of some of these gobies but keep invasive species like tilapia further downstream. So let's engage in this conversation with the community of what is occurring. We don't want the tension. We don't want dams in our stream. We don't really want issues with fish migration and passage. But let's have the full story so we can make proper decisions. And I think what this group was born of was this frustration that this thing was rushed. It was totally rushed. It didn't have properly community input. Seven out of eight neighborhood boards in the affected watershed and I believe it's a 19 square mile watershed or something like that just from the everything that drains into the Alawai watershed basin. So seven out of eight neighborhood boards asked for the Senate to not give matching funds for this after the city. The city council asked for a study and to put a pause on this as well. That's correct. But the mayor and the governor have sort of gone around and they're looking at issuing some cops which are a financing vehicle for this. But essentially there's been so much community pushback that the ocean did a study and said this thing was rushed. It was you know and not certainly don't want to disparage our good colleagues and friends in the city and at the Army Court of Engineers because they were doing the best they could but they probably were relying on some outdated model. And it seems like it's this one got picked off the shelf pretty quickly. And when they got money for Puerto Rico this was I think sandwiched in there. So people didn't want to lose the money. But at some point maybe we got to think what are we really giving up here because this is a half a billion dollar project from the start and really little community input. So protect our Alawai watersheds was formed to counter this. Yeah. Yeah. Thanks for tying us back to that group. So. And maybe actually we're going to have a forum on next week. Right. OK. Yes. So this is our forum flyer. These are some speakers that are going to be out at this forum. So this is a grassroots led forum. People working in the watershed who have alternative methods who want to be heard who do science in the Alawai watershed and people like you know our water our water keepers. We have folks coming out to speak about green infrastructure current stream monitoring in the Alawai watershed. So that would be members of like protect our watershed or protect our Alawai watershed. And so that's going to be at the golf club house of the on October 29th. Which is a Tuesday. Which is a Tuesday. Tuesday night. So a week from tomorrow. Yes. At 6 30. Yes. 8 30 it said and the Alawai golf course club house. Yes. Thank you. That's the ballroom upstairs. So on the second floor plenty of parking. Yes. And I'll be at 6 30. So that's in the evening. So folks that are working can come and attend and to listen to what the community has to offer as far as like wanting to be heard and alternatives that the Army Corps should you know adopt. And hopefully they'll be attending there and listening to that as well. And this is really interesting because you're having this spontaneous community of groups coming together and saying hey here's all these really wonderful ideas that maybe you guys haven't considered and these are really important for us. So let's just put it back on the table. We teach our kids and our professionals you know at our universities that these methods don't work in the long term. We you know as far as ecosystem services and the cleaning up and and so yeah I think people are pretty upset that hey we have there's there's science out there that proves otherwise that we can adopt these these other these projects. And I was talking with a friend yesterday and she said the old model maybe when I was younger was about command and control whether it was employees or the government or whatever. So could this is what you do and this is how you do it. But we've moved away from that a lot in our society and how we do education raise children even and it's about collaboration it's about input it's about negotiations and real buy-in because when the community doesn't buy and we're seeing this all over a while who I think where this the city or the state have said this is what we're going to do whether it's Mount Ikea or bellows or yeah that's exactly what's happening. Yeah and then the same for this right right that we are bypassing community engagement and neighborhood needs opportunities are going to be missed if people just pass this plan as is and instead of you know incorporating the things that we've been taught and learn to make forward thinking ideas and solutions I mean this could be a model if Hawaii can do this the right way it would be a great model for collaborative thinking and and you know having protection of property and business but also doing it in the right way engagement and economic services it's a great it's great to hear that and are you feeling hopeful at this point about that that the community is actually going to be listened to and heard and that these ideas will be incorporated in or maybe some of them might or I'm I'm really happy that protect our waters are all Hawaii watershed that group has formed in this forum is going to be well attended and but I you know I hope so I think that I do have you know some optimism and that and that maybe ocean it will bring you know really look into what we say and put some cost do a cost and benefit analysis I mean we really need folks working on the numbers on some of these things and not just ideas but to actually show the benefits long term and so if we can do that I think it would be pretty impactful however you know in my experience people just the process is listening to the community and then once they have that box checked they're still going to go on and do the project so I really hope that that doesn't happen in this case and I feel like there's some loud voices that I think that can turn that but are you are you thinking we're seeing something different here because I've been in Hawaii a while and I don't remember the community rising up like this on so many issues around the island it's everywhere it's all across is saying no we don't we don't want this are you is it are we in a different time period where people are just wanting their voices to be heard or well it's practice I mean you know I think it's a new practice that people are actually doing active listening and and doing social studies around what people are saying and incorporating that into city planning those are new practices and I think that with those practices being properly implemented yeah I think that they can make great examples of how that's done and maybe that's what we're on the fringe of of that the old ways and these new ways and they're you know kind of clashing but yeah this is the first time I have seen a group organized and with so many you know voices to but they said no we don't want this project we have alternatives these are the people that see these alternatives it's time and yeah maybe we're on the fringe of that that battle well I hope so and as I think maybe it's the trickle up theory and that we're getting young people that are finding science-based alternatives that say okay the way that we had it that was the best we knew then but now we have a different way that we that's better you know in the old days that's like you said babies were you said oh put them on their stomach and now no we leave them on their backs and so yeah we went with the best that we had so hopefully our friends that in the city and the state and and the Army Corps of Engineers will step back a little bit and say well maybe we can learn something from from what's percolating up and what incorporating these community concerns so we were going to go for a break here but again I wanted to put up about the this forum that's coming next week on Tuesday October 29th it's going to be a forum for alternatives to the Alaway flood mitigation project holy grass roots 630 to 830 do you know how at the Alaway golf course clubhouse which is at the Alaway golf course exactly there's great parking there it's a two-hour show it's going to be broadcast on Olalo as well on channel I don't know what channel it is but I think you can it says 30 I think that's 30 years but it's going to be on Olalo do you know how many speakers are going to be there approximately I think there's going to be at least 15 15 speakers so each one's going to have about five minutes and there's going to be booths there and lots of time to get that also to get input from the public and say maybe somebody's has has a great idea that we that hasn't been considered yeah there'll be just as many tables as there will be speakers so this is the start of the dialogue that was missing in the community's been feeling missing yes well it's a great pleasure to have young lady who's teaching us how to be collaborative and and work on these issues that are really important here especially when we're looking at spending half a billion dollars and that would be the conservative estimate and really tearing up the the echo the ecology of the land really and and putting in things that may not have been wanted by folks that are living there so we're when we come back we're going to explore some of those and look at what the flood modeling is because we do want people and property protected of course nobody is saying that we don't want to do that we just want to do it the right way with the best practices that we've got today so I am with Aurelia Gonzalez who is a master of science student at UH of natural resources and environmental management she's a member of protect our all Hawaii watershed and president of Hawaii streams and ecosystems we'll be back in a moment with more of the story thanks to our think tech underwriters and grand tours the atherton family foundation Carol Mon Lee and the friends of think tech the center for microbial oceanography research and education collateral analytics the cook foundation Dwayne Karisu the Hawaii council of associations of apartment owners Hawaii energy the Hawaii energy policy forum wine electric company integrated security technologies Galen Ho of BAE systems Kamehameha schools MW group limited the Schuyler family foundation the Sydney Stern Memorial Trust Volo foundation Eureka J. Sugimura thanks so much to you all hello how we are back and we're live I'm Winston Welton this is out and about on the think tech live streaming network series and today we are talking with Aurelia Gonzalez who is a master of science student at the University of Hawaii studying natural resources and environmental management she's a member of protect our all Hawaii watersheds and president of Hawaii streams and ecosystems and it's delighted I'm delighted to have you back here thank you and so we are talking about that next week for the folks that are listening at home on Tuesday October 29th from 6 30 to 8 30 we're going to have a forum presented by protector all our watersheds with a whole bunch of other groups coming in about you said 15 or 20 groups and they're going to all speak for pretty strict amount of time there's going to be a lot of booze available so people are going to be able to come in and give their two cents we're going to have an alternative and have informal it's just chat while with folks to come and share their ideas to hear ideas to spark some things and maybe this will bleed back up into the powers that be and we're just going to start a real dialogue here that results in really well thought out plan that protects people property and maybe restore some ecosystems yes that's correct so just to give people at home an idea of what we're looking at if we could look at the first slide here this is what we're looking at so this is from the final EIS which was produced environmental impact statement by the Army Corps of Engineers and so if you look at the the one on the left there that's the 10 year flood model showing well what's supposed to happen every 10 years now if you live in Hawaii in amount of time you know that that's never happened so the but let's just give it a go and say on the right hand side is the 100 year flood model and they say it's not and if it's a when okay we I can go with that we do get rain bombs whether it's crazy now but Ilani school states that a lack of scientific integrity should be rejected and it's clear that the scientific analysis modeling and methodology are flawed and cannot be relied upon that is in this study here so when Ilani school pretty smart people there they are obviously in an impacted zone as are the seven out of eight neighborhood boards and said don't fund this plan it's it's it's we need more time more community input more study so that's the less what the Army is trying to the Army Corps trying to protect it against so you know the protection idea great idea we want to protect people of property but let's look at the next slide there and we'll say because this is a little bit closer look at this and so this you see there all the white key is protected here right so this is with the wall built now where Ilani is another where Ilani the golf course all the way back to the freeway it looks like up on dole looks like where market city is and then across the university there too lots of flooding there back in Manoa in polo in yeah the athletes department look underwater underwater even houses I'm sorry not kakako all the way over to McKinley high school you've got a lot of neighborhoods are underwater with this plan built so you can see why people are saying wait a minute okay so we protect the economic engine of Hawaii and sacrificing everything else it's not a well thought out plan that doesn't protect everyone we want some I guess fairness here you know and spread this around to make sure that we're getting the right thing in there so at the next one maybe is a closer up of what we're looking at as well with the debris dam so on the left you have what it looks like and on the right you have what it would look like so sort of just wholesale right and most people are familiar with these debris dams because we are we have some already but they're overgrown and they're not maintained so the debris dams that we currently have they already pose issues with our watershed and that could be because they're un-maintained they're just in my opinion a lost cause they're supposed to retain down trees and water that are coming from the mountains to not block the stream system and you know it's a maintenance issue when it comes to that so why propose six new ones six more of them you know who's going to maintain these if we already have some that are being maintained in the community has issues with them but people are saying okay but we've got to protect our keiki and the property and the Manoa flood right where it went through the university was this like one of these dams that just got locked up that was actually a maintenance issue and it was on city and county for you know and it got blocked up because the area was not being properly maintained and so a lot of people say oh with these debris dams are supposed to you know protect from another Manoa flood happening but it's really a maintenance issue these you know we don't have the workforce and the money to maintain the current infrastructure and now we're adding on to that infrastructure requirements yes okay and it's it didn't work then so why more more the same okay and then the last one we have here is an example of the Hokulani elementary school they didn't even know about this project as again a key stakeholder they're downstream that is one of the detention basins that is planned there from the EIS there so and the neighborhoods on the bottom on the other side of that wall so that they were not informed and communicated with and do you want that kind of amount of water right behind you I don't know I mean it's scary and if a levy breaks a levy breaks or what happens so we've got some other other options that that you might be proposing here and one of these is green infrastructure what is green infrastructure yeah so green infrastructure is man-made designs they really it encompass a lot of different ideas so this could be anywhere from planting trees to mulching areas having just more green space but it could also be like large underground retention areas storage tanks things that sit against a building that are you know ten stories high that would store water and slowly percolate that water out so it's a way of controlling the sheer volume and energy of stormwater that is mainly the issue is that that with our current infrastructure we have concreted streets we have concrete neighborhoods and we have concrete canals and this doesn't allow water to naturally percolate and infiltrate into the aquifer and so what happens is you have a surge of stormwater that causes flooding it's a health issue you have concentrated forms of pollution so green infrastructure would retain restore possibly filter that water so it's to a manageable degree so and in I believe in full force that we could we could protect property and we could protect lives with implementing these solutions and in the cities behind but we're on a track possibly to get us there with our new stormwater management fee but we have to direct the people making decisions to make the proper decisions currently I think people want to use our future stormwater management fee to maintain the infrastructure that we currently have like I mentioned we have a maintenance issue so but ideally stormwater utilities fees are supposed to promote forward-thinking solutions like green infrastructure that that promote environmental social and cultural benefits for all and it's not just another form of getting some money to do something that we're already supposed to do it's it's a form of of having a new bowl of money to do do forward-thinking projects to elevate our cities into sustainable management which we were required and we have so many you know goals to hit that we publicize and that's what I really feel like the stormwater fee should be used for is helping us reach these goals not to maintain things that we should and so you're talking about things like the Clean Water Act or other considerations by the EPA or our own health department yes so mainly by EPA and the Department of Health and so we have compliance with our current our system which is we call an MS force system it's a is that rainwater and sewage are separate systems and that rainwater goes directly to the ocean so it hits our streets gathers pollution trash and then goes straight to the stream and then the stream goes to the ocean which causes reef issues browning events things like that and so we have the obligation to make sure that these waters are are not polluted before they go out to the stream and we don't have a really good practice of doing that is it is possible to integrate maybe some of these ideas like a detention basin that's not being used most of the time along with some of these green practices yeah so the the detention basin that you showed in a park is actually although they would have some stakeholders that are pretty upset it is a it is a form of green infrastructure it's a way of retaining water and allowing that water to slowly percolate it's an it's an idea so it could be a pilot idea maybe that's not something that we want to go with but maybe we're okay with underground storage and then we want to talk about okay well where's the water table where's you know you know where can we do underground storage so yeah okay and there's gonna be a lot of ideas that are presented at this forum yes which you're part of the group protect our all away watersheds yes I will be speaking if you guys would like to learn more please I'll be there you will be speaking in that is next Tuesday October 29th at the all away golf course clubhouse and on the second floor it's going to be at 6 30 at night where you're going to be speaking with about 15 other groups just sparking the mind and getting some some juices flowing there's going to be kids it's going to be a fun event it's going to be a friendly event we're just going to be sharing with each other it's not a one-way thing it's a it's a learning on both ways so someone may come up to you and say have you thought about this that or the other so your brain is going to be sparking that day too right and a lot of people say that green infrastructure doesn't protect you against a hundred year flood and of course a rain barrel something that you have at your house you know it's going to overflow in a large storm and of course your you know your rain garden that you know your nonprofit and you helps design in your neighborhood it's not going to protect against a hundred year flood but if we which we will we will be forced to to adopt some of these on our private property we're going to be taxed by the amount of impermeable impermeable surface that we have on our property and so more people are going to start to think about this and I think that with that in large magnitude we can get water off of the streets and to be a flooding issue and more sustainable and green as we go along and even with the plan that's presented now it's not going to we saw those areas that would still be flooded under the Army Corps plan so it's time to incorporate some of these other ideas and see if we can't reduce that impact as well and get caught up to where we are in 2020 almost with the best practices that we've got out there and like you said maybe we'll be the model for the rest of the country and incorporate this here and share it with the rest of the country. I would encourage all of my viewers and does it want to hear our Elia speak to come out next week October 29th at 6.30 at the Alawai golf course for a forum for alternatives to the Alawai flood mitigation project. This is a great opportunity for community involvement it's paving the way forward so that we can show it's the kind of society that we want to live in where people are engaged and engaging and I appreciate you stepping up to the plate and unfortunately we are out of time our time is always very short. I love talking about the issue and would be happy to answer anybody's questions. I encourage everyone to come out. Okay and they can do that there or maybe you'll come back on and we'll this she's not going anywhere we've got years on this so it's been a great pleasure to have you on the show. Thank you. It has been my pleasure especially to be talking with our Elia Gonzalez who's a master of science student of natural science. She's a member protector all of our watersheds and president of Hawaii streams and ecosystems so we look forward to seeing a lot more here her on the show. I'm Winston Welch this is me signing out of Out and About on the ThinkTech Live Streaming Network series and a big shout out and thanks to our broadcast engineer floor manager and all around great guy Eric Kalander who puts it all together for us today and all the other good folks Haley and Robert and I'll see you every other Monday at 3 for more of Out and About. Aloha everyone.


prescription. Kate's daughter told the reporter that she found the safeguards to be a roadblock and eventually a physician was found to write the prescription and Kate Cheney died from the lethal dose. S-74 would make it even harder to determine if a patient was feeling pressured or coerced and make the doctor shopping seen in the Cheney case easier. Under Act 39, not only is the prescribing physician required to do a physical examination of the patient, a second physician is required to conduct an evaluation of the patient as well. While it is not explicit in statute, the practice under Act 39 has been that this second opinion would also be the result of an in-person consultation. But S-74 would allow a physician to prescribe the lethal dose of medication without ever meeting the patient or conducting an evaluation of the patient in person. While telemedicine is a useful tool in some cases, we all know from the past two years that online communication is not the same as in-person communication, especially when you are meeting someone for the first time and don't know them at all. While it has been the practice under Act 39 that the second physician also conducts an in-person exam, the law does not explicitly require it. So under S-74, the patient would not have to be evaluated in person by either the prescribing or second physician rendering the safeguard of a second opinion meaningless. The physician may have no relationship with or knowledge of the patient other than reading a medical record. In addition, the medical records could be provided by the patient. They would not necessarily be sent by a physician who performed the exam. The patient would be able to limit the information sent, for instance, by leaving out mental health records. The prescribing and secondary physicians would not know if they had received all relevant medical records. The lack of a required in-person meeting between the physician and patient becomes even more concerning in light of Oregon's 2021 Death with Dignity Annual Report, which lists anorexia as the underlying condition for which lethal drugs were prescribed. This is very significant as it marks the first time a mental illness has been included as an underlying condition that qualifies someone for a lethal prescription. As it is literally a matter of life or death, it should be required that the prescribing physician examine and evaluate the patient in person. When Act 39 was passed, the lethal drugs commonly prescribed were secobarbital and penibarbital. However, those drugs are no longer readily available in the U.S. due to their connection to execution by lethal injection. In recent years, proponents of assisted suicide have been experimenting with a variety of lethal drug cocktails, trying to find a combination that kills most efficiently. Given the ongoing changes being made to the drug protocol, its experimental nature and side effects such as regurgitation and prolonged dying, immunity should not be given to pharmacists and healthcare providers. The pharmacist currently providing the drug combination to patients states that he requires an indemnity agreement be signed to protect himself. I would hope that agreement also makes patients aware that an expectation that the drug combination will result in a quick, peaceful death may not be what happens. In 2013, supporters of Act 39 insisted that the safeguards included were wanted and necessary. Now they have done a 180 asking for some to be stripped away. What will they be asking from this body next? Instead of removing safeguards, this committee should consider strengthening protections for patients. Is this the opportunity to vest a government agency with oversight of Act 39? Require full disclosure of the experimental nature and potential side effects of the lethal drugs being prescribed. Take action to make sure mental health conditions do not become the basis for assisted suicide in Vermont. And ensure that physicians involved have a bona fide relationship with the patient. More protections are needed, not fewer. And I urge you to vote no on S74. Thank you for your time and I'd be happy to answer any questions. Thank you very much. I'm looking for questions, comments. Formulating a question. Please. Go ahead. I'm still thinking. Oh, you're still thinking. Okay. Is she going to stay with us? Sharon, we do have a question from Representative McFawn and I'm wondering, are you going to be able to stay with us this morning? Yes, I can. No, I can stay with you. Thank you. Representative McFawn. Madam Chair, thank you. I want you to make a decision about this question. I'm going to bring people to page two, small five. And it says the physician determined that the patient, that's the heading. And the underline section under A says a physician's physical examination of the patient. And then down lower, it talks about the physician informed the patient in person or by telemedicine. Is that a question for the Legislative Council? I believe it is, although I'm not quite sure what your question is. Well, the question, my question is, is there a need for an in-person physician's physical examination? The testimony here is there isn't. And I'm looking at these two sections. One says a physician's physical examination. You can't do a physical examination over telemedicine. So I want to make sure that I want to get that clarified. Okay. And I think I'm going to ask Legislative Council to clarify what is in statute. So please. Sure. Do you want me up there? I guess we do want you there because then we can hear you. Good morning. Jennifer Harvey from the Office of Legislative Council. So looking at subdivision five there on page two, this is the requirement that the physician determined that the patient in subdivision A was suffering a terminal condition. And that is based on the physicians and under the language in the bill, review of the patient's medical records and a physician's physical examination of the patient. So a physician, whether it's this physician or another physician, must have done a physical examination of the patient. And that physical examination, I agree, a physical examination would need to be done in person. That's the physical aspect of it. But that is adding to or leading to that determination that the patient was suffering a terminal condition. So not only was in their medical records, but that must include a physician's physical examination of the patient. Am I answering your question? Yes. And that physical examination is that they were capable, was making a informed decision, had made a voluntary request, et cetera. All of that stuff is done in person. That physical examination is just modifying that determination that the patient was suffering a terminal condition. So the physician has to determine that the patient was suffering a terminal condition, was capable, was making an informed decision, that whole list. But the determination that the patient was suffering a terminal condition is based on the physician's review of the relevant medical records and a physician's physical examination of the patient. So the answer to my question is, a physician has to do a physical examination of this person. Is that correct? That is correct. Okay. That's the main thing I wanted. Thank you, Robert. Just on that same point, but it doesn't have to be the referring physician as far as I understand it could be another physician did the physical examination. And that's a concern to me. Okay. Thank you. Okay. Chopra, do you have another question right now? I can't hear you. I'm sorry, I have to get my hand down. There you go. Okay. Thank you. And Sharon, if you can stay because there may be some more questions and now we have David Engliger. Good morning, Congress committee. I'm delighted to be before you today. I see you taking away my pillow and snacks, please. So good morning. My name is David Engliger. I'm a senior policy and legal advisor at Sharp Health. The chair's indulgence, accused indulgence, I don't know how much, how much you meant your pain. There's a lot of information. Would it be okay if I could serve a brief history to locate the bill in time? Certainly. That would be helpful. That was confusing. He said certainly. Certainly. But I'm going to have to ask you to speak up. Okay. Project. I will try to project. So in 2013, I'll kind of do this straightly. Remember the table. I'm going too slowly. Okay. In 2013, when the legislature took this matter up, at that point it was being called death of thinking. The legislature for many weeks and back months, I believe, considered a Washington-style bill where there was a stepwise process for physicians and patients, where there was also comprehensive reporting that was currently required by the Washington Department of Department of Health. As things sort of took a turn, as things went to the Senate, at the final hour before the vote, that bill was changed radically. It removed the reporting requirements. It also had some imperfections that were currently living with that I think to some extent this bill addresses. So the Department of Health testified on this bill we were supported by the shuttle administration. The chair and other committee members may remember that actually Steve Shapiro of what that time was, the chief medical designer came and testified his support of the bill and the importance of having the underlying cause on death certificates and have the death certificates not reflect this. And what he said was, I think, was particularly striking, which is this is extraordinary but not exceptional to the extent that this is the last decision made between the patient and the doctor in the lifetime of the decision. So following the passage of Act 39, the Department of Health, as is on our website, it said, the member read it, it said, Jeff, he probably means I wrote that paragraph. There is no, there is no overseeing entity, but the Department of Health to the extent that anything is administered, the Department of Health administers the, we administer the act to the extent that we collect all the information from patients and doctors. But what we wanted to do, what the Department of Health wanted to do was to ease access to the, to the act so we convened a large stakeholder group, which nurses and brought ethics network, and even a medical center, we created a whole series of FAQs for doctors, for patients, and the general public. And that's, you don't have to add any words. So I've made those available to the FAQs were produced and published on all of our websites. So that's available on the Department of Health website. There are also all of the, all the requirements of the act were just turned into a form so that, so that doctors and patients didn't have to create word documents to ensure that all pieces of the activity follows. And that was a series of, it's a series of checkboxes and signature blocks. We did not add as craft, the Department of Health didn't add as craft anything, it simply, it simply follows the tenants of the act. As we sat down, the stakeholder group sat down to discuss this, we noticed rather quickly that there were not liability protections for all health care providers. So it was important to think about pharmacists that they were going to be held liable for, for providing a legal dose. We reached out to the Office of the Attorney General who provided us an opinion saying that if our pharmacists were working within the act, within the scope of their license, and were participating, you know, under the act that they would not be held liable. So that is actually in our, that's in the FAQs. Actually, that was, we got permission of the Attorney General to actually publish it under their, under their name. Two years later, so, oh, I'm sorry, a critical piece of Act 39 for passage was that the, the bathroom during the sunset three years later, the idea was that the stepwise process made out the act would simply become a part of the standard of care, and that there was no longer, there would no longer be need for a legislative imposition of requirements. But two years later in 2015, there was no consensus among the Department of Health and stakeholder that the, that's that stepwise process was still very useful. And also that there was an interest, there's a general interest and a little bit more information about what was happening with the act, policy makers on all sides of the, of the, of the spectrum, as well as the general assembly, the administration didn't really know what was going on because all information is held with confidentiality. So Act 27 or 2015 did the two principle things. It required the Department of Health to adopt rules that would have, that would, that would provide us the ability to collect information from providers. It also required that we establish a rule for the disposal of the dose that was prescribed if it was not used. So since 2015, the Department of Health has produced a report required by the Act, I'm sorry, it was produced every two years. I believe I have, I believe you all have that now. The information, as you see, is, is fairly, it's fairly basic and a fairly high level. We say, for instance, the number of persons suffering from cancer, we don't say what kind of cancer. And that's simply to protect people's identity, that if we have Washington style reporting here, we're talking about somebody's right ethnicity, their age, specifically what they're going to be going from. In Vermont, those people were going to be identified. If somebody is a certain age, let's say hypothetically 49, and they live in Huntington or they live in Victory, that, that's my intervention to be identifiable. So the General Assembly with the Department certainly supported, created this report that gives folks, gives them law makers and policy makers in the public a view of sort of what's happening broadly, but doesn't allow you actually to identify who's actually using it, which is, which is central. I mean, it's embodied by the fact that all of making this kind of confidential and the fact that the underlying disease is not reflected in the, in the desert. I'm sorry, general disease is reflected in the desert, not the, the final intervention by the physician. Where, where this built to the Department's position, where this built fits in, is it closes the liability gap that, that, that we try to close with, with working with the Attorney General, but it makes it very clear the law and there's liability protection for health care providers. So that the policy question, to my mind, before, before the General Assembly is, is really fair, fairly narrow. It is about the use of telemedicine. And that, and from the Department's perspective, as we think, we try to think both broadly and deeply about equity, these telemedicine has been valuable, you know, in the time of COVID. There are, in the case of after the night, patient choice, there are a small number of providers across the state who will participate. And if you have persons who are not, are not located close to a, to a physician who will do this, the ability to use telemedicine lowers the, lowers the barrier to access with somebody who will live far away. And they don't have to, you know, I think that they don't have to expend it today and their family to spend the time resource in order to go to the physician multiple times. We count on physicians in Vermont to do a whole host of things. And one of those things is constantly assess the patients and their treatment. And so, to my mind, the manner in which a physician is assessing a patient under the act is not, is not so different from the way they, they make all kinds of assessments every day. Again, I will come back to that formulation of it is, it is extraordinary but not, but not exceptional. So with that, I'd be delighted to take your questions. I'm, thank you for being here this morning, Mr. Lunder. I'm just looking at the report that was submitted this year to the legislature. And so noting that over the last two years, it looks like there have been 29 confirmed deaths, 17 of whom used the prescription. However, it notes that 21 had actually built the prescription. So presumably four people either died from the underlying disease, chose not to use the prescription. And one of the things that I know in this, you also have sort of cumulative statistics from enactment. What I don't see in that, that's sort of the general, give you the general of 116. And since you have the information about confirmed deaths and whether they use the prescription, why is it that you don't include that in the cumulative information? I'm sorry, the total number of prescriptions not used? In the biennial information, you give the total number of confirmed deaths, the total number who used their prescription, people who died from the underlying disease, that sort of like break out there. But for the cumulative information, since the enactment, we only get the first level. Obviously, because we only started collecting this information relatively recently. Oh, okay. Well, that answers that question. Yeah, I apologize. All right. Thank you. So I should have said that all positions are required to fill out a form when they and get under our rulemaking. They are not required to necessarily determine the cause of death. Because sometimes the attending position is in the presence of the patients at the time of death and sometimes they aren't. But the vast majority of positions have a factor less whether or not they were the ultimate cause of death of the patient. Okay. Representative McFawn and then Representative Rosenquist. Thank you, Madam Chair. Mr. Englander, I would like to bring your attention to one of the requirements that a person has to be a Vermont resident. Um, my understanding is the act is not specifying, like does not give a definition of a Vermont resident or who qualifies as a resident. Is that true? That is true. And it's unusual that that the determination of residency is actually made by the by the decision that sounds in the in the reporting forms the Department of Health provides just to be helpful. The kinds of things a physician might look at, whether it be a driver's license or a lease or a heating bill. But the but the ultimate determination of residency is determined by the by the position by the by the doctor. Which one? The first doctor that did the physical examination or the doctor that might be doing it by telemedicine? Or is it either one? It is by the it is by the original physician makes the determination who starts the process with pain. Okay. So is it a could this happen? I own a summer home in Vermont. Or I lease a summer home in Vermont. Could I leave Massachusetts and come up to Vermont and have this procedure done here in Vermont? Would that would that qualify me as a Vermont resident? That would really that decision would be made by the position whether whether they considered they considered you a resident. So basically, if any physician that is dealing with that individual, if they decide based on certain things like if I rent a property, is there any time limit on how long I have to be renting that property? Could I come up from Massachusetts and the next week start the process for a physician assisted? Because there is no time limit and because there are different kinds of residency requirements in Vermont law, it's not consistent. Like it doesn't say six months make somebody a resident. It would be up to the physician. I would say that having spoken with many of the providers who engage in this law, they take it with an extraordinary amount of gravity. And it's not something that anybody does lightly. So I think if somebody had a summer home, it's hard to imagine it's not that it's impossible because it would be allowed under the law, but it'd be difficult to imagine a physician taking somebody who is here seasonally as a resident. So that's an opinion. That's what everything else has to pure fact. Yeah. And I would think that, I mean, I don't know. I'm surprised or I'm concerned that a physician makes the decision whether or not a person is a resident of Vermont. One of those physicians, the physician that may be doing it by telemedicine, they not even know that person. Or anything about. So I could come in from Massachusetts two weeks ago and my family is here. So I came here. And okay. That answers my question. Thank you. But it is on the physicians, we rely on the physicians ethos, their morals, their ethics, the law, and the fact that their license is always on the line. So these are never decisions that are made by. I understand that. But a person coming up to Vermont to have this procedure done because they rented an apartment or maybe they came to stay with their family. I see all kinds of ways that wouldn't affect a physician's license because they're following what it says. All you have to do is rent the place, own property. You don't even have to live here. All you have to do is own property. And that could allow you to be considered a resident of Vermont. I just think it's pretty loose. So I guess I would say as a lawyer, renting doesn't make you a resident. By near fact of renting doesn't make you a resident. You do have to live here. That is what residency means. Well, it says you can lease property. But Vermont has to be your home. Okay. I have my answer. Thank you. Representative Rosenquist. Thank you, Mr. Englender.  Going back in history, could you fill in a little bit of why? I mean, to me, I would have thought certain communities in Vermont would have been concerned about this law because it's not equitable to all people suffering from terminal diseases and discriminatory in that way that certain people like ALSO uses, for example, would not be able to avail themselves of this procedure. And I was just curious why there wasn't more focus on that and to come up with maybe a method, not to say I agree with this, this thing anyway on other grounds, but I was just surprised that it was such a discriminatory and not equitable law to begin with for people having ended life issues. So maybe you could give us a little background on that. And you were referring to the fact that a person must, a patient must self-administer the dose. Correct. They need the physical capability to pick up, to pick up the glass to be able to be able to swallow. That's a, it was a policy decision made on the part of the general assembly that, that physical, that, that they can use a Vermont, that a word is used uniquely in Vermont law, which is, we say somebody is capable, that's not, that's not used elsewhere. And so, so my observation is that the general assembly felt that capability fold into, that was both a mental and a physical capacity. It is in dish of intent, but you're certainly right that there's a point at which patients are going to be physically incapable and they, and they, they don't have access. Yeah. I mean, to me, these people are the same with a lot of people. I think they have more of a reason to do it than people with other types of terminal diseases. It would seem like, anyway, I, it would seem, well, I guess a follow-up would be do other states allow people, they can't self-administer to, to do this, I mean, to avail themselves of this. At the, at the time there wasn't, I don't know, there may be, there may be folks in the room who know whether other states allow, I would say this, that if you allow another person to administer, there is a, there's a greater chance of, of, of, when somebody, some of the ministers, we know that they're, they're, they're making an active choice. No, I understand this. There certainly is, right, if you, if you balance that, again, the person that do that with the legislative, you balance whether you think that, that that is going to create a problem for people who aren't, who aren't capable. Right. And there was, I mean, there was, and stakeholders did express, as it was expressed today, express the concern about coercion. I, I do want to know that my name, that there are, there are, there, there have not been any instances I'm aware of in Vermont where a weird coercion has been brought up as an issue. In 2015, I'm sure the chair will remember, there was a floor amendment on, on the act that would have had the Department of Health report done to do an annual report saying how many times persons who were not supposed, were not authorized to sign, sign. And what I said, I think sitting right there is, there's no, there was a chair there, I don't know, anyway, is that there didn't need to be a report because if that happened, we would immediately contact law enforcement because something was in danger. So, you know, there have not been, there have not been any instances of that in Vermont. Okay. I know that you also talked about this question, I just. Okay. All right. I don't know what to say, I just think it strange that they wouldn't have tried to come up with some method that somebody could self-administer or anyway, I just surprised. Dane and then Topper, I see your hand up. So, you will be after Dane. Oh. Thank you, Madam Chair. And thank you Mr. Engler for being here. This is a question I've raised a few times and my understanding is you might be the person to provide some context, the rulemaking regarding disposal, if somebody does not administer the medication, could you just describe a little bit about the process? Sure. I mean, to be honest, the rule is as broad as DEA regulations allow.  So, a common method. So, there's two things, we want to destroy it, we also don't want it in the environment. So, typically that means something like being mixed with coffee grounds or kitty litter, the two most frequently mentioned, and we all have them in abundance family, and then putting those things in an air, in a liquid type bag, you're mostly a teacher way to say that, and then just going to get in the trash, or can be brought to, you know, disposal site. I think the idea was that we wanted patients to know that there was an expectation that that would be disposed of. So, it's not, it's not more restrictive or more detailed than DEA regulations, simply a clear notice. Carl. Yeah, just, if I could follow up to something that Ms. Toobard brought up was the fact that the, I guess, most common drugs are not readily available anymore, and I'm trying to come up with some other concoctions. And so, what sort of level of testing would have to be done before those, that new concoction would be distributed or used. I recall several years ago, there's lots of discussion on end-of-life things at correctional facilities that they went through a whole dream of different chemicals on almost everybody. Almost all of them got voted down or were not allowed, and I don't even know what to use these days, but it was a big process, and I was wondering what sort of referring back to her issue there that some people may die more slowly than they'd really like to because they're using some cocktail that isn't as quick as people would like it to be. So, what sort of protections do we have on that from a pharmaceutical standpoint, I guess? Sure, and just to breathe through the history of that is that there was the most common, the most common dose that was used was also made by a German manufacturer that was also used in prisoners' executions, and so the German company stopped exporting to the United States because of their more opposition to the death penalty. So, we did what spurred the need for this to explore other options, and to answer your question, the answer is that all drugs would require FDA approval. For that intended use, right? End-of-life, okay, and I always said FDA would have to approve a brand of life? Well, that's actually a good question. I think, I don't want to get over my skis. I don't think FDA approves drugs for end-of-life, because there is a prohibition on use of federal dollars, I'm sorry, end-of-life, excuse me, a patient choice. So, I don't know off the top of my head, and I want to guess, but I can certainly get that for you. I don't think that FDA says this can be used for. Yeah. I mean, usually when a manufacturer comes, they say what the intended use of the drug is, and FDA determines that it will do what they purport it to be, and that's one of the things we see on the back of FDA approved to do what it says it's going to do. So, just a curious issue. I believe if we go on our web page, there is something from the pharmacist that references this, and I'm not quick enough to find it right now, but I believe the answer of as much of an answer as we have is on, we've got that testimony in both verbally and in writing, verbally from the lawyer, and a letter from the, I believe, single pharmacist who is providing medication. And I believe that a hand is going up by representative Taylor Small. Thank you, Madam Chair. I did that quick research for you to find it on our web page. It would be under Jeff Hockberg, which you can either go to Friday, April 1st to find that, or under the witness list. Are there other questions right now for the health department in David Englander, or do you have anything else you want to say? I'll be here all day to answer the committee's questions. All right. Thank you very much. We will go to Sarah Teachout. Good morning. Good morning. Nice to see everyone here. I'm Sarah Teachout, and I represent Blue Cross and Blue Shield of Vermont. And I want to say thank you for considering this legislation. Blue Cross and Blue Shield of Vermont very much supports it. In particular, this section that provides pharmacists some protection, some legal protection specifically. Our role, just to step back, is when one of our members requires these medications, we have to locate where the drug can be purchased. At present, there is only one pharmacy in the state of Vermont and one pharmacy in New Hampshire where we can procure these medications. So we believe that this may help make the medication a little bit more widely available and easier to get the person to make them. I don't believe that this alone is the issue, but I think it will help. So that is the reason we are supporting the bill, and we support all of our numbers health care choices. So happy to answer questions. Certainly. Carl. You said there's a manufacturing site or a pharmacy that this is available? Pharmacy. A pharmacy. In other words, it's not available in Vermont at all. There's one pharmacy in the state of Vermont that will build prescription. Yep. Are there other questions or is this anything else that you want to add? That was it. Thank you. Thank you. Thank you very much. Are you there? Yeah. Please go ahead and Julie, could you let, I know it's a bit earlier than you confirmed, but I thought if we have this and then we take a break, that that would be more appropriate. And Alan, please sit down. This is Alan Jewett McKay. And Alan McKay Jewett. Yep. Okay. Thank you. If you would wait 30 seconds, a fellow committee chair would like to be up here. Representative Brad would like to be up here. Oh, so we could. Yes, I'm sorry. You know some of us, but you don't know all of us. So let us introduce ourselves. I'm Julie Campion from St. Braugton. Yes. Tapper, could you introduce yourself? I'm Tapper McFlawn, and I represent Barrie Town. And I'm Jessica Branstad, and I represent Shelburney, St. George. I'm Dan Noyes, representing, we'll get Hyde Park, Johnson, and Belvedere. I'm James Grabber. I represent Fairfield, Fletcher, and Bikersfield. I'm Allison Allen, with the Montgomery, Buston, Stratton, New York, and Bendman. I'm Dane Whitham from Huntington. Nice to meet you. I'm Ray Glock, I'm a representative of this. Carl Rosenquist, represent the town of Georgia and Franklin County. Good morning. Taylor Small, representing Winniesky and Burlington. Taylor. Good morning, Ellen. Nice to meet you in person. Teresa Wood from Waterbury, and I also represent Fulton Field School in Huntington. Great to meet you all. Thank you so much for inviting me. Thank you for being here. We have just checked to represent the grad, and perhaps we'll wait a minute, and if not, we will go forward so that you know. Thank you. Thank you so much. Thank you. And for those of you on Topper and Sharon, just so you know, Sarah teach you how to just let so that you know who is in the room.  Yes, Madam Chair. Just a question. We're waiting for representative grad. Is she specifically interested in this witness's testimony? Yes. I think without, I believe that she would like to be here in person. But just this particular witness. Yes. There's other testimony. She is interested in all of the testimony. Okay. Former Representative Jewett was a longtime colleague and vice chair of House Judiciary. And as such, she wanted to be in the room if possible when his wife testified. Right. Okay. I'm sorry, Jim. Thank you. Since we're waiting, I asked Mr. Ingliter a question or one that he could possibly answer. Oh, absolutely. All right. I thank you for the reference that Taylor looked up for me about the prescription. I've thought all along that it was an injection or whatever reason. I don't know why I thought that, but I'm just letting it be known that I didn't realize it was a suspension and something would take my mouth. That even makes me question more my initial issue. But anyway, just saying. Was there something that led me to believe it was an injection or not? I'm trying to thank people. I can't say what might or may not be your mind, Representative. But it is a liquid. I think I made, I think I thought it is a liquid. As much as I would like to wait, I think it's hard for everybody. So please Ellen, please go ahead. Thanks. I'm Ellen Blackmore. I'm Jim McKay Jewett and I'm Willem Gudeau. And I really appreciate you guys inviting me today to talk about our family story. Many of you. Could you speak up both for this end of the table and for this thank you. Many of you knew my husband who worked with him here in the state house for many years and you knew that he was a strong advocate for Act 39 when it passed in 2013. I'm sure he never thought back then that he'd need to use it himself. But his diagnosis of a very aggressive new coastal melanoma in December of 2020 and the failure of immunotherapy, chemotherapy, radiation to control it, made medical aid in dying an option that gave him and us, his family, enormous peace of mind. We are extremely grateful that he had that option. You know that Willem was a fighter. He had more energy, determination, grit, and courage than anyone I've ever known. He wanted to live more than anything. We were making plans for adventures right up to the end. This was a man who was 100% committed to living. He loved his medical team at Dartmouth Hitchcock. His girls and I and countless friends supported him every step of the way through this sickness. He was all in with his treatment. But knowing that he had access to medical aid in dying, gave him and me and his brother and his daughters great comfort during his last few months when it became clear that there would be no cure. Willem hated using words like battling and fighting when talking about his condition. To him, it was more of a project. A project that he tried very hard to control. Karen Olschlager, another Ramonner who benefited from Act 39, put it well when she described her long illness. There can be a lot of pressure in our society to keep fighting, keep fighting, keep fighting, especially as a young cancer patient. I think that's what folks don't always, I think what folks don't always realize is sometimes keep fighting is really just a lot of prolonged physical suffering that gets worse and worse. Pointless suffering at the end of a terrible illness serves absolutely no purpose.  He thought about it for months and very clearly knew this was the route he wanted to take. He gathered us together in June of last year and told us this would be his plan if treatment did not work and we all supported his decision. He was a world-class athlete and he was good at listening to his body. It became very clear very quickly when his prognosis worsened. He knew when it was time. Willem got to the point where he could no longer get into the car and drive to Hanover for treatment. And for him that was the signal that he reached the end of the road. At that point he was very, very grateful to have the medical aid in dying description on hand. Five days before he died he reached out to patient choices Vermont and offered to lend his voice and firsthand experience to their advocacy to revise some of the bill's original wording. Some of that language made it incredibly difficult for dying Vermonters to jump through all the hoops necessary. Tell medicine visits for example rather than in-person visits would make their last few weeks much easier. Doctors can decide as they do with all other patient care if telemedicine is appropriate in each case. As Willem said let's not let the legislature get between patients and their doctors. At 39 gave Willem a peaceful and dignified death.  While he was still the person we all knew and loved. He did not have to endure an increasingly medicated painful and drawn out death. We are so very grateful for that gift. Dr. Diana Barnard and Stephanie Stoddard our spectacular hospice nurse from Addison County Home Health and hospice were with us at home that day. While it was a blur of emotions for all of us what I remember most is the courage and humor that Willem was still able to share with all of us and the gratitude we felt that he was still in control of the most important decision of his life. It was a calm and peaceful and strangely happy death. None of us were happy that he was dying but all of us were happy that he was still calling the shots. I'd be happy to take any questions. I don't have any questions but I would say thank you for sharing your stories. It's very very powerful. This point and people need to understand that at the end of the day it's virtuous and it's not the beginning of life. It's not the I think Switzerland has a lot that's very we'll say liberal where you can just choose one day not to be there. This is dealing with absolute pain and if people nobody deserves to go. So I'd appreciate it. Thank you. Thank you for sharing a very personal story for the courage that you have in terms of sharing it. Like several of us in this building we knew well and we knew how much he loved life. I couldn't keep up with him walking up the stairs and he was feisty and his courage and the support of you and his family in his decisions and thank you. Thank you for sharing this. Is any sort of I don't know whether there's a place for questions or further comments to you or if there's anything else you would like to say? Well I just you know I mean it was such a short time before he died that he reached out and started you know that final push to help these changes go through. He believed in it you know 100% not only from a you know ethical and legislative point of view but from a personal point of view he was in it he was in it and he wanted to make sure that other people had a slight had had slightly fewer barriers to get through when it came to them and you know I'm just really happy that I can win my voice to help that stuff go forward because it's what he would have wanted and yeah. Sorry I'm not very loud with my mask on but thank you. I would just share that two years ago my mom died at home in a state where we did not occur this and it was horrible. It is a gift it is a gift that Vermonters had this option so they don't have to go through that awful and for the families for those of us who are left it I think I absolutely believe that it has enabled us to heal more thoroughly you don't have to go through that awful period of helplessness and fear and you know horror and for the survivors that makes a huge difference it makes a huge difference. Thank you. It was let's just it brings it back. Yes I am I'm so glad that I have an opportunity but you so thank you thank you for being here and committee what I would say is this is a good time for us to take a break and why don't we come back at quarter of 11 and when we come back at quarter of 11 let's talk about what we have heard if we have remaining questions for legislative council in terms of what the words mean and let's just talk amongst ourselves have a committee discussion about how we're moving forward so thank you very much and you're going to take a pause.


Hey guys, welcome back to Come Again, TV the only place on YouTube where all geek culture collides. I'm Shannon, and today on the show, we're taking a look at the Transformers Siege War for Cybertron trilogy, Optimus Prime. As you can see, as usual, it's from Hasbro. It's part of the Transformers Generations line to Kara and Tomy. There's the side of the box, the other side you see nice image of Optimus there, and there you see Optimus on the back. Very cool. This, I never had an Optimus Prime growing up. I had very few Transformers growing up actually. I always liked the cartoon.  They were just so expensive. I couldn't really get that many of them. So I'm glad to be able to get some now. My collection is expanding quite a bit. I just picked up quite a few of them. And it wasn't until I came across caveman reviews here on YouTube that I started getting more into Transformers, all the lore and the figures themselves. We're collaborating on a couple videos that should be coming out in the near future. Hopefully, fingers crossed. I did a review on a Transformer for his channel that he should be coming out with soon. Now he's back doing YouTube again. And he's going to be doing the voiceover for a history and origins of Megatron video for Comic-Con TV. So make sure you stay tuned for that coming out in the near future. So anyway, let's go ahead and get into Optimus Prime. He does come with some directions, which I did have to go over before filming this because I don't mess with them too much. I keep them all displayed. Occasionally I will pick them up and transform them just so that the joints don't get stiff and all this. But I digress. Anyway, as you can see, he comes with a blaster right there. And he comes with his X, which in and of itself transforms as well into a blaster. All you do is fold this part down, fold this part up, and you can use it like that as a shield or as a blaster like that. Pretty cool. Set those off to the side. And I really love the sculpt on Optimus. Optimus was always my favorite character in the Transformers, as I'm sure he was many people's favorites and Transformers. He was my grail growing up. I never got him. I never even saw him in stores because they were always sold out of him. I do plan on eventually picking up one of the Re-Release Generation 1 Optimuses. But I don't want to do that until I can find a Re-Release Generation 1 Megatron, because they kind of go together. It would feel unbalanced if I had one and not the other. I had Megatron for a few weeks, and then I finally managed to pick up an Optimus. So anyway, like I said, the sculpt on this guy is awesome. You can tell he's got some battle, some battle damage here. Paint, wearing off from battle. Very cool. I did get my son the film version of Optimus Prime a couple years ago. Somehow he managed to lose the head. I don't know how he managed to do that, but he did. Because I was going to do a review on him a while back, but with no head it seemed kind of pointless. I do actually prefer the film version of Optimus Prime over the square body red semi of the animation and generalized style of him. Even though this was the original, I still prefer the blue with red flame semi Optimus Prime. So anyway, let's go ahead and get started on this. We're going to bend the elbows just like that, and I'm going to take you in the order that it shows on the directions, and then we're going to flip the legs around right at the knee. I'm going to bring this part out and up, then flip the wheels around just like that. Same thing on this side, the wheels out just like that. And now before you connect this, you're going to want to, this part right here, it's very difficult to try and get a grip on it to flip it open on both legs. So you're going to want to come at it from the sides just like that, flip them up, and then we're going to go ahead and bring, close the toes, toe and heel, and then we're going to connect, as you can see here, this tab here tabs right in above that tab, and that tab tabs in right below that one. Tab those together, this octagon inserts right there, tab together just like that, and then once we got that done, we're going to fold this up.  So you've got to take right behind the crotch piece, fold that whole piece up just like that. Okay, then fold those in. All right, then what we do, we bring the backpack up, spin it around just like that. Generally, this is where the directions will tell you to go ahead and fold the feet, but I went ahead and did it ahead of time. So anyway, you take this piece, fold it up, and fold this piece around on his arms, just like that. And they can only go one way. If you don't try taking it the other way, because they are blocked by this piece here, you may end up breaking them if you try. So fold it around just like that, and then bring his arms back just like that. The wheels take a little bit of effort. They're a little awkward. You bring the wheels down, and you put them flat for now. And then once you do that, bring the arms around. This part's a little awkward. The fists slide right in to this groove here. Okay, same thing on this side. Make sure you get that tab over, then we go ahead and bring the wheels up. And then we open his chest. So we open his chest, go ahead and fold down his head. All right, make sure it's folded down all the way. We open up the backpack, fold out the gray piece, bring it down. This gray piece will cover up his belt, bring this part around, clip it in both sides. It clips in just like that. Okay, once we got that done, we can close the chest piece and then finish tabbing everything in. All right, there you have Optimus Prime in semi-mode. Now there's a number of things that you can do with these. All right, you can put his gun in either one of these peg holes, which looks okay. You can put it on the side here, which looks good. Looks all right. Or you can plug it in in the back, which looks good too. You can also plug it in back here and have it flip around. That looks good. Although I'm a very symmetrical person, so I really need him to have two cannons to make it even. Kind of my OCD kicking in. And then this one, you can pretty much do the same thing. It fits just about everywhere. And the axe part does tend to unclip from time to time, and it just clips back in. Let's see. Tab it back in. Something else you can do with this is you can go ahead and take the axe back out and kind of like that. If he passes by a Decepticon, he can go right past it and just cut it in half and back up and do the which is cool. You can also do that back here as well. Cut them right in half, flip it around, hook onto the other one, and drag them backwards. So anyway, there you have it, guys. The Transformers Siege War for Cybertron Optimus Prime. If you enjoyed that video, make sure you hit the subscribe button right there so you can stay up to date on all things geek culture. Also, make sure you check out one of these two playlists on the side for more videos just like the one you just watched. I'm Shannon for Comic Getting TV, the only place on YouTube where all geek culture collides. Take care, Geeks.