Good morning, everyone. Again, some of us have settled out earlier in the morning at the social equity caucus meeting. And we are now on YouTube, so this is the House Health Care Committee. Welcome. It's the 10th of February and 9am. So this morning, and actually today, our committee is focusing on issues of health disparities. And this morning, we are going to first hear from Susanna Davis from the Office of Health Equity, or not the Office of Equity for the State. Apologies, Susanna, I want to get your title properly. Executive Director of Racial Equity. And after we hear from Susanna, we're also then going to be turning our attention to the introduction of the Health Disparities Bill H210, which was introduced yesterday. And we will be hearing from Representative China, as a member of our committee, who is the lead sponsor, as well as a number of witnesses who helped develop that bill. So with that, I want to welcome Susanna Davis to our committee and invite her to share with us recommendations and information that has been developed as a part of her work with the Task Force, particularly focusing on health and health disparities and recommendations. So good morning and welcome. Yes, I am Susanna Davis, Racial Equity Director for the State. And I am pleased to be here today. I'm going to talk a little bit about the recommendations that came from the Racial Equity Task Force in its September 1 report to the governor that was also made public. And I think it was shared with the committee. The purpose of that report actually let me back up and talk a little bit about what is the task force, how did it come to be. So in June of 2020, the governor created the Racial Equity Task Force and assigned it three main charges. The first was to examine systems of support that exist in Vermont for communities of scholars generally. That was the first report. The second would include the following two items. First, any changes to state law that could be made to strengthen protections against hate speech, including displays of hate symbols such as Confederate flags. And the second item for that second report was the ways that we could get more diversity in public office at all levels in the state, including boards and commission.  It was made public, I believe last week and I, if it hasn't already been shared with the committee, I'm happy to do so. And I think that that second report really builds on the first one, which discusses systems of support generally. So that's the one, that first one that I'll be talking mostly about today. That first report has a lot of discussion around COVID-19. It was explicitly mentioned in the executive order to evaluate systems of support broadly, but also in the context of COVID-19 health disparities. So I'll talk about that today. The task force itself, we're very proud of its composition. We have about 12 members and designee. And of those 12, six of us are women identified, five are women of color, nine are people of color, and that includes members of the Indigenous and Asian and Latino and Black communities. At least five of us speak languages other than English, including people for whom English is the second language. At least three were born outside the US, including people who arrived to the US as refugees. We have three generations represented. We've got members of the LGBTQIA plus community, the community of people living with disabilities. We've got small business owners and each of us lives in a different town in the state across seven counties. We've got parents, grandparents. So it's a diverse group. And I don't just mean racially and ethnicity diverse. It's a group that has given a lot of consideration to these questions and has relied on lived experience. And those lived experiences vary widely. So let's talk specifically about the recommendations. The health related recommendations that the task force put out in its first report largely have to do with COVID-19 and the COVID-19 response. But something that we've got a shout from the rooftops and we can't say it enough is that COVID-19 exacerbated existing disparities, not just in health, but in other sectors. And so a lot of the recommendations that came through the task force about COVID-19 response are really things that are more systemic in nature and are going to move the needle on health equity beyond and outside of COVID-19. So, and I apologize if you're hearing background noise that sounds like someone is sawing wood. It is unclear to me why a person outside in the snow would be cutting wood. So here we are. So thank you for dealing with that. So let's talk about the recommendations. I'm just going to list them kind of rapid fire. And then, and then dealt deeper. They fall into four main categories. One is language access to access to testing. Three is data collection and reporting. And fourth is the economic fallout. Now, again, COVID-19 has created a lot of challenges for people, not just in health, but in a lot of other sectors. So when we talk about health disparities, those campaigns, right, we all know, and I don't need to preach to this committee. You all are well versed in this, but health disparities create economic turmoil to people. And the economic turmoil leads to things like misderemptain and evictions, dings to your credit score, medical debt that prevents you from being able to get credit for other things. It stunts your ability to seek certain kinds of employment, or maybe you can only look for employment that has employer sponsor healthcare. It has downstream effects. The impact of our health affect our work performance, our school performance, which affect our outcomes, promotional path, et cetera. So all of those things have to do with all of those things. I'm going to list through these recommendations and then go back and kind of explain them. There are 15 total that we have listed under COVID-19 response, and they are as follows. Mandate that all communications related to COVID-19 be translated into Vermont's most commonly spoken languages. At each testing site provide COVID-19 educational material in the most appropriate languages for the region and give out PPE. Ensure that COVID-19 related grants, whether awarded to or administered by the state, include line items for translation. Contract with or facilitate subcontracting with refugee and immigrant service providers and or translation service providers if the state or grantee lack cultural and or linguistic expertise to provide core COVID-19 related services to people with refugee and immigrant backgrounds. Continue to consult with entities such as AALD and USBRI to ensure that people with refugee and immigrant backgrounds can access unemployment insurance and pandemic unemployment assistance or future versions of that benefit in a timely manner with efficient troubleshooting. For COVID-19 tests administered to limited English proficient people, ensure that interpreters with all patients are relaying accurate information. Ensure that people experiencing homelessness have access to testing and support increased infrastructure for homeless Vermonters impacted by COVID-19. Address testing accessibility issues by collaborating with community organizations that serve marginalized groups locally to design and coordinate walk-in testing sites. And again, a lot of this has to do with testing because this is September at the time we were doing more testing and there was not as much vaccine work happening. Assess which locations in Vermont have not had access to free testing without referrals needed. Using that assessment, prioritize test kits and human resources to allow more focused testing for vulnerable populations and those in outbreak areas who lack resources for transportation. Conduct broader testing in prisons in state and out of state. Increase VDH resources in COVID-19 test results data entry specifically for efforts in collecting race and ethnicity data from COVID-19 test results. And retroactively include all race and ethnicity data including manually entering race and ethnicity data from TAPOR COVID-19 test results. And assess and ensure that moving forward hospitals are able to digitally transfer uniform data reporting on race and ethnicity data with their COVID-19 test results. Collaborate with community and health organizations to provide training on cultural humility and best healthcare form intake practices to providers that administer COVID-19 tests. Have VDA to work with the Executive Director of Racial Equity, the Racial Equity Task Force and other stakeholders to create a better system to collect, track and report race data regarding health disparities from the Vermont Health Information Exchange to monitor and analyze racial disparities in healthcare on an ongoing basis. There's two more, stick with me. Establish a state-level relief fund for remodels who were barred from receiving federal stimulus payments due to their or someone else's immigration status. And finally, ordering an in-depth assessment on people of color who have suffered income losses. This should include but not be limited to job losses and closure of minority undisputed. So those were the 15 recommendations that we expressly put under the COVID-19 response category. I do, of course, repeat the caveat that this was issued in September and deliberated between July and August. And so health related inequities today in February looks a little bit different than it did four months ago because now we're talking a lot more about things like treatment and vaccine and a little bit less about things like testing. I'm going to stop there because I just talked a lot at you. Just to pause and see if anyone has questions or anything to repeat something. Okay. Thank you. Suzanne, would you either now or later in your presentation or after as a part of your presentation, would you be able to update us on issues that have emerged subsequent to the report in September around COVID, vaccination, et cetera. That you shared some of that earlier this morning, but perhaps some of that either now or whatever it's most appropriate from your point of view. I can do so now. So the, I have had a lot of conversations with members of the community and with representatives from the health department and others and partners and other jurisdictions, et cetera, to really understand the landscape in Vermont and the vaccine, the a correct vaccine strategy. And you know, the thing about Vermont is that by comparison, the community of people of color in Vermont is small, but it experiences we experience outsized disparity in things like infection rates, death rates. I mean, you name it disparity and pretty much everything. So one of the things that is true nationally and the elements of Vermont is that people of color are disproportionately vulnerable to this virus, not because of things that are inherent to us from the genetic perspective, but because of largely factors that contribute to poor health outcomes. Things like living in counties that are more likely to have PPM 2.5 kind of particulate matter and for air quality, which means things like asthma, which then leads to things like less physical exertion because of asthma, which leads to things like diabetes, right, or living in a place that's considered a food desert or a food swamp, which means that your nutrition, your nutritional profile is probably more likely to give you things like diabetes obesity or heart disease. A lot of these epigenetics factors have to do with housing, it has to do with the siting of health deleterious or health promoting neighborhood amenities. It has to do with factors that are outside the control of whoever's got the vaccine and the people that said, even apart from that we have seen a lot of their evidence that show that people of color are at disproportionate risk of infection and death and therefore should be prioritized for vaccination if they choose to receive vaccines. So, in Vermont, the data show that the greatest loss of life to COVID-19 has occurred in the senior population. And so the state, I think initially took a strategy of saving the most lives by pursuing a primarily age banded vaccine strategy that prioritized people in higher age groups and then increase the pool of vaccine recipients going down in age. Now, the thing in Vermont is that people of color tend to use younger. And so if we're pursuing a purely age banded strategy, then we are necessarily putting people of color at the end of the line because we just are younger on average. And I can get some numbers about that. The median age for white Ramoners is 45 years. The median age for indigenous Ramoners is 47 years. And the median age for all other Ramoners of color is mid-20s, so 25, 6, and 7, depending on relationships. So, considering that it became clear that a prioritization strategy outside of or rather parallel to age banding would be necessary to ensure that people of color would not remain at an outside, outside vulnerability due to something like not being old enough to be vulnerable by age but still clearly being vulnerable. And another thing that's important to keep in mind is not necessarily everybody who is getting prioritized and a want a vaccine.  And so it has been really important not just to make sure that people have early access to the vaccine if they're part of vulnerable groups, but also to make sure that they have access to whatever educational materials they need. And so it's a form decision that's right for them and for their families on whether to get a vaccine. That said, this really necessitates a lot of language access, translation, interpretation, etc. One of the recommendations that the racial equity Task Force made separate from this report. I know it feels like I'm jumping around a lot. I'm sorry. One of the recommendations that the Task Force made outside of this report separately was to go to vaccinate to put priority for vaccinating cultural brokers and interpreters because these are folks who are often omitted from vaccination plans. For example, they're present in the room when patients are being tested or, you know, having an intake or being vaccinated or what have you. But they're not, they're often not part of hospital staff. So they're not part of the hospital staff vaccination plan, but they're not explicitly considered priority either because they may not be in the current age group. And so they're kind of flipping through the crack. They're very much frontline. They're very much in the hospital at these meetings with patients. So that was something that there was a community collaborative that strongly made that recommendation and the Task Force supported it. So thinking about where the folks who are helping the language access being realized and are we ensuring that their physical presence is not a jeopardy to their health was another important piece of this. So where we ended up is that it's very clear that communities of color are disproportionately vulnerable here. And as such, there should be heightened prioritization for these extra vulnerable people to be able to receive vaccination. That was a recommendation that came from the Task Force and also from the racial equity advisory panel, as well as a number of collaborators and ad hoc communities that were created on this topic. Thank you. We have, we will be also reaching out to Dr. Mercedes Avila to testify she testified with our committee during the last biennium about health disparities generally, but as she had just also presented in the social equity test for the social equity caucus. We will be reaching out to her to come and share some of her presentation with the committee as well. So I thank you for outlining some of those concerns and I think there was another, there was a, rather than continue with my questions, I think there was a question with did represent Goldman did you have a your hand up earlier. I was just wondering, I'm not an auditory person and you were, you know, listed a ton of recommendations which were important and I'm just wondering, is there a link to that. Yeah, absolutely. She provided that link to committee members from Colleen that was sent recently. So each, you should have a link to that report, which I did use in the last several days so may have. Are you looking at the September 1 2020 report is that the one you're thinking of. I believe that's the report, that's the report that is being referenced. Is that right. I was understanding that they were updated recommendations but maybe I misunderstood I'm sorry. Yes, let me clarify thank you for that. I just put into the chat the links to both task force reports. Report number one is the one that contains these recommendations that I've just discussed, and to save you. And to give you the stress, please note that the last two pages have all the recommendations summarized, so you don't have to read them in paragraph form. There was rep Goldman you're correct we did submit an additional set of recommendations directly to VDH. Those are not included in the report. They have to do more with vaccination strategy and I can forward those to the committee itself. Great. What would what would make best sense at this point. Would you like to continue to share some of the recommendations or are there other pieces of this report that you would like to bring to our attention this morning. Well, perhaps I could give an update on some of these a number of these recommendations have already been implemented. As a matter of fact, one, at least one of them was already underway at the time that this report was published that was the state level release for those who excluded from CARES Act funding through the immigration status. So I'm very pleased to announce that that is the economic stimulus equity fund that this body passed last year, and it is in the implementation phase. I think in our first two weeks, we must have gotten over 1300 applicants, which was more than a fifth of the total number of applicants we thought we could have. And it took a lot of work. The contract partner we have been working with is the Vermont Community Foundation. But they in their wisdom recognize the importance of working with community groups who have close ties to historically marginalized groups, so we would want to see apply. And so this has been a huge lift, a team effort that includes everyone from, and I don't even want to mention CBO because I'm going to forget some of them, but it's a lot of the folks you may be thinking about AALB and migrant justice and CBOEO and a lot of other organizations. So I'm very pleased with the progress from that. We have, as you know, moved away from mass testing and done a little bit more targeted testing. And of course, now we're doing less testing and more vaccination. So a number of these items were implemented over the last few months, but the focus has turned to testing. Now, I cannot say that there has been widespread and explicit focus on communities of color for the vaccinations yet to the degree that I think many of us would like. I am aware that there have been additional pop-up sites placed in places like Winnipeg and that we are vaccinating members of multi-generational households who may not be in the upper age band, which is absolutely some of the stuff that we should be doing. Because that's a way that you can get at those disparities. So I know that schools are underway and we're building that out, but I don't think that we're fully there yet. I have to say that because us having made the recommendations different than it being included on the ground. So I needed to say that. What else? Those consultations that we recommended with groups like USCRI and AALB were being done. We are working closely to do things like translation videos and written translations, which has been very helpful. And there was actually grant money, I think federal grant money that was allocated for improved data entry. We heard anecdotally from folks that some providers in some of our southern counties were still using a paper and fax system to deliver information to the state, which proved clunky and sometimes a little bit inaccurate. So there was grant money that was used to improve that so that we have a unified reporting system. So I suppose that those are the exciting updates on these recommendations. Are there other parts of this report or the next one that I would like to highlight to your question, Mr. Chair? And I think the answer is yes. Our second report, which was just made public, its first recommendation is that the state to clarify racism of public health emergency. This is something that has been done already in numerous jurisdictions. The city of Burlington has done it and places outside the state as well. And the biggest question that we get is why? What does this mean? What does it do? And what it does effectively is, first of all, acknowledges systemic racism exists and is a thing and that is huge. The second, and now that the state hasn't already made that acknowledgement, right? But doing so formally through a declaration of the public health emergency brings with it certain weight. For example, we know that systemic racism has a lot of downstream health impacts. Everything from mental health to physical health. We talked about the impact of nutrition. We talked about the impact of poor air quality, et cetera. So by acknowledging the downstream health impact, it gives us the responsibility to do something about it by recognizing formally that systemic racism is a cause. It then commits us to addressing that cause explicitly and directly. And so this declaration is more than a symbolic gesture. It is in fact a formal acknowledgement that systemic racism is not just a nebulous concept that everybody feels bad about. Not everybody, but we're working on that. But rather that it is an explicit cause of tangible and measurable downstream outcomes that are harmful to public health and that go against the aims of, for example, the 186 population level outcomes. So that's another item that came from the second report that does have broad health implications and just social implications generally. You will also find that a lot of these recommendations have big impact on mental health. For example, our second report talked about school discipline and oppressive disciplinary tactics. We talked about the importance of helping students to make sense of the world or rather having curricula in schools that teach against hate. We talked about the impact of harassment and bigotry and discrimination for people who may be considering serving in public office. It seems like every week there's a new story about a person of color who is in a position of leadership at the local level who has left that position of leadership due to poor treatment, harassment, threat. So the impact on mental health really cannot be overstated. And so a lot of these recommendations do not appear to be directly related to health in the way that the committee might be considering. But it's a huge impact on the emotional and social well-being of our community. It feels as if I'm talking so much, but there's a lot to say and I just want to pause to see if you'd like to refocus me or if there's anything I can expand on that. Well, let me say that I appreciate that the, from where we started where you started that the COVID pandemic has revealed the underlying system disparities of the healthcare system for people of color that this is not just a momentary point in time based in the pandemic, but something which requires ongoing attention and action, not just something we must address it during the COVID emergency, but that alone is far from sufficient. And so I think what I hear you saying as well is that it's making tying those connections to the underlying issues around mental health, around hate speech, around school, inappropriate targeting and disproportionate targeting of students of color in schools and discipline, etc. So I think those are the kind of important links that we need to be hearing about in addition to the specifics around COVID. And let me let me turn to several committee members have questions and then we'll come back and there's some areas that we I'd like to ask you to speak about further as well. Yes, thank you. Commissioner Davis, I wondered if you could give me a specific concrete example of systemic racism in the healthcare system. I am so glad you asked. I will give you an example of systemic racism in healthcare, not only in a way that directly impact health concretely but in a way that impacts our ability to trust data. So, a lot of people do not know that black Americans are overdosing and dying of opioids less than white Americans are. Well, that's great. We're one of the black people. But in reality, this actually highlights underlying discrimination.  Number one, it is often presumed by medical professionals that they will either sell or abuse those drugs and therefore they are not prescribed them even if it's appropriate for their treatment and care. The main reason that they are under prescribed opioids is because there are deeply ingrained stereotypes about patients of color that imply that they have that we have higher tolerance of pain, and that therefore we can take it, even if those treatments may be appropriate for our medical care. And those assumptions don't come out of nowhere. If I may, I'd like to just very briefly share one slide. Let's see if I can find it in a reasonable amount of time. And that slide is going to demonstrate where that preconceived notion about pain tolerance comes from. Where are you? There you are. I don't have screen share capability. Well, I will paint you. We can provide that. Colleen, would you provide Susanna with screen share capabilities, please? Yeah, she should be good to go now. Although I think, at least on my screen, Susanna has frozen up. Let's just pause. I'm getting a message. No, I think it doesn't like. Oh, dear. Oh, come on, don't do this.  It might be that the internet is not strong enough to both screen share and have your video going. Sorry, I forgot you could still hear me go ignore my outburst. I got kicked out of the call. Back. Well, now you're muted. I don't know. Yeah. Okay, my bad. I got kicked out, but I forgot you could still hear me, but please ignore that outburst. It doesn't appear that I can share, but that's fine. I'll just, I'll describe it for you. It's an image of a textbook, a published textbook for a nursing student that lists different racial groups and describe pain treatment for them. And it says things like Jews, Jews may be vocal and demanding of assistance. They believe that pain must be shared and validated by others. It says that indigenous people may select a sacred number when asked to rate pain on a pain scale. It says that blacks, blacks often report higher pain intensities and other cultures. They've been pain and suffering or inevitable. Chinese clients may not ask for medication because they do not want to take the nurse away from a more important path. Hispanics may believe the pain is a form of punishment and the suffering must be endured to enter heaven. So these are things that are being taught to medical professionals in their early education, informative time when they're developing their understanding of their profession. And so those are some of the underlying reasons, the systemic factors, if you will, that give rise to disparity in healthcare. That's just one of many, many examples, but it also is an example of why we have to make sure that we are being data driven, but thank you so much for that. Of why we're being data driven but not data hostage. Being data driven is recognizing the under prescribing of opioids because of these disparity or discrimination factors. Being data hostage means looking at a lower overdose rate of black Americans and saying, well, that's a good thing. So we don't have to do any work here because that's a positive, it's a positive data point without recognizing it's actually indicative of deeper disparity. It's a long answer representative, I apologize for that, but I hope that's one example that helps to clarify. Well, of these things you cite here being taught now, that's from right now, that physicians are being taught this. I would question that very strongly. And I would tell you that your example is not systemic racism, it's people being racist. If they're doing it, it's not the system, it's people. And I think throughout this whole thing, that's what it is. It's people being racist. I think the field is level. I think people need to be changed. That's my two cents. Thank you representatives. So our systems are made up of people. Our systems are just collections of individuals. And so individual racism is what creates individuals to create policy. And then that policy is systemic. It is enforced broadly and systemically, and it becomes systemic because it is the collection and the product of individual biases. To your earlier question, is it still being taught? This screenshot of that textbook is from 2015. It is relatively recent. That particular page was pulled from that textbook. I think it was McMillan with the publisher after backlash around it. But an important thing to note is that while this particular textbook has left this explicit page out of its future textbooks after that, up until this time, up until that year, it had been taught and it had been taught explicitly. And so when we look at the medical profession, we're not just looking at doctors who are nurses who are graduating after 2015 who are not seeing it in textbooks. We're talking about the body of professionals who, for whom that became deeply ingrained truth in their mind. So I appreciate your questions. Is it still being taught? I believe it is probably informally, though I admit I cannot point to any particular pages since 2015 that show it. But of course it's also considered part of the bad habit that many of our doctors who graduated before 2015 did receive. Okay, I just, yeah, I just would refute the idea that anyone would read that and then under prescribe medication because they feel that a black patient is more able to tolerate pain. I just, I can't imagine that. I mean, I don't know, I'm not a doctor, but I just find that very, very difficult to swallow. And I still maintain that the people of the problem, not the system, my two cents. Let's, let's, let's hear from other committee members who have questions. I think did representative burrows, did you have your hand up earlier? Is there something you wanted to ask? Or am I missing that? I was wondering whether you could describe or go into more detail about what immediate, what immediate steps you see being taken after the public declaration of systemic racism as a health emergency. I think I said that right. I think we tend to say a public health epidemic and public health emergency kind of interchangeably. I know that medically they're considered a few different things, but public health big deal, if you will. So some of the steps that can be taken are are easier. Some are more difficult. For example, it means that when we acknowledge that there's a public health problem, we tend to devote resources to that problem. That means that we might create, create staffing positions that are directly looking at that problem. For example, the, I believe the legislature created the role of Chief Prevention Officer sometime back. That's because we recognize that there was a public health emergency in the opioid crisis for the state. And we reacted by creating a leadership level position to address it. So that's one step that can be taken. Another one is to make sure that we're providing adequate funding, not only for state services that address the issue, but also for community groups, not for profits and anyone else around the state who's working to address the issue as well. It means, again, when we talk about systemic racism as a public health emergency, it's not just about systemic racism in healthcare, which we have many, many examples and rings of data, but also systemic racism in other sectors like housing and employment and education. So just as an example, if we know that your health is more, one thing that we used to say when I was at the health department in New York was that your health is more impacted by your zip codes than by your genetic code. Right. So, for example, we'll, we'll just take, we'll take the city of New York. I know it's not a jurisdiction that's comprehensive Vermont, but we know that in white neighborhoods, there are no waste transfer facilities. That is where we process trash. Those are all in neighborhoods inhabited by people of color. We know that homeless shelters are almost entirely located in communities of color. We know that the places where you can find green spaces, civic centers, rollo shop, gyms and libraries tend to be disproportionately located in wealthy areas, etc. When we look at places like Vermont, the picture is a little bit more fuzzy because we have a socio economic divide that is not as clearly divided by race and ethnicity as it is in some other jurisdictions. For example, we have a larger raw number of people living in poverty who are white in Vermont than who are of color. However, when you look deeper and this gets back to data hostage versus data driven, when you look deeper, you can see that the rate of poverty is so higher for people from communities of color. And so understanding that the, the raw number and the rates are two different things and recognizing that something like where you live could heavily impact your quality of life means that we can look at things like housing and transportation. Right. Do you how long is your commute? What is your commute like? Do you live along a major traffic corridor because that's the only place that you can afford to live, etc. These are some of the questions that we just look at and some of the sectors that need to be addressed in order to get at those downstream health impacts. I guess part of the thing that I'm wondering is I, if it's declared a public health emergency. I mean, what we, you and I and other people in this meeting are talking about is, is fixing some of these really deeply ingrained problems, but how can, on the top level of what a public health health emergency would besides resources. But some of the, I guess some of these things are so deeply ingrained that they will take a while to fix. And besides resources, what would declaring a public health emergency do and do you see the public health emergency as, as lasting decades until it is all fixed or do you see it as kind of push to get the work underway? I thank you for the questions. I see a public health emergency for this specifically lasting as long as it takes for us to fix it. We didn't get here overnight. We've been centuries and centuries down this track with policy that has been expressly designed. And that's not my anecdote. This is documented in state houses around the country policy that's explicitly designed to oppress and suppress the well being of certain groups. So when you have centuries of that at play, it's really difficult to predict how long or how short something like a declaration of public health emergency can last because it all depends on how quickly and effectively and sincerely really need to move on it. What are some of the other steps that can be taken aside from allocations and sources? It means policy change. It means maybe folks in state leadership or our friends in the legislature looking at those upstream causes and saying, hey, we may need to strengthen our protections around, I don't know, lending discrimination, or we may need to strengthen our protections for people who are living with questionable or no legal immigration status because they're not presenting in medical facilities because they're afraid of retribution. So that might mean getting criminal justice professionals and other administrative law professionals involved in order to craft stronger protections for people who may be under federal scrutiny for immigration reasons. It means really, it means doing the harder stuff. A lot of the solutions that we propose are often the low cost or no cost things, but I think to a large extent we've exhausted those and it's really time to step it up a little bit more. Again, we have a body of work from which to borrow because we're not the first ones to have done this. So I think that really working with our counterparts and other jurisdictions to be able to look at what's work and what hasn't. For those who have declared this sort of public health emergency would be beneficial. I guess it's really forcing a prioritization of these policies and resources. Is that right? Correct. Yeah, I mean, a declaration of emergency is not in and of itself going to reduce disparities. What it does is it commits us to giving a dam and doing something about it and I'm thinking about years ago under the Bush administration Bush junior. When Colin Powell referred to an ethnic conflict, and I hate that term because it really involves the global north of responsibility there, but ethnic tensions in Rwanda, he described it as a genocide. And I remember the Bush administration was very angry with him because he used the G word and once you call something a genocide, it triggers certain international protocols that then require you to do something about it in the U.S. Wouldn't necessarily want to do that. So the way that we approach it, the language we use and the way that we designate something in terms of importance or emergency can make all the difference in terms of triggering necessary follow up actions. And I think that community just gets that. Thank you very much. Thank you. I'm going to turn to representative Cordes and then representative page. And I want to be sure that I don't want to, I appreciate the questions actually are providing opportunities to fill in more of the needed information for our committee, Susanna, but I want to make sure I don't cut you off from anything that you are wanting to add as well. But first represent Cordes and then represent page. Thank you very much for your presentation and I, a couple of comments on the medical education issue. One is as someone who has grown up over the last more than 30 years within the system of health care in Vermont. I can tell you experientially that racism systemic racism is alive and well and whether or not you studied a textbook and with a professor 30 years ago or in 2015. Those beliefs superimposed on existing cultural learning that we all have taken on in this country perpetuate the system of racism. Again, whether it's really hard to unlearn them. It takes attention, it takes listening and it takes the amount of data analysis and responding to that to fix it and if I as a white woman and not willing or able to listen and and learn, then I will never know about systemic racism because I don't experience the deleterious impacts of it. So it takes effort like this I very much appreciate this conversation and this work. And I just wanted to pipe up as someone who still to this day witnesses the impacts of systemic racism in the care that we provide to patients on a regular basis. Thank you. Representative page. Yes, director Davis. I have a question regarding your initially us prioritization of vaccinations. And I was curious whether that level has been raised with the executive level, your concerns about people of color that are more susceptible to COVID and whether I mean you certainly have discussed it enough here in other places about those individuals that are vulnerable. Has, has this issue been raised to a certain level, like to Dr Levine, and pointed out your concerns for these individuals that perhaps they should be brought up to a certain level like right now I guess you're giving vaccinations for individuals there 75 years and older. So has that been raised to the Department of Health. Regarding your concerns there. Do I make myself clear. Yeah. And, and what is, what have they decided. The, I had numerous conversations with, with Dr Levine and with the deputy commissioner as well and have talked about it with the governor's office. Also, the health department has made it really clear that they want to narrow that gap for communities of color and that they want to create a vaccination strategy that that appropriately is being appropriately delivered to people of color. So, yes, they're all very aware of everything that I've said, and, and have stated that they're committed to doing it. But there's no movement as of yet to raise that raise those individuals to a higher level is that correct. I think there has been movement. I think there has been movement, it could be deeper. Okay, thank you. Representative Goldman. I would just like to echo the comments of representative Cordis as someone who has worked in medicine for decades to that I've had many opportunities unfortunate opportunities to observe racist practice and medicine. And I also agree emphatically that the individuals make the system. So we really have to accept the fact that the system allows it and reinforces it. Thank you for that representative and if I may, Mr. Chair, I would like to just mention something that I think is particularly important to you all as legislators, which is the importance of not falling for the myth of race neutrality in policymaking, because there are oftentimes in the history of this country and the state perhaps that we have created policy that on its face appears to be race neutral, but in reality is not I can think of a few examples one being something like the new deal that had a lot of worker protections, but it explicitly excluded agricultural and domestic workers and that appears to be race neutral because it's by profession but I find that was, it was an explicit compromise with the southern states and it was because agricultural and domestic workers were almost entirely black people. And so that was a way that we could say it didn't target black people it only targeted agricultural and domestic workers but at the time that's that's who they all were. And we see that today lasting a lot of I mean this is an agricultural state and the lack of certain agricultural protections that are afforded to other people in the country, by profession tends to just the person that we impact people of color specifically now Latino, as that demographic has shifted a little bit. Honestly, that's also why we don't tip slide attendance. And that that's a, that's a anecdote for another time. But oftentimes there are policies that appear, not to be targeting particular groups but are in fact, doing just that. I can think of a lot of other things like for example sentencing disparities between rock and powder cocaine which chemically are indistinguishable, but it took. It took 15, it took like 100 500 grams I think of cocaine to get you 15 years in jail because it tended to be used more by white people, and it took five grams of rock cocaine to get you put into jail because it tends to be used more often by black people. We have a system. We had a drug epidemic in the 80s that affected communities of color more often and we met it with law and order and crime and punishment and villainize a lot of people and tore apart a lot of families today we have the opioid crisis. 80% of its victims are white people and needed with compassion wrap around services we treat it like a public health emergency we create positions in government that have nice titles like Chief Prevention Officer, and we should be doing that that's how we're supposed to treat a public health but when we look at the evolution of policy in the country it just it becomes extremely clear that we have found very creatively to to create differences without appearing to be created. Thank you represent black. Thank you. Exactly what you were just referring to. You know under a CA certain preventative services must be covered at 100%. Those services are rated by the US preventative tasks. Prevention Services Task Force of a level a or B. Those levels are set by research and study. On the population of a whole as the whole but we know that there are certain conditions that primarily affect people of color. And also that studies have not been done in non Caucasian large enough studies to make recommendations so therefore certain conditions that we know primarily affect people of color are not considered a and B services so therefore they're not covered at 100% under an AC a compliant health insurance plan, which is a huge disparity. Correct. Absolutely. In fact, I am thinking about and this is true not just with racial and ethnic groups but also with other forms of discrimination I mean for example we all know symptoms of a heart attack right in the left arm things like that but that's actually not a symptom for women as a symptom primarily for men. Many people don't know that a symptom of a heart attack for women could be a headache, which I mean, come on, right. How can you tell if it's a headache or you water, but the point is is even the way that we internalize our understanding of common medicine is often reflective of people who are living in dominant groups. There's wonderful research about, believe it or not, office temperatures and the fact that the ideal office temperature is actually modeled on a study that was done in the 15 of 10 men at their resting resting metabolic rate. Those men were an average of 4045 years old or like 40 years old and 145 pounds. And of course I think this was in the 50 so everybody was wearing like three pieces back then. And somehow the resting rate of 1045 pound middle age men is what determines today's office temperatures where we have more seniors working longer, more women more young people, etc in the workforce. And so when you always ask why certain people always feel cold and certain people are always comfortable. Perhaps we base our formula and it's a complex formula I'm not a mathematician so I wouldn't dream of trying to explain it here but it's you know some guy decided that his math is good and now half of us are freezing all the time. So I think it's very important the way that we internalize research that's narrowly conducted. Thank you for saying that. Suzanne, I'm wondering, I want to just, if I may just say that in reading your September report. I want to just acknowledge that I continue to learn and appreciated the report and I'm going to just say out loud that in the area that you talked that your report talked about the need for the recognition of why there's a lack of trust for many communities of color with the healthcare system is and is it is it is an important piece for us to understand and acknowledge in that, frankly, as I was reading the section around the importance of understanding the historical trauma and why lack of trust within communities of color is an issue. I find myself needing to look up some names that I was not familiar with. There were some areas where I was familiar. But the the kinds of egregious actions that historically have been taken and directed at communities of color as outlined on page four of your September report, I think are important for us all, who may not have that historical background as complete to have us understand and to take a look and understand what some of this history has been within the healthcare system. So I welcome you to, if you're inclined to say a few words about the importance of understanding the history of the healthcare system and some of the traumas that have been actually imposed upon the communities of color and how that might impact current healthcare. Absolutely, thank you for that. Yes, it often I think for a lot of us feels like Lucy with the football, you know, how many times are we going to run up to it and try to kick it, and then be burned again. And I don't mean to imply that all healthcare has always been bad for people of color all the time. Western medicine has brought a lot of positive advances. But it oftentimes occurs either absent our participation or to our detriment. I'm thinking of people like Jay Marion Sims, who was largely for a long time regarded as a father of gynecology, who was doing some pretty just incredibly unscrupulous and unethical experimentation on color Mississippi appendectomy. It's what they used to call it colloquially but it was when in the United States we were doing unnecessary hysterectomy on black women for the benefit of medical students who needed the practice and the training. And before we go thinking that that's too far in the past as recently as last year it was revealed that we were performing non consensual hysterectomy on migrants at the border here in the United States, like last year, we were performing hysterectomy on brown people, because they were being held in the immigrant detention center. So basically saying, we've decided you can't have kids because you entered without infection. And I mean Vermont's not immune from that. We were not the people in this state were sterilizing Abinac women into the 70s. That is within the lifetime of the people in this call. So it is history but it is not as ancient as we would hope that it would be. Of course there are things like Tuskegee, which you know the former name is the Tuskegee study of untreated syphilis in the Negro male, but it's a 250 black men and either gave them or allowed them to get syphilis and told them they were getting free healthcare. When in reality they were just watching as that virus ravaged their bodies and they studied it in the name of science. We know that people like Henrietta Lacks had her genetic tissue taken without her consent after she was diagnosed with cervical cancer. She died at I think 31 or in her 30s from that cancer. But her genetic tissue that had been taken was used and studied and it led to so many great advanced medical advancement. And if not for her, we may not have discovered those things, at least not at those times. But of course, I mean these were things that were considered. These were things that were commonly done in the US in health, but they were certainly unethical and they weren't done for the benefit of the patient. They were done in the name of science, whatever that means. So yes, those are some examples of the reasons for which we need to build and rebuild trust. And I have to be honest, every time we screw that up and backslide once we're undoing decades of trust building. So we thought that maybe the hysterectomy in women's prisons was the last time or the ones on Puerto Rico were the last time or the Abinac women were the last time. And then last year we find out that we're still doing it to immigrants. So that sets people back a lot of times efforts and Abinac people in the state who have said, I do not intend to get tested or vaccinated because they had Indian registry really recently and I can't go through that again. So it's very real. It's very close to home for the state and I think that we have a moral imperative to do better at that trust building. And there's no one size fits all way to do it. There's no single thing that we can do to say you can trust us again. It's just continuous demonstration that we are in it for the right reasons. Thank you. I'm thinking as well that again we're getting to the end of our time but one of the issues that comes up and will come up as we look at the bill that's about to be introduced. H 210 which is addresses health disparities and addresses health disparities across issues of race as well as disability and LGBTQ issues as well that again if you any kind of there's a kind of intersectionality that that happens as well as I as we talk about issues of race. That if you are welcome you to speak about the the impact if you are a member of another group of with disabilities or LGBTQ community as an examples and our person of color the the layer being on of disparities and discrimination can be even more profound. Yes, absolutely. So, I can use myself as an example. I am the child of immigrants, first generation in this country. So, statistically speaking, I am less likely to have access to things like higher ed, or other advancement opportunities less likely to have access to things like home ownership, or, et cetera, then my counterparts who have roots in this country. As a person who is Brown, I am more likely to be murdered by the government, I am more likely to be to experience for health outcomes like some of the ones that we already talked about, as a female identified person, I am specifically less likely to make the same wage for the same work that my male counterparts are. And so when you layer all those things on top of each other it creates a picture that makes people who may look like me or come from similar background, doubly or triply vulnerable to things.  If I am a person living with disabilities, not only am I more likely to live in poverty because I am Brown, but I am also more likely to live in poverty because I am a person living with disability. Intersectionality is a huge factor here. It can often be the difference between people, us thinking that we have provided a benefit to people, but in reality not having done so. Here's an example.  Why don't you come down to this workshop that we're doing at this particular location that is not wheelchair accessible. We will not be recording it and we will not be translating. So if I'm a small business owner who's a woman and I cannot get to your physical location, I am, I cannot participate in that in that affair. And so in a lot of senses, there's that. We know that people in the LGBTQIA plus community are more likely to experience assault and violence because of that membership. But we know that trans women of color, specifically have the highest rate of murder in that community, in that community. So it is very much the intersection of race and gender identity there that creates heightened vulnerability to being attacked and killed. There was something else I wanted to say, and I've forgotten it. So it's fine. That never happened. Thank you. Actually, I'm so sorry. I do remember it now. I wanted to say that, you know, I'm talking about all this and we're, I just want to make it really clear that equity work needs to be done, more of it needs to be done. It needs to be done better and it needs to be well resourced. But I have to say this and I say it often. Nothing will make me happier than the day that I get brought into a room, a conference room. And the governor and the pro tem and the speaker and the secretary are all there and they say congratulations, you're fired, because we don't need you anymore, because equity is so firmly baked into the state's work that you are now not needed. That is going to like, I'm waiting for that. I have a bottle of champagne waiting for that day. Because the point is that the point of equity work is we want to put ourselves out of business, frankly, and I'm sure there are some who would disagree with me, but it's my goal. I want the work not to be needed anymore because we will have reformed the foundations of our society in such a way that they're not landed from the start. And I think that a lot of times people see equity work as special treatment for the few, but in reality what it is is undoing the special treatment that has already existed for the few for so long. And so the standard that we know now the society in which we live feels regular to people because it's all that they've known. But in reality, it itself has been unjust for so long that any deviation from that, they see that deviation as uncalled for change, but in reality it's getting us closer to that neutrality. But because we've never known that neutrality in this country, people see that as a deviation from the standard, rather than approaching a correct standard. And I just think that that's really important for us to keep in mind that change doesn't have to equal loss. And for those of us who see life as zero sum, that is where the trouble lies. Okay. Representative Pierson, I see your hand is up. I wanted to bring this to a close. And I think I will. And we're going to have more opportunities as a committee to have committee discussion and talk with other witnesses. We're going to continue our work later this morning. And this afternoon again, Suzanne, I want to thank you very much for spending time with our committee this morning. And I look forward to the opportunity to work together. And hope that you're out of your job soon. I mean, in the best sense of what you were just saying, we could only be so fortunate. And also actually, I have a specific request. We will be turning our attention to House bill that's been introduced House bill 210. And I did not ask you to comment on it specifically because I wasn't sure if you'd had the opportunity to review the bill with or those who are bringing the bill forward but I would welcome your comments on that. Thank you very much for being with us this morning. And at this point in time. Once once the bill now that the bill has been introduced and after you have an opportunity to review the bill. As well. Happy to thank you. Thank you. So again, thank you. Thank you very much for being with us this morning. And at this point for our committee, I'm going to suggest that we take a break that we need. To reconvene at 1030 that's that's that's reconvene. Actually, let's ask committee members to be back at like 2720 25 after 27 so that we can start promptly at 1030 we have a number of witnesses and much to cover. So that let's ask committee members to be back on the zoom at 25 after but that still gives us a break. Thank you very much for that. We will go please do take yourself off mute and video even though we will go off YouTube briefly they will be we will go back on stay on the same zoom link. We'll be going off YouTube but we will be coming back onto YouTube at 1030 to resume the house health care committees deliberations on health disparities. Thank you.


All right, Cyber Traders, welcome on back here this Tuesday morning, January 4th, shortly after 9 a.m. Eastern time. Welcome on back here for our morning meeting. Great to see Bell, Grant, Mario, Michael, Ari, who did pretty nicely earlier this morning on the IMX trade. Great to see all of us live inside Cyber Group. And of course, if you're joining us once again on social media, Facebook, Live, or YouTube, welcome on back as well. So folks, let's hop right into it here today. I'll tell you what, it's one of those mornings where I had not really much of a breakfast, no water, just a lot of caffeine. So if I sound a little off, my apologies. We'll be good to go, of course, for the market open, though. And of course, for later on this morning, we have our Traders Talk workshop for all of us inside Cyber Group.  So if you have any questions that you would like to send over, I already have a bunch that were sent in from students and members alike already. Just send it right to my email address, josh at C2trading.com. For all of us inside the trading room, that is, if you're unfamiliar with Traders Talk, just so you know, you know, some folks ask if there's a link for that. If you could hear my voice, you have access to it. And I'm speaking to only those in the trading room right now. Now, of course, if you're on social media today, Facebook, Live, or YouTube, if you wanted to take part on that, or in that, just go right down to the link on the banner below of the stream there to get yourself started. But to begin, FLGC on the screen to begin here, up over 17%, albeit pulling back down now, pretty much off the VWAP 236, 235 area, making lower highs actually. So it really needs to see some a bit of buying here coming up. If not prior to the open, then perhaps like very shortly after, otherwise, though, if there's no signs of life coming up here on the way up, then it's only going to continue to drop off and be more of a disappointment. So, you know, this stock is a really good opportunity, not just because it's up this morning and it's cheap and it has, you know, good liquidity. It's a partial gap fill, or mini-gap fill, you could say, back from mid-November, right? Dropped off from like 350 all the way down here to 270. So should it end up breaking that top at 270? Perhaps there's more leeway for a run-up higher to 350 even. So, you know, that's what makes it interesting. I'll put this on our watch list right away. Definitely want to see a nice pop here coming up soon, though. Grant inside cybergroup saying nice early call on IMMX early this morning. Well, pretty funny how that worked out, right, Grant, because I was from my house, my home office, and I knew I was running late. So, you know, I had to share the screen early, post a really early list, which I don't like doing because there's always stocks that pop up, you know, at 7.45 at 8 o'clock. And after, of course, I ended up keeping the IMMX on this screen here in hopes of a potential run and not a dump off. Oh, man, this was a really good slingshot early this morning in pre-market, right? Oh, man, I mean, hey, right now it's stalling out. It's trying to pop higher up to 8, but failing to do so. This is the one that we had yesterday that gapped up early in the morning. I forgot the news on it, so pardon me on that, but it's just to say relatively new stock. It only opened up back from the end of last year.  That's right, $6.31 back in mid-December. So, the interesting point about that is, well, this trade, it ended up moving up there in pre-market. It ended up breaking above that price a bit later on and actually held above it pretty cleanly as support right here. So, that's what made this a really interesting trade yesterday morning. Ended up running up beautifully afterwards. Now, of course, heading into the market open today, of course, like we just said. Look what happened. Just funny enough, kept the line there. $6.30, $6.31, that passed all-time high back from mid-December just held perfectly as support. I didn't even notice that until now. Just funny how that plays. But, ended up making a nice push for right now. We'll keep this on our watch list just given the activity so far this morning here. IMMX. I'll tell you what, I only put four stocks on the watch list here this morning. Let me cover two of them. So, what we'll do is cover the other two. We'll just go right from top to bottom otherwise. A bit of a move up on Bitcoin this morning. Happy to see that, but today is Tuesday. So, you'll hear more about that at least tomorrow, at least Wednesday. PSTV, one of the other stocks that we had on the pre-market list for this morning, ended up making a nice pop prior to 8 a.m. much like the IMMX trade. I'll tell you what, you have some really funky spikes on the chart this morning, not just for PSTV, but for a lot of these. So, perhaps that's something that we'll cover inside our Traders Talk workshop earlier or later on this morning. But, going back to that PSTV trade, at least for right now, obviously it's a great trade currently. Testing and breaking above two. Even right now, filling a pretty large order for about 20,000 shares on the offer at 203. So, right now, this thing looks really healthy. It's making the type of pop that we hope to see the FLGC make coming up. All right. So, three stocks on the pre-market watch list, three stocks on the morning watch list. What's the last one that we had so far? I think it was the NT, or NRBO? Was that it? This was the only bust from the pre-market list at least. You know, it ended up making a nice pop prior to 8 a.m., fell flat. If it's not going to break higher, only one other way it's going to go. So, it's still active this morning, folks, right? Up over 28% or 24% trading over 7 million shares. So, I'm going to keep this on our watch list too. I definitely like the first three a lot more. So, this one, we'll put on the bottom of our list and we'll keep it on the bottom of our list at the end. All right, Charles Z ended up picking up just about 21 cents on the trade. He was in from 178 on PSTV a moment ago inside a cyber group here. In from 178, out at 199. There we go. I got to respect the whole number price level at 2. All right, so there we go. Out early. And plus, it is to say at least, you know, after 9 a.m., we see a lot of consolidation as well. So, if this fails to break higher and runs from here, I think Charles would make a pretty wise decision to get out and take the money, all right? So, what we'll do is keep going, folks. We'll go right from top to bottom otherwise. The only other stock I think we actually focused on outside the pre-market list. And there were two. There were two.  So, I'll keep this on our, or I'll put this one on our watch list as well, kind of near the bottom, much like the NRBO. I don't want to have too many stocks on this list at the end of it all. Let's see what else we got here. I think the other one was the ISPC. We'll get to that coming up pretty shortly. AMRK. I actually didn't mean to click this. Only trading 76 shares. I don't know what that's about. Ogen here, pretty cheap. I'll look at it quick. I'm not a fan of the stocks below a buck. Normally, we don't tend to trade those as frequent. But hey, look at Hoth, ended up popping. Now, the ISPC was the other one, of course, that I had mentioned. We ended up calling out after we posted the pre-market watch list this morning. So, aside from those three that we really focused on there, this was one of the only other ones. Ended up making a nice support level here off 950, 940-ish just a moment ago. But as you can see, we called it out off the pop from 850 as it topped off right around 10, 1020-ish. For right now though, there seems to be a bit of a historical level. And it's right around that 1020-ish area, 1020, 1030, pretty much right back from here going from the end of the year. And you're not trying to hit one exact price level, folks. It's just a matter of consistencies. So, 1030, the low back on the 16th, 1030, the low back on the 17th, 1017, the low on the 20th. So, those all fall pretty close to one another in relation to a stock that's making, I don't know, a $5 move a day, pretty much. So, that's a pretty prominent level, I'd say. 1020-ish to 1030-ish. For right now, pushing right back on up. So, I definitely like this one. We'll put this on our list just for reference so you folks know how I kind of like rank these and so forth. And I put this one above the bottom two. All right, Susan. Susan and Bell, the ladies of the trading room there picking up on the PSTV trade they got. Or Bell got just about 20 cents herself and Susan did really nicely. She got about near 40 cents on it. She was in from 167. Bell in from 187. Congrats, ladies. Very nice. Love to see that. All right, so we keep it going. We'll see what else is out there. In RBO, we talked about ALNA and other cheapy, FLGC. We talked about on our list already, I believe, right? Yep. All right, we keep it going. Keep it going. We keep it moving. ENTX, pop and drop, done with that. NLSP, we called this out off the pop, flattened out. It's still pretty active or just trading a lot of volume for that matter. So, I guess I could slip this on the bottom of our list two with the other two that I'm not as keen on. But let's cherry pick now. Let's see if there's anything looking a lot better than this. Got some shouts on Ford. So, from our side list here, perhaps Ford can make the main watch list at the end of it all. I was pretty interested about Mavis at first, MVIS. Microvision is officially the name. Us here in the trading room, we nicknamed the stock Mavis. But Mavis ended up making a nice little run-up after 8 a.m. I thought it was low volume at the time. I don't even know if I typed in the chat board because I was pretty reluctant on it. So, ended up pulling back. So, from that point, listen, we tend to find a lot of these familiar names on our gainers list at times like OCGN, fuel cell, CCL at times even. If they're not trading a whole lot of volume, like the minutes prior to 9.30, if they're not showing good signs of life prior to 9.30, like the last 30 minutes, 45 minutes prior, I'm not going to be as particular about it. So, hey, we did well on the stock MVIS in the past. I would love to call it out if it has another move up later on. For right now, though, we'll see if there's better opportunities first. I'll tell you what, geez. Number 50 on the gainers list is up 3%. I don't know what that's about because, I mean, just from the afternoon yesterday, there were so many stocks that were up big. So, we'll take a look on the loser's side here for right now, see if there's anything that's shortable or getting crushed or, you know, anything of that nature. AFI dropping off, shortable, but not a whole lot really going on there, really. SE to expensive, footlocker. Yeah, little spotty chart here, FL. I don't know if this is earnings related or not. We've traded footlocker in the past off of news, but typically it's traded a lot more volume than this. So, I don't know what this is about. Maybe it's some sort of downgrade by a firm. I feel like they'd be trading a hell of a lot more volume compared to that if it's earnings. PDD, a little expensive there, trading a lot more volume than footlocker, at least. Folks, I think that just about does it. I mean, of course, we'll talk about the GMPX pretty quickly. GMPX was a huge move from yesterday. We ended up trading this all throughout the day, going into the afternoon. It broke higher. So, you know, this one, we're going to have a lot more time to cover this stock in the Traders Talk Workshop later on this morning. So, for Bill, Ari, Grant, Charles, Wendy, Michael, again, we're going to cover this stock from head to toe, coming up at 11 o'clock Eastern time. I think two students already emailed me about this trade, actually. So, early bird gets the review. There we go. So, for the GMPX right now, at least it's down six and a half percent, I would rather focus on this GMPX compared to that, you know, Mavis trade or compared to even like the NRBO, which is on the list here as well. So, you know what? GMPX will slip on as well. We'll see if there's anything going on with Ford. Oh yeah, big time. It was up two plus percent last I checked in on it. So, you know, hey, this is a pretty nice run here. Let's just check the news on Ford, just out of curiosity. I mean, I could have checked the news for any other stock here, but Ford's a pretty brand-name stock. I know a lot of us tend to trade this, if not even the options. So, let's see, kind of similar news to Tesla and NIO over the last couple of days. No, Ford nearly doubles their F-150 Lightning production target to open order bank this Thursday, as best they could order book. Order bank this Thursday for reservation holders. So, just, I guess, you know, probably higher result compared to what they projected. A nice pop here. I know Bill obviously, he's been trading this every day, so he's been doing pretty nicely on this run here. So, Ford definitely will put on our watch list. How can we not? All right, for anyone on YouTube Facebook Live, if there's anything that you folks see, definitely let me know. If you don't, no sweat. I think they'll be touched upon a lot of them, if not all of them. Check Benzinga Pro here pretty quick, at least that signals page I go back to every now and then. Needless to be said, but Ford's popping up there right now. PSTV popping up there right now, so that means PSTV is breaking higher as we're speaking. Yep, there we go. So, as I always say, folks, at least in the afternoons and here in the mornings, if you tend to catch me, of course, I'm tagging in for Fausto this week as he's out. But, you know, hey, we don't need to put every stock under the sun on our watch list. We don't need to, you know, make a 15-stock watch list, right? When we have the PSTV ripping right here, we have the IMMX trade, which is really volatile, and then, otherwise, Ford. Ford, what a run. So, there's plenty to go around, folks, heading into this market open. I look forward to it. Again, for all of us in social media, Facebook Live, I appreciate you sticking with me each and every day, each and every morning. So, if you have any questions, any questions, definitely let me know. Send an email right on over to Josh at ctutrading.com. For all of us on YouTube, I gotta take care of all of us inside the live trading room first and our students, most importantly, but I typically get back to you within a day or two time if you're on social media. For all of us live inside the trading room, I'll get back to you folks coming up in the next 15 or 20 minutes. All right, folks, take care.


Hello, and welcome to this session in which we would look at a CPA exam question that deal with an investment and that investment is available for sale, it includes accrued interest, it includes bond investment amortization. So you have three different concepts going on at the same time that deals with a bond and we talk about the bond as well. So you have to understand actually four different things, how bonds work, how accrued interest work, how you amortize any discount or premium when you make an investment and it's an available for sale bond. Before I start I would like to remind you if you are studying for your CPA exam to check out my website farhatlectures.com. I do have supplemental material for your CPA exam or if you are taking your accounting courses. Now I don't replace your Wiley, Glyme, Roger, Becker, Sargent or any other course you are taking. My job is to supplement. I can be a very good addition to your CPA course where I can add 10 to 15 points to your CPA exam score. I don't short change you in the explanation. In other words, CPA prep courses they assume you know you have a certain level of knowledge. I don't assume anything. I explain everything in details from scratch. If you're an accounting students I do have accounting courses as well. Please connect with me on LinkedIn, subscribe to my YouTube. I always post videos and if you like them please like them and share them so you can help others as well as on Instagram and Facebook. So let's go ahead and start to dissect this problem that involves again many many aspects of different concepts. So on November 1st, 2014 Adam Company purchased Maggie Inc. They purchased the Maggie bond. It's a 10 year 9% bond with a face value of 600 000 for 540 000. You want to make sure you understand everything in the first statement. We have an investor and an investee. An investor and purchase bonds basically made an investment. The investor is Adam Company. They purchased the bond. The bond has a face value of 600 000. They purchased them for 540 000. First of all this bond is at a discount and the discount is 60 000. That's the first thing we know. And the date is important here. The date is November 1st. An additional 15 000 was paid for the accrued interest. And be careful here how the information is given. Here you are told additional interest was paid. So it's not part of the 540 000. The information could be given as rather than give you 540 000. They can say you paid 555 000 including 15 000 of interest. This is the same information. Here in this question I made it easy for you. You said you paid 540 000 for the bond and additional 15 000 for the accrued interest. Now once you say you paid for the accrued interest it means this bond was purchased in between interest payment. And let's see. Interest is payable semi-annually on January and July. Indeed it was purchased between interest payment. So here's what you need to understand. This is the timeline. Interest for this bond is paid on January and July. This is when the interest is paid on July 1st. You purchase the bond. Adam purchased the bond in November 1st. When you purchase the bond the buyer of the bond Adam will have to pay the seller accrued interest. Now Adam happens to pay the seller 15 000 of accrued interest. Now is this the correct amount or not? We're going to find that out in a moment. But you have to understand that the buyer will pay that accrued interest. The bond with shore on July 1st 2021. This is important because we need to know how are we going to amortize the discount. Remember we have 60 000 of discount. Adam uses the straight line method for amortization ignoring income taxes. The amount reported in Adam's 2014 income statement as a result of the available for sale investment is how much. Simply put Adam is going to receive interest from this bond. How much of that interest or how much interest revenue would Adam record on his income statement for the year ending 2014? That's the question and the answer are 10 500 15 000 18 000 or 27 000. How would you approach this problem? Well first let's compute the interest for the whole six month. Simply put if Adam purchased the bond on July 1st well if Adam purchased the bond on July 1st it's going to be 600 000 times 0.045. Why 0.045? The bond pays interest at 9 percent. We're doing it for we're computing the amount for six month. It will be 27 000. And the answer is 27 000 if if Adam purchased the bond on July 1st at face value. So that's not the case here but now we know the total interest for this period cash interest is 27 000. Now remember Adam purchased the bond on November 1st. So that's the total amount actually that's the total amount of cash Adam would receive because when Adam on December 31st the issuing company whatever that issuing company is will pay will pay 27 Maggie will pay will pay Adam 27 000 in cash. But is this going to be the interest revenue and the answer is no. Why? Here's why. First of all Adam purchased the bond on November 1st. On November 1st. What does that mean? It means part of this cash interest that that that Adam received should not be interest revenue. Why not? Because someone else held the bond for July, August, September, and October. So someone held the bond for four months. What does that mean? It means Adam will have to back out. Although Adam received 27 000 in cash Adam will have to back out the accrued the interest that was accrued that someone else will need to record that revenue on their income statement. So simply put what we're going to do we're going to take 27 000 and divide 27 000 by six months. So we're going to take 27 and divide 27 000 by six months. So let's go ahead and see how much interest per month 27 divided by six. So per month it's 4500. Now Adam did not own the month did not own the bond July, August, September, and October. So if we multiply this by four that's going to give us 18 000. So this 18 000 is simply the accrued interest. Now when Adam purchased this bond Adam only paid 15. You might be saying why? Wait maybe the seller was so desperate they said okay I will forgive a one month worth of bond for you. It doesn't matter. Adam held the bond for two months. Therefore Adam will need to deduct 18 000 from the cash in terms of revenue. Although Adam received 27 000 18 000 of it is not really interest. So what Adam left with is nine thousand dollar nine thousand dollar in interest revenue. Well we don't have nine thousand as an answer we are missing one more thing. What are we missing? We are missing the fact that the bond has 60 000 of discount. When you buy the bond at a discount your interest revenue will be higher than the cash that you received. Although although you received 27 000 in cash if you compute the interest revenue the interest revenue would be higher because you received the discount. Now what's going to happen? Adam will need to amortize this discount for November and December. For those two months November and December this is how much you're going to amortize the discount. Now how are you going to amortize the discount? You're going to be using the straight line method. What does the straight line method mean? It means amortize it equally over the life of the bond. Now we need to know how long is Adam holding the bond. Well it's going to go from November 1st 2014 till the bond mature July 1st 2021. So let's kind of go real quick and count to see how long will Adam held the bond. For 2014 he's going to have two months for 15 16 17 18 19 20 and 21 so it's going to have 12 for each uh now 21 it's going to have six months for 21. We'll count 21 separately 12 12 12 12 12 12 months for 2020 12 months for 2020 and for 2021 it's going to it's going to mature in July. So if we're going to take one two three four five six we're going to have six full years so let's take six multiply by 12 that's equal to 72 so those equal to 72 month plus eight plus eight equal to 80 month. So Adam's going to have this bond for 80 month therefore he's going to amortize the bond over 80 month so 60 000 divided by 80 month it's going to give Adam per month 750 of discount being amortized so we're going to now do November and December we're going to multiply this by two. So in addition to the 9 000 Adam is going to recognize in revenue an additional 1500 in bond in discount that's going to be turned into revenue therefore after all said and done the answer is 10 500 the interest revenue that Adam will receive that Adam would record on the income statement. Once again real quick the total amount of cash is 27 000 if he held the bond for six month well he did not we'll have to back out the four month will keep us with 9 000 then we have to account for the discount the discount per month is 750 750 times two is 1500 so this is how we will solve this problem and the answer is 1500. Now if you're having any difficulty with these concepts don't sit for the exam yet you are not ready you have to understand how bonds work and you have to understand how bonds work from the issuer's perspective and from the investor's perspective in this problem we looked at the investor's perspective now you have to understand how to issuer account for this bond and this is where I would like to invite you to check out my website for hatlectures.com where I cover these topics in details whether it's from the issuer's perspective or the investor's perspective again if you're taking any of these accounting CPA prep courses I don't replace them I wish I can if I can I will I'll be charging you more than this nominal amount 29 99 is nothing based on the value that you will you will get don't shortchange yourself the CPA is a lifetime investment in your career put the exam behind you move on so you can succeed in your career good luck and most importantly stay safe


Hi, this is Mitch Mitchell and today I'm going to talk about something that I think is in my opinion one of the biggest Scams this country tries to pull on its citizens and especially in health care Which is kind of my background although I'm in the finance area and that's the flu shot scam Now why am I calling this thing a scam?   Here's a statistic in 2011 because that's the earliest that you have for yearly statistic it takes some three years to put these things together I don't really know why but in 2011 out of a population of three hundred and thirty million people just United States now 5.5 million people went to the doctor or to a hospital claiming that they had the flu Now that comes to about one point six percent of the population now. How many of those people actually got the flu? Actually truly for the entire country for the entire year of 2011 around seventy eight thousand people That comes to and I'm looking at my numbers because I did the math that comes to 1.4% of the people who went to a doctor or a hospital thinking they had flu and it Eventually comes to point zero two percent of the American population And you know how many people passed away from the flu that year about one hundred and the people who passed away were Sickly people and little children mainly older sick people which basically says that you know If you're somewhat healthy, and you got the flu you survived it Here's the thing a lot of the people who got the flu Took the shot. They didn't get it from the shot. What happens is that every year? throughout the country They have these different regions, and they try to predict what strain of flu They think is going to hit and then that's the flu that they get and it takes about four months to make up a Flu shot for the you know for these different strains and that's what they give you so here's the thing They're guessing what strain of flu they think is going to hit where so what has happened this year this year They've got a strain of flu that is mutated from pretty much any strain of flu that they thought throughout the entire country So they've just figured this out and the thing is they can't do anything about it because it's like I said It takes four months to develop something to try to combat that and by the time They actually can now develop this thing flu season will be over because there's this particular time of flu season I don't know really where they ever came up with this idea, but supposedly flu season is considered beginning of December through the end of March that's full flu season. Yes, you can get the flu shot in October and You know such but the truth flu season is considered December 1st through March 30th Yeah, 30 days has a temple April June mark 31st So now this thing here, I'm not saying that if I'm 5065 Lord have mercy I'm not saying that if I get to 65 I'm not going to take a flu shot at 65 because now you know You're in that area where maybe you need to watch out a little bit more for your health Especially if maybe you have other health issues, but I Think that overall this is one of the biggest scams now last year when I was working out of town Even though I was not working in a hospital I'm working in an office park at this hospital system, but I'm in an office park They made me because I refused to get a flu shot wear a mask From December to the end of March I had to wear a mask I mean talk about your scarlet letter now a lot of other people just took the shot Why because they didn't want anyone looking at them and thinking they're not team players I'm an independent consultant. I'm president of my own company.  This is just how this works I'm not even in patient care now My wife is in one of those situations right now where she's working at this hospital She travels for her job as well, but she works in the hospital and she already had a contract for you know To work through April, but now this particular hospital is saying well We want her to go see one of our doctors to see if she's allergic to this shot because we Want her to have this shot because we're having all our employees get the shot My wife went to a doctor here in town has this thing saying she cannot take the flu shot but they're saying no we want her to see one of our doctors and They say if it turns out that they agree with her own doctor that she can't take the shot They have something else that they developed that they won't said that she would have to take are you kidding me?  She has said she would wear the mask the entire time if it comes to that But this other thing is a scam you want to know what kind of scam it is. I'm gonna tell you New York State just announced that The flu strain is prevalent in the state. It's prevalent So now anyone who hasn't gotten the flu shot who works in health care has to wear a mask now I don't know if business offices have to do it, but everyone has to wear this thing. So the thing is In Anaheim County, which is where I live which the population is around 250,000 you know how many people have the flu 11 11 people that's point zero zero four percent 11 people this is prevalent Come on really? It's ridiculous. Now. I kind of understand if you're dealing You know with patients who might have different sicknesses which they do all the time by the way and they're worried that you may catch something from them Okay, wearing a mask not a big deal, but prevalent I mean my goodness one of my friends posted earlier today on Facebook that there's over 10,000 cases of whooping cough in California in the LA area of all things whooping cough Something that a lot of people thought was gone now to me. That's a big deal 10,000 cases and that's just already in a you know city like Los Angeles, but those people are kind of packed in you know So to me that's kind of a big deal.  Your family is done. Is that covered by life insurance? I don't know But that's not the point The point is that the government gives carte blanche to these companies to make this stuff Without necessarily knowing one if it's gonna work or two if it's gonna kill somebody. They don't care It's a scam. It just is I Had some other thing I was gonna say but you know what I'm gonna stop here because I want to know What you guys think about this flu shot thing? Do you really think that it's fair that in some states in some places people are being forced to take this shot? And have to sign these waivers, you know, I mean, I don't want to get a flu shot not getting one Luckily I work for myself But if I'm working in a hospital and I am forced to take this shot or lose my job Which New York State actually tried to do three years ago and then they ran out of the stuff more rounds, but If you have to take the shot But they make you sign the waiver. Is that fair doesn't that sound a little tricky? Oh, here's the other thing I just want to add a lot of hospitals are kind of enforced this kind of thing because The federal government Medicare People so don't blame this on Obama had nothing to do with him Soon as for Medicare and Medicaid Services came out with this thing a couple years ago saying that if hospitals didn't take precautions Like this to make people either wear a mask or get the flu shot they could have their reimbursements reduced by 2% There you go, but But the rule is only for people who work with patients So if that's the case Then what's the point of someone who's working in a business office who's nowhere near patients? Having you take the shot It's just a question So let me know your thoughts on what I'm calling the flu shot scam or hoax I'm not gonna call it a hoax because I know some people are saved by this But the way they're pushing it for the numbers that they have isn't justified.  Anyway, this is my rant for the night. I'm Mitch Mitchell I hope to see y'all and please let me know what you think. Goodbye


Hey guys. Today really quick. I'm pretty excited. I want to talk to you about the father's day, the Vitamix father's day slash summer early summer sale. It's buy any new machine and get a secondary container for 50 bucks or 65 if you're in Canada. If you go through our YouTube channel and our website, our recipe index, anytime we use a secondary container, not the 64 ounce, we're using the 48 and that's because the 48 ounce container comes with the tamper. So you can make smaller batches of the really thick blends. So nut butters, ice cream, hummus, things like that. You only get one $50 container with your purchase. You can't buy them all for 50 bucks. So which one do you get dry grains container is good. If you already grind your dry grains, but I'd say that's like 5% of the population and the personal container. So the personal cup of adapters for classic and the eight and the 20 ounce starter kit, those are fine, but they aren't that versatile and they're better as sort of down the road when you feel the need for them, when you want a gift, when they go on sale, which they do periodically once or twice a year on their own, get those that so pick your Vitamix. If you don't know which one you want, watch our which Vitamix by 2020 video, we'll put a link right here and then pick a compatible 48 ounce container. You might notice if you're going to choose a classic, so 5,200 or pro 750, you do have a choice between a 32 and a 48. The minimum batch size between the two are the same. So there's no benefit to getting one or the other. It's just kind of the size that you're working with. The 48 is a little more bulky, but the 32 is you can't go wrong either way. Smart system, there's only the 48, which is great. Just use our links to make your purchase and you'll see the discounts in cart. Also, take a look for to see free standard shipping and next to that zero six, no yoke, our name, that makes sure that we got referral credit. And if you don't see it, just hit that activate referral button and that'll make sure that we did get the credit and we really do appreciate that you're doing that for us. Once you've checked out, be sure to notify us of your order and we'll send you our ebook and get you six months of VIP support. On a personal note, I've been blending with my little guy since he could hold his head up and we make green juice together and he talks out and we're gonna do the same with our youngest soon once he can stand. And guys, I'm showing you the like really kind of general recommendation for what to get and which container to get for which for this big sale. If you need a personalized recommendation, please email us or call us, send us a text. We're here. This is what we do. We're so happy to help you. And guys, subscribe to our channel if you haven't already hit that bell to get notified. And if you appreciate videos like this, hit that thumbs up. Thank you so much for watching and we'll see you in the next one.