All right, committee we're back after a short break and we are taking up age 210 that came to us from the house and we have representative leopard here to introduce the bill to us so. Welcome representative leopard I know this is a bill critically important to you and I think it's going to be important to us as well so please. Introduce yourself for the record and welcome your input. Thank you. Good morning everyone represented bill leopard chair of the house health care committee and was I was the presenter of age 210 on the floor of the house. So I'm going to give a brief overview of the bill. And then I may. I'm also our committee is also of course taking testimony this morning so I may not stay for the entire time, but catch up with you all later. But let me say that yes to age 210 which is an act addressing health disparities and working toward issues of health equity is a bill that has. That our committee the house health care committee spent a great deal of time with and it's an important bill from in moving forward toward the kind of health equity issues that we believe are critical for all of our monitors. I want to acknowledge at the outset that while I was personally interested in beginning to address the issue of health disparities in our committee. We were there we were. We took up age 210 which was initially crafted by members of the affected communities and particularly from the Vermont racial justice alliance and introduced by representative Brian China as the lead sponsor. The bill is introduced. Really focused on addressing creating creating infrastructure, I would describe it as an effort infrastructure for addressing issues of health disparities. We have a long section of findings, which we. We've seen that sometimes findings are not seen as essential to a bill but in this instance it was very important for us to share with our colleagues. Findings which are each one of the findings is anchored in documentation from either the Department of Health or other sources and so we integrated the documentation into the findings so and there is also a separate single sheet with a series of links that could be made available to your committee. I'm sorry, I didn't think that was available to you today, but we found it of use, because in each of the findings there's a document, and there's a link that you can go directly to that document. These findings really anger the bill in terms of issues of health disparities around race and ethnicity. The LGBTQ community and the disabilities people with Vermonters with disabilities. We know that COVID, the COVID pandemic has made painfully clear the level of health disparities we have in Vermont, particularly around COVID and race and ethnicity. What the again coming back at the bills introduced immediately would have established an office of health equity within the Department of Health. Given the health departments 24 seven involvement in the pandemic. It was our conclusion that at this point in time, it was probably not realistic to ask the health department to take on a new initiative, even though this bill aligns very strongly with the health equity work that the Health Department of Health has been doing for a number of years. And so, while the bill asked to have an office of health equity established immediately it also called for the establishment of an advisory commission. And we made a decision in consultation with the office of racial equity and the director of racial equity who's here to join us to think about how to not simply not move forward because if we couldn't establish an office immediately. Instead, look to establish the commission and to empower the affected communities who are the primary members of the commission. And to, and I want to say express our gratitude for the willingness of the office of racial equity and Susanna Davis as the director to take to contemplate taking on a transitional role of standing up the commission. And then, using the commission to actually help think further about establishing the office of racial equity, as well as looking to help establish how we should move forward with cultural competency training for all health care professionals, as well as taking on its role of advising the general assembly and advising the Department of Health as well. There's also a data component. And again we in was it House bill 315 we actually appropriated some separate dollars as well for issues of data collection and alignment, because both proper collection of data around these issues, as well as should be to ensure that data is collected and to ensure that it's the proper kind of data that it's not that it's disaggregated and it's not, and that it should be studied and reported on on a regular basis. I would say that the structure of the commission is more unusual than usual typically has is a large number but it has many members of the affected communities as well as representatives of the state. And within the commission, we, we asked for an appropriation. Well, let me back up and say that it would not have been realistic, nor appropriate to ask for the office of racial equity to take on this transitional role. And there not been also a commitment to the staffing of two additional positions in the office of racial equity, which now I believe is reflected in the House budget on an ongoing basis. And we advocated for that and said if that was not in place we wouldn't ask for any treasure transitional role, but it was also not appropriate to give to ask for this transitional role without additional resources. So $180,000 is appropriated for the next fiscal year to support the director of racial equity. To hire in a manner that's determined by that office staffing or consultants to help stand up the commission as well as to provide the support for the commission in its initial work as I've outlined it. I think the underlying issue, the underlying dynamic that we hope is reflected here is to elevate the voices of the affected communities to empower those voices those members to have a significant role in moving forward with developing the infrastructure to address health disparities. And we recognize that this bill is in many ways modest in nature, and yet very significant in trying to establish infrastructure that will allow health disparities to begin to be mitigated and address significantly over time. I think with that, that's my general introduction to the bill. We are very pleased you're taking up the bill today. And we look forward to working collaboratively along the way, if there are ways to strengthen the bill. Thank you. That's very helpful. And, and obviously I know we've both been through some dip our both of our committees have been through some difficult times with the pandemic and one of the. We'll share with folks because some of our committee members are new but one of the first things that we did during our discussion and our legislative work was to add in racial and ethnic disparity data collection for COVID. And that has, I think, been an underpinning for a great deal of the work that continues to go on in the Department of Health and we're, we're, we are actually proud of that one. But this one seems like this bill will take us a giant steps forward. So, you know, thanks for your work on this so we really appreciate it. And the question I have for you is, what was the vote out of committee. Oh, it just something. I think the vote out of committee would we. So just to put it in context, we have one member who is in leadership in the house and is does not participate in the committee so there's always one person absent. So it, but it was a nine one vote. One nine nine one opposed and one absent. And then how about the floor was it a voice vote or it was a voice vote it was very strong voice vote. Okay. And anything else whether whether folks who testified who were categorically against the bill in any way or we're requesting specific. It would be fair to say, well, first of all, we heard from many members of the affected communities and that those, those were the voices that were most powerful for us to hear. And both from the disabilities community from, we heard from the racial justice alliance we heard from the LGBTQ community we heard from the Abenaki community. And for those who feel like the bill should have been strengthened further by having an immediate establishment in the office of health equity, and that we should have immediately required training for health professionals. It was our determination that the it was not, we were not going to be able to establish that office immediately. If you determine otherwise, we certainly would support that. So I think there are those who would see the bill as wishing it had been enacted as introduced. But I think there were many people who also see this as a significant step. Yeah, okay. Yes, I can. Did you did you hear from the Department of Health on the open? We did. We heard from the Department of Health initially and one of the things that was most striking immediately was how, how in alignment the structure of the bill was with the work of the health equity work of the department and How do you climb it? But what testified and and we were both impressed and heartened by the efforts that have been put in place. But it also was clear that there was more that needed to happen. I would also just say that the initial I think the initial absence of race data. In terms of COVID was both an indicator of where of why we need why we need to do more. That that wasn't in place initially was an indicator of the exactly the challenges that we're facing. The structural failure to include race data. And, but then the subsequent commitment to making it. Available and using that analysis, which then led to the understanding of the disparities without the actual data collected. We can't fully understand where the disparities lie. Okay, thank you hamstrings us from taking steps for further. Yeah. Okay. Committee questions for representative Lippert. Go ahead, Senator Hooker. Thank you. Thank you. And thank you representative Lippert for bringing this forward. My question is with regard to an office of racial disparities. Do you anticipate it. Office of racial equity. Great equity. Thank you. Do you anticipate it being eventually in the department of health? Well, interestingly enough, as the bill is introduced, made it clear that it should be in the department of health testimony that we heard from. Well, we heard from the office of healthcare advocate, as well as hearing from Suzanne Davis as the director of racial equity. Well, she can speak for herself, but obviously there are different different views as to where and how the office should be located the bill introduced as says it should be in the office of in the department of health. We allowed for the commission to recommend how that should move forward, rather than us saying in statute at this point in time. Because there are there are clear advantages. Some feel that there are advantages for being an independent office such as the office of the health care advocate outside of state government. And others feel like there should be it should be within state government. I may have a personal view at this point, but the committee did not take a position. And I think there are a lot of reasons why being working within state government allows you to have a powerful access and influence, but it also could also at times have a challenge in terms of working within a structure that you may want to advocate to change or influence. So the bill itself allows the commission specifically to give direction on that. Thank you. Which I think is actually appropriate in terms of having the affected communities, which did help to introduce the bill, but at this point I also think once the commission is in panel to give them the ability to speak to that issue. Senator Hardy. Thank you, Madam chair, and thanks representative Lippert for being here. And I just scrolling through the bill there are 11 pages of findings which I think is the most findings I've ever seen in a bill. You mentioned. There's lots to find. You mentioned that there was some document that goes with it that has hot links to sources. Could you send that along to. I will make sure that sent out fact out. When I get back to my screen in my zoom room. I will ask to have that sent to you. And just to say, you know, let me acknowledge that there were some challenging questions asked. Not everyone at the vast, vast, vast majority of our committee strongly supported this bill. We believe that we this is a part of addressing issues of structural racism as well as broader disparities. Not, we found that there was some disagreement. And while I say, we had the vast majority we had a strong vote of nine members of our committee supporting this bill. We believe the findings anchor the very facts of health disparities. And for some members we felt it was important in taking this to the floor of the house that there might be some members who question this. And while our committee doesn't question this. It was it was really an attempt to anchor the information in data. In addition to the anecdotal powerful anecdotal testimony as well and I don't mean to demean that by saying anecdotal. But we've learned that data in addition to the lived experience and stories of individuals affected directly. That becomes a powerful combination. And so that's why it is unusual long unusually long set of findings, but we felt it was essential. Okay, thank you. All right, unless there are other questions for representative lipid I'm going to suggest that we ask Katie McClinn to walk us through the bill and then we'll hear from Susanna Davis and Susanna. If you feel that your time is starting to run away. Let me know please just raise your hand or send me a chat. And we can we'll interrupt the bill and we'll and we'll we'll hear from you but I thought it might be helpful for us to look at the bill first. Thank you very much. Okay. Senator Lyons, Katie and Susanna other committee members. I mean no disrespect but I think I need to go back to my committee. And so I will follow up and make sure I understand what your discussion is here this morning and the further testimony, but I appreciate you taking up the bill and I look forward to us working together on it. Okay, thank you. Thank you very much. And then, okay, so Katie I know that you have a your, your between between shows. We have a hard stop at 11 so we'll we'll go into the bill and I think, I think rather than read each, each finding and each section of the bill to give us the more of a 2000 foot level, just so we understand what is here, and I, we, we will definitely hear more testimony and take some time to go through the bill more thoroughly as we continue our work on it. Let me pull up my screen. There we go. Are you seeing to 10. Okay, I see had not in great. So as representative Lippert said, the first section is the finding section, and I'm just going to scroll through it for today. And it sounds like we'll come back to this at another point. I think maybe there are some there may be some things that are that should be highlighted and a few. I can see what most of them are and I think we've read most of it already but I can tell you that the findings are broken down and part into categories because this bill focuses on health health equity of various populations so there. There is a section of findings on LGBTQ adults and also on LGBTQ youth there are findings organized by race and ethnicity there are findings organized by Vermonters with disabilities so the finding section makes an effort to provide statistics on the various about various populations and communities impacted by this by this bill. Section two of the bill is on page 10. And this is a legislative intent and purpose section I'll go through this, that it's the intent of the General Assembly to promote health and achieve health equity by eliminating avoidable and unjust disparities and health. It's an economic and comprehensive approach to address social economic and environmental factors that influence health. To this end, the General Assembly believes that equal opportunity is a fundamental principle of American democracy equal enjoyment of the highest attainment attainable standard of health as a human right and a priority in the state. A structural racism defined as the laws policies institutional practices cultural representations and other societal norms that often work together to deny equal opportunity has resulted in health disparities among Vermonters. Great social costs arise from these inequities including threats to economic development democracy and social health of the state of Vermont. Section four, the General Assembly believes that health disparities are a function of not only access to health care, but also social determinants of health including the environment, the physical structure of communities nutrition and food options, educational attainment employment race, ethnicity, sex, geography language preference immigration or citizen status, sexual orientation gender identity and socioeconomic status. You want me to move through this more quickly. No, no, no, I don't I want to go back to number four very briefly. Yeah, no, I was going to ask a question about the, it says social determinants of health, including. But I'm not sure whether that the including relates to social determinants of health because the what follows or not social determinants of health. I'm just thinking that we may want to clear that I'm just pointing that out right now so we may want to clarify the meaning of that paragraph and to clarify what specifically our social determinants of health and what are not. Okay. Okay. I will flag that thank you. Thank you. In Division five the General Assembly believes that efforts to improve health in the US have traditionally looked at the health care system as the key driver of health and health outcomes. However, there has been increased recognition that improving health and achieving health equity will require broader approaches that address factors that influence health. And lastly, the General Assembly believes that health equity is the attainment of the highest level of health for all people. Health equity can be achieved only by eliminating the preventable differences in the health of one group over another, as the result of factors such as orientation, gender, disability, age, socioeconomic status or geographic location. And then we have a purpose section. The purpose is to eliminate disparities and question. I don't know much, but I just want to highlight some areas that I think our committee from the health and welfare from the health and welfare perspective so it goes into disability and age and then it says socioeconomic status or geographic location, which might suggest the health and improvement plan process, or the hrap that we see. So this could, I'm just, I'm just wanting to have a firm understanding of what is implied by socioeconomic status and geographic location and what the extent will be considered. When we get to the commission. That's all. It's just a question, and we'll come back to it. Is somebody say something. Yeah, it's, it's an go for it. No, just wondering, when it says socioeconomic status. I'm just going back to my old, you know, sociology tests. Are we going to be looking at socioeconomic status. On BIPOC people. What I'm wondering is, is health status more function of ethnicity race, or is, is it as much a function of poverty, or life, you know, and because if we're going, I think we need to know what we're going to attack to fix it. Okay, this is a Senator, I think this is a question that now we have recorded and as we go through and hear from folks, it'll be one to bring up and I think there are people probably on on YouTube with us now on zoom with us looking at what we'll be able to respond to your question and that's why I'm raising these questions as we go forward. So either Susanna can help us, or as we go through the bill further we'll be able to get some clarification. Okay. And I would just. Senator Cummings refer you back also to the findings I think the, the potential witnesses that you will hear will probably have great responses to that question. I'm referring back to the findings there's a lot of tie in particularly with the findings with regard to housing conditions for persons who are black indigenous and persons of color, and that tie in with socioeconomic status so that's I'm just wondering if as a balance that we would also look at her non persons of color and do people in the same socioeconomic status have the same health outcomes, you know just trying to get at what is the root cause. Otherwise we kind of presume what the root causes. Those are very good questions that will and I think Department of Health may well be able to help us either answer the question or to suggest data collection that would inform that good. Okay. So that brings us to subsection B, which is the purpose section and the purpose to eliminate disparities and health status based on race ethnicity disability and LGBTQ status by establishing better and more consistent collection and access to data, enhancing an equitable range of available and accessible culturally appropriate health care and public services across Vermont, ensuring early and equitable inclusion of reminders to experience health inequities because of race ethnicity disability and LGBTQ status and eliminates to efforts and efforts to eliminate such inequities. And lastly addressing social determinants of health particularly social, economic and environmental factors that influence health. And social determinants doesn't actually include economic or environmental so you know it's very well defined so we're that that's when I do want to make sure that we're clear on it because we don't want confusion about what about meaning there. Okay. And then the next section. We're creating a new chapter on health equity. And in this chapter, there's a definition section and then it's creating the commission that representative liberate was referring to. So the commission itself plays kind of a short term role in providing recommendations to set up the office of health equity. It's an ongoing commission that has duties that extend far beyond the short term goal of kind of giving guidance on the setup of the office. So the first section is the definition section. I won't spend too much time on the definitions at this point and we can maybe go back and look at them in a bit more depth. I did want to draw your attention to the fact that there's a social determinants of health definition. And it seems that that's a place that you're interested in so we might want to spend some time looking at that when we come back to the language. Okay, so the next section is the creation of the advisory committee. And in our first paragraph paragraph we can have the mission statement of this group it's to promote health equity and eradicate health disparities among Vermonters, including particularly those that are black indigenous and persons of color individuals who are LGBTQ and individuals with disabilities. And the commission shall amplify the voices of impacted communities, regarding decisions made by the state, the impact health equity, whether in the provision of health care services, or as a result of social determinants And the advisory council is also to provide strategic guidance on the development of the office of health equity, including recommendations on the structure responsibilities and jurisdiction of such an office. So that's kind of the, as I said the mission statement of what this group is going to do and it's long term and short term focus. And then we have the members of the advisory commission. It's a long list. And I know you have other witnesses so for today, maybe I'll just say that there are representatives from the state and there is also an effort made and the health care committee to include representation from members of all the impacted communities on this list so for today I'll scroll past the list. Okay, and subdivision question just quick question and something we may want to raise with Susanna when we get there. And that is we do have a chief prevention officer in the agency of administration. So it may be that that person would offer some benefit to the commission and or the prevention director or manager that we have in DOH so just a, just a question. Okay, and I just wanted to flag for you that the last subdivision in this list of members includes any other members at large that the commission deems necessary to appoint to carry out the functions of this section, including ensuring equitable representation and balance between impacted communities and the health care provider perspective that health care provider perspectives are represented based on a majority vote of the members. Then in subdivision to we have the term of the office appointed shall be three years with the exception that members at large shall have a term of one year. And of the members first appointed who are not designated as at large members for or to be appointed for a one year term for appointed for two year term and 10 appointed for a three year term so this is kind of not all membership would turn over at the same time there's a rolling membership. Members would hold office. Yes. Sorry to interrupt. I, it's this is a huge commission. Are there. Is there a. Sorry, a chair it or how did they choose a chair to run the meetings or whatever. The bill that passed out of health care did have. Susana actually as the chair, the director, executive director of racial equity and then there's amendment on the floor to allow the advisory commission itself to select a chair from among its membership. So that that is a piece that has had some conversation and some change, since it left the health care committee, and we'll get to that language where. Oh, it's not we haven't gotten to yet. Okay. And is there any type of sort of executive committee or smaller subgroup. That has sort of separate subgroup of power sometimes with these huge commissions there's often a set of. There's need quickly or something does that in order to. I'm not suggesting we should do that. I'm just wondering if that was any ever just justice. There was certainly a conversation about empowering the commission to organize itself how it would. That it would be best suited to kind of determine the right structure for itself. Honestly, off the top of my head I can't remember if there is language about creating subgroups. And I'm sort of well we'll see when we get there I don't remember that there's a big language on subgroups but my recollection is that there was a lot of conversation about empowering this group to find the right way to organize itself. Yeah, I think I think the commission does takes care of the. And in the absence of language on a subgroup. That doesn't, of course, preclude any subgroups it's just not directive. Yeah, I'm just thinking committees and that kind of thing if that's necessary to have in or if that's just a given that these groups can make committees or executive committee or whatever. Right. So I'm so Katie, before we go further, I think, Susanna Davis has under pressure with her schedule so let's interrupt at this point. We'll put a hold on the rest of the bill and we'll have Susanna provide her testimony. Thank you for letting me know. Yes, and thank you all for your flexibility I apologize for interrupting the walkthrough for the record. Okay, for the records was on a Davis racial equity directed for the state. And I don't have prepared remarks today I just thought I would come in and answer any questions you might have and speak a little bit about the, the purpose and the intended benefit of the creation of this office and the setup of the commission. I did want to follow up on a couple of the questions you all have already asked. So I'll just take them in the order in which I recorded them. First, Madam chair you note in finding section number four, the social determinants of health. And I think also points number six and eight if I recall, and just making sure that we've clearly defined that and that we're accurately reflecting the social determinants of health. I just want to confirm that from my perspective and from my work in the Department of Health and Mental Hygiene in New York, that we do include all of those factors in social determinants of health and I think the CDC also has things like environmental and economic factors listed as well. So I would agree with the way that the bill findings lay out social determinants of health for what that's worth. The next one. The senator asked if health disparity was more a function of race or of poverty and whether we'd be tracking socioeconomics of people who are not people of color or just people of color. And personally, I would say let's track everything we can. You got data I want it. And so the, I think it's important to track socioeconomic status for all people so that we can really get deep insight into the effects of poverty or wealth into people's health outcomes. And, just as an answer to that first question, disparity, we often see is more a function of race than it is of poverty in the United States, not just in health but in other factors, because often when we control for socioeconomics, we still see deep steep disparities I'll give you one example related to income earning potential we see of course disparities in lifetime earnings and income for, let's say black Americans and white Americans. And that tends to be across the board, but when we control for socioeconomics like if we have white children who grow up in the so called 1%, the 1% top earners in the United States, compared to black children who grow up in the top 1% of earners in the United States, we still see that over time they both will grow up to have a 12 point difference a 12% difference in lifetime earnings where the white child who grew up in the 1% is still earning more than the black child to grip and 1% and of course that's with economics. But the same ends up being true about health disparities. So it ends up being more race is a better predictor of life outcomes than poverty is, but I still strongly think that we should be tracking poverty metrics or wealth metrics for all groups. The question was raised whether the chief prevention officer or the DOH prevention manager should or could have a role in this work. And without coming out and volunteering other people for more work, I would say there's absolutely a place for that in this and to the extent that those people and offices have the capacity, they would be very, very welcome additions to this work. And then commission chair selected by the body. Yes, and I think that that's one of the ways in which we are really accomplishing process equity by doing a little bit less dictating in the statute how a group shall work with one another, but rather allowing that group to determine the path forward for itself to make sure that it works in a manner that suits it so that amendment is is one that I agree with. I'm going to end up with those questions. I don't know if you had any others I can address. But I guess I just wanted to say generally about this bill that I strongly support the creation of an office of health equity. I along with the advocates remain disappointed that that is not a more immediate part of the bill that is to say that we've deferred the setup of the office of health equity for after the creation of the commission, although I understand the reason for it. It's about capacity and bandwidth. On the part of VDH given the current activities they're focused on. And I mean, I know you all have heard me say this in different hearings and in different contexts but I people of color have been asked for so many years to wait for justice for centuries really. While I recognize this the incredible urgency with which we must act on these and other factors. I also believe that I'd rather take a little more time and get it right rather than get it done now. And so, if we're not confident that we can set something up in a way that we're most proud of and in a way that's going to be most efficacious, then let's take our time and do it right and so So for what that's worth. I think that going about it in this way allows us not only to begin doing some of the work that is the setup of the commission, but also if you look at the list of members of that commission and the partners with whom they're supposed to be working. It really presents us an opportunity actually doing it this way, instead of doing them both simultaneously for those members of the commission and external partners to inform the setup and operation of the office of health equity. So I think that presents us an opportunity to make sure that the office is being set up not just based on what the state thinks is appropriate but really incorporating the feedback of commission members and members of the public and I think in the long run we talk about things like process equity and community sourced governance that that might end up working very much in our favor so I'll pause there and invite any feedback questions that you may have. So as you're as you're talking through this issue and the and looking at the commission and then the fact that the commission can add folks and we'll have a have a long arm to reach out to educational institutions. To medical facilities and folks and then might be recommending making recommendations regarding how medical students are taught how social workers are taught I mean you this could end up being a huge work period it's a it's a lot of work I can see that in addition to work which there's the whole area of the judiciary which I know you're anxious to get to but the are the are the parameters designed in the in the bill the charge or the mission for the commission. A are they too broad are they not broad enough one and how specific. This is hard I mean just how specific should they be our are we asking for this commission to do a total and complete and thorough analysis of all the cultural defects and I mean they are defects and gaps and places for improvement is is that what we're asking of this commission this is a huge task. I think that we're not necessarily asking the commission to do all of that work and all of that analysis but to play an advisory role in the office doing that analysis. And we we know that the health department has already been doing health equity work for years so they're they're they're well versed in it. I think it's just about having a robust and intentional structure dedicated to that. So the commission I think certainly would have a hand in identifying those shortcomings or as you say the defect. But I think it's really about more the serving as an ancillary supportive role doing things like grant making so having that I on the outside and the external partners who could be of service and being able to help guide the trajectory or at least help identify how we should focus it. It is a lot and one of the things that I that I'm grateful to chair liquid for being receptive to was my caution that, while I recognize that we do a lot of our work based on timelines that we allow for the flexibility here to make sure that if we do a lot of our work based on timelines that we can. Again oftentimes, you know rushed policy is rarely good policy. And so, so I think that the bill lays it out in a way that is fine. And if we determine that it's not quite fine in terms of timing that we that we have procedural grace. I'm sure that we empower the commission and eventually the office to have what it needs to get this right. I hope that's clear and then I didn't. Well, I think it will probably be made clear as we go through the bill because we haven't looked at the kind of the forgiveness policy for timing yet but appreciate that thought and and I do think that I understand what you're saying about social determinants but we may come back to that simply because this committee has had experience in putting in place policies related to social determinants we want to make sure that we're we have consistency across our our statutes so that that's why I raise that as an issue. Senator Hardy. Thank you madam chair and thank you, Susanna for being here today and your testimony. I was scrolling through the rest of the bill just to see if I understood the duties of the commission are, and it sounds like a lot of the duties are to come up with what the duties of this new office should be is that, and then there are some ongoing duties of the commission after the office is set up. And then your office has a large role in the whole thing and we haven't gotten to the fiscal note yet but I was just scrolling through that is there. It looks like you're tasked with making a budget request for next year for what you might need, but are there resources provided to your office. In the FY 22 budget in this bill or are they in a set, are they in the big bill or how was your office being resourced to do this work. Yes. So, so the proposal is put forward with the expectation that the separate funding proposal for two staff positions for the Office of Racial Equity be put in place. So absent that it's, it's, it's not clear that this could happen at least not in the timeframe that we've that we've carved out so one would be those two staff positions coming to or creating an Office of Racial Equity, and then there's a what I believe $180,000 note in there that would be for contracting with a third party contractor who can serve as a consultant and helping us to get up the commission and therefore get that ball of ruling. At some point after that I get to step away once VDH comes in. So my, my involvement really is, is more transitional than anything. Yes. Okay. And just in general, I mean, just a first read through the bill, it reminds me a lot of a bill that we, we passed two years ago act, what came Act one that's a similar kind of charge and group, working on this similar issue in our educational system. And I think one thing that I'm happy to see in this bill is that in these two years we have much more of a structure to do this work because of your office. And there seems to be much more of a, you know, an infrastructure that will help this move forward in a way that we kind of struggled with with that Act one two years ago so so I guess acknowledgement of and appreciation for all the work you've done over the past two years that we can get a little further along. And glad to see that we're doing this similar work in education and health and you know next the judiciary perhaps there's just so many places to tackle but and I guess my final question for you is, is there anything that you want to flag for us that you want us to look into that either the house didn't get to or that we should, or maybe didn't do in the way you would want them to, or, you know, something that we should change or people that didn't get heard from in the house that we should hear from. No, actually, I don't I'm grateful to the house for being for making changes and updates that are reflective of the guidance that they heard from directly impacted communities and from me as well. I just suppose that I would reiterate reiterate to you all that for this to be as successful as it can be. It's really going to be important that we trust communities enough to hand the reins over to them in making a lot of the determination so I think a lot of the sort of nuts and bolts questions that may be unanswered in the bill are really ripe for allowing members of the community members of the Commission to set those parameters. I know it's it's difficult because we are people who love and make rules. I think self determination is a really big part of this, particularly in Vermont we have an indigenous community that had largely had self determination taken away from them we saw yesterday the historic vote for the eugenics apology and and so much of our health outcomes for people especially indigenous community have had to do with not being able to make certain decisions for yourself so I would just reiterate the importance of that and because you mentioned Act one I cannot help myself I just I have to plug the importance of us resourcing the act one group. I sit on the committee I see how hard people are working and how important it is, and it's, it's, it was a wonderful and important piece of legislation. The work is happening, but it needs to be refueled in order to keep happening. So, I'm putting in an act one plug here. If you don't mind. Communicating that in an email to Nellie and copy me please. I think and copy the chair of education I think that was a bill that went through the Education Committee and I completely agree and that's what I was sort of referencing the sort of infrastructure of that versus infrastructure of this. So, good, good, good. And Senator. Thank you. Any other questions for Susanna. I think Susanna will be helpful to have you return as we go through the bill. If you have some time to do that. But you're obviously very a strong leader in this. And we need to have that input from you so thank you. Very happy to return thank you for your flexibility and thank you for your time. All right, terrific. Good luck in the judiciary committee. Thank you. Take care. Okay, so we'll, we'll just we'll finish up going through the bill for the next five or six minutes. And then we're going to jump over to another topic. Katie has a hard stop. So let's do that. Okay. Maybe I'll just skip ahead to the powers and duties of the commission. Yes. Okay. So first, the advisory commission shall provide guidance on the development of the office, which is to be established based on the commission's recommendations as soon as it's fiscally practicable to do so. And the specific and guidance will include the structure responsibilities and jurisdiction of the office. And the process of the office is to be independent and if not, in which state agency or department it should be situated how the office is to be staffed. The population served and specific issues addressed by the office. The duties of the office including how grant funds shall be managed and distributed, and the timeframe and necessary steps to establish the office. The commission should include providing advice and making recommendations to the office once it has been established, including input on rules and policies proposed by the office. Awarding of grants and the development of programs and services, the needs priorities programs and policies relating to the health of the impacted communities, and any other issue that the office of equity health equity requests, the advisory commission on also the advisory commission is responsible for reviewing monitoring and advising all state agencies regarding the impact of current and emerging state policies procedures practices laws and rules on the impacted communities, identifying and examining the limitations and problems associated with existing laws, rules, programs and services related to the health status of the impacted populations. And advising the health department on any funding decisions related to eliminating health disparities and promoting health equity, including distribution of federal monies related to coven. The extent funds are available for the purpose of distributing grants that stimulate the development of community based and neighborhood based projects that will improve health outcomes for impacted populations. And lastly, advising the General Assembly on efforts to improve cultural competency and anti racism in the healthcare system through training and continuing education requirements. We'll come back to that piece because there's kind of a short term report back on this piece. Senator lions. Yes. Yeah, what I didn't hear in there is how the office is going to be paid for. I may have missed it. But we just talked about how we're underfunding all of these things and now we're starting a new program. And I didn't hear anything about how the, how this new department would be paid for. Well, that's something we can ask and we can add that. I mean, I think, yeah, it's a, it's an important point. You can't have an office without some resources. Right. All right. In the interest of time, I'll kind of move over some of the more technical aspects of creating the commission. There is a section on data responsiveness to health equity inquiries. I'll just flag that as something that we should come back to the section for amends the existing duties of the executive director and racial equity to include the new duty of temporarily overseeing the establishment of this advisory commission until the office is up and running. And then in section five, there's a short report in the short term from the commission. It's to come back October 1 2022. And it's to consult with various licensing boards and professional organizations. And it's regarding recommendations for improving cultural competency and anti racism in Vermont's healthcare system through initial training continuing education requirements and investments. And that ties in with the last duty on the commission's list of duties. And then as I believe center lines mentioned, there is language in the report about asking the commission to make a budget recommendation to fund its work in fiscal fiscal year 2023, if necessary, to continue its work. Okay. Sometimes, you know, the work just extends to the time allowed, but so that'll be a, but we also want to be well done. But I also have a I have another question. Yeah, so Katie, I haven't memorized the bill yet but and I may not do that but the the issue of this is actually about health, right. So anything in here, there is in here about determinants of health social determinants of health. Is there anything in here about collecting data that identify the causes and influences for health disparities among these different groups. We'll have to open question, we can look at. Okay, there's a whole section on data that I went over very quickly just because I am scheduled to be in another committee at this time. So this section subsection a each state agency department board or commission that collects health related individual data is to include in its data collection health equity data disaggregated by race, ethnicity gender identity age primary language socio economic status disability and sexual orientation data related to race and ethnicity is to use separate collection categories and tabulations disaggregated beyond white and non weight in accordance with the recommendations made by the executive director of racial equity. And then there's language that the Department of Health is to systematically analyze this data. Using the smallest appropriate unit of analysis feasible to detect racial and ethnic disparities, as well as disparities along the lines of the categories that we just went through and to report on the results of this analysis on its website periodically but not less than by annually, and the department's analysis is to be used to measure over time the impact of actions taken to reduce health disparities. I don't want to keep you I'm also I've also been thinking about how we'll have to go through the bill again but just just how this commission interacts with, for example, the Prevention Council I mentioned the chief prevention officer but there is the whole Prevention Council and maybe, maybe there's some something to be gained by changing the constituency of the Prevention Council not not right away but going forward so just, just, I'll have to remember that. All right, and so just one last comment this did not go to house human services. I don't believe so no, I didn't go walk through with them. Okay, go to appropriations. Yes. They have $180,000. I think is what representative, the bird said in the budget set right and that's to do. That's probably one time money. It is. It sounds like. Okay, but somewhere we're going to have to talk about how we pay for an ongoing department. Yes. And that and they. So I think the original bill established CMEs for physicians and others to train for cultural competence competency. So I think that's a that's a goal here is to have some training for health care providers to ensure that they understand differences. I'm, I know that that's a goal for some of the folks. Okay, I'm trying to figure out if we have already determined what the outcome is going to be. If we're provide if we've already talking about providing training before we've done that. That's the problem. I mean, I. Yeah, I think these are these are really important questions for us to ask. And because you're what you're saying we don't want to. That's really not good science that's biased discrimination. If we've already determined what the answers are, then why bother doing the study. If we're doing the study to find out the answers, why are we putting in a solution before we've defined the problem. Well, and I want to move us off the conversation. However, I remember a research project that I started years ago on discriminatory practices in the sciences. It was on gender based discrimination. And I started out thinking I know what I'm going to find right. And I went through a long period of data collection and qualitative and quantitative data collection and low and behold, wow was I surprised it was completely different from what I had anticipated so we would hope that that sort of disinterested objectivity might prevail with a group like this we don't know so we'll find out. All right. Senator Hardy last question. It's it's mostly just a comment that I don't think I think we already know that there are that that there are disparities that are at the result of racism and discrimination and homophobia, etc. And that is clear the data is absolutely clear and that's what the first 11 pages of the bill is this study is is more about how do we what in our structure of the provision of health care in Vermont and the oversight of health care in Vermont needs to change as because of the data that already shows that these disparities exist, and then creating an office that will help improve and do away with those disparities that can be distinctly an office about, you know, so helping to solve the problem. So, I don't see it as a study of trying to figure out, do these health care disparities exist, we already know they do. There's no question that they exist. And, and so it's it's moving beyond that question as a way of how do we change our structures to to Yes, you're absolutely right. I think what Senator Cummings comment was. If, if we know that there are disparities and people are walking into it with ready made solutions or they are they are automatically know what the solution should be then what I do it so our goal is to try and sort out that we're going to see that this group is going to evaluate what the issues are and maybe not come up with the Pat solution there might be something completely unexpected that's all. Huh. Okay, so very good comment. Good, good, good discussion, we're going to get back to this. I have another time, unless I hear differently from the committee will keep working on this bill as well. And we'll have to will it'll it'll also be something that appropriations will be working on because there is an appropriation with it. I have with us. Part two of options for regulating provider reimbursement and so Robin, thank you for being here committee are you interested in a one minute stretch. Yes. I think it would be helpful for come back a two minute stretch. So at 1110 with great apologies to Robin and Elena and Sarah that will just take a very quick two minutes. Thank you.


weapons coupled with the fighting skill of the American soldier stands ready on the alert all over the world to defend this country you the American people against aggression this is the big picture an official television report to the nation from the United States Army now to show you part of the big picture here is Sergeant Stewart Queen our need for military preparedness is said to be more urgent today than at any time in our country's history but military preparedness depends on manpower or a system of mobilization that can supply men for any or all services at times it seems as if new and powerful weapons are making the individual soldier less important our military experts say this is not so experience has taught them that an increase of weapons always increases a need for men men have become more important in modern warfare because not only is there a need for great numbers of them but more training is required to give them the knowledge and know-how to operate our complicated weapons through a selective service system we are trying to mobilize in peacetime for any eventuality since Korea selective service has delivered to the army approximately two million men as director of the selective service system Major General Lewis B. Hershey will tell you more about this manpower organization throughout history arguments between nations have resulted in war our own country has fought in a major war on the average of once every 22 years since wars basic need has always been manpower nations have had to mobilize their manpower in order to wage war the Congress has declared that an adequate arm strength must be achieved and maintained to ensure the security of this nation the Congress has further declared that in a free society the obligations and privileges of serving in the armed forces and in the reserve components thereof should be shared generally in accordance with the system of selection which is fair and just and which is consistent with our maintenance of an effective national economy the selective service system in accordance with law and benefited by the experience of manpower procurement through our history has established methods of operation it is with these methods that we wish to acquaint you how they work and what effect they have up on you these are young Americans selected as being qualified to fulfill a military obligation established by Congress this obligation is eight years in length and covers all physically fit young men in the nation normally a minimum of two years must be spent on active duty when this time must be spent depends on a man's age and his eligibility for deferment these are draftees the final product of our selective service system they've had two weeks training in the United States Army but even after that short period of time they're beginning to look act and in some cases feel like soldiers we've heard why they're here but how did they get here who selected them why were they selected and how do they feel about it man am I beating I think secretly they heard us test these shoes to find out how quickly they were up the way I feel it's gonna be me first you better tear up the worst is yet to come places driving me nuts walk walk walk I've lost two inches since I've been here the time I think of those greetings I get teed off mine came on an engraved card how about yours sure with a black border on it yet I wouldn't mind so much if there were a war going on or something but this business here we are and everybody in civilian life is taking it nice and easy well not everybody I'm most of them anyway there I was all set to get going for myself and then they put the finger on me now what two years and nothing well I'm in the same boat and I guess just about everybody is but I don't mind it too much I don't think time with the service ever hurt anybody except like a hole in the head by the way what are you recruiting for no I'm serious it all depends what a guy tries to get out of it and as far as coming in now what's the difference you still have to come in sooner or later you could get a deferment that's what I should have done yeah but you still have to come in sooner or later no matter what you do you mean I know guys who got them for school and for work and it's still got them as far as I know sure but you see a deferment is good for only one year and then you have to ask it all over again and if you haven't got a good reason they'll take it away from you you can get them renewed keep doing that pretty soon you're 26 you get it made ah you see a deferment is given only if the draft board thinks it's better to let a guy keep on with what he's doing and suppose you think about this once you get a deferment you're liable for the draft until you're 35 instead of 26 is that right yep well they told you that when you would enter register like that's when I found out up until then the only thing I did know was that you had to sign up within five days after you're 18 no matter what if you don't you're liable to get picked up for being a draft doctor knowing that I thought I'd be gone for I could say I yes or no but I soon found out that they can't draft you until you're 18 and a half that is unless you want to go sooner and volunteer top people in each community your neighbors are picked to be members of the board that classifies you they're familiar with the needs of their town or city and therefore no best when it comes to deciding what selections and deferments should be made this plus all the authority given local boards by selective service law makes it easy to consider each case individually about 85% of the people with selective service are not paid they feel you can't put a price on being patriotic and that's what it is because none of them have to do the job if they don't want to selecting people some of whom may be friends neighbors and even relatives especially in time of war is tough it's an honor to since members are appointed by the president on recommendations from the governors even foreigners have to register for the draft some may not choose to serve a choice given them through our treaties with their native countries but if they don't they can't become united states citizens yes that's right generally after aliens have resided in nine states for six months they're required to register under the selective service act now if you'll sign please here there that about does it now several days will send you this registration certificate now you must carry this with you at all times most of boys put it in their wallet when you receive it you will notice there'll be a number on the back of this card and every time that you communicate with this board will appreciate your including this number as it is one of the quickest ways for us to locate you in our files now I mentioned this because regardless of where you move you're always going to be remain a register of this local board mean if I move to another state I have to come all the way back home now that will be necessary you can go to nearest local board and they'll work with us on it then we will send you very soon a classification questionnaire you'll fill that out and send it to us in 10 days now on the basis of the information in this questionnaire the local board will classify you now if you desire to submit anything else that you think that would help the local board in properly classifying you you may do so now every time you move you must notify us of your change of address and any time that you have any questions what or any problems you think we can help you with you come in and see us now if you're classified in class 1a the local board will notify you where and when to appear for your pre-induction physical examination if you're found qualified or a local board will notify you then you'll be placed on a list in this local board according to your age with the other available man in this local board the age merely establishes your priority in relation to the other available man in this local board the top man is the first one to go when we receive our next call okay but what are some of the other classes well now I have a list of them here maybe you'd like to see it now here we have class 1a those are the registrants who are available for service then we have the class 1a o those are the registrants who are morally opposed to serving in the armed forces in a combat combatant capacity but are willing to serve as long as they don't have to fight conscientious objectors you know then we have class 1c those are registrants who are members of the armed forces public health coast and geodetic survey and certain registrants who have had previous service then we have class 1d those are registrants who are members of reserve and rotc units now we have class 1o that covers the registrants who on religious grounds object to serving in the armed forces in any capacity however they are available for assignment in certain civilian occupation now we have class 1s those are the students who are deferred by law I want to ask about that I was planning on starting college well if your number comes up in this local board for induction in your full-time college students the local board under the provisions of the law will defer you until the end of the academic year now mr. Yates our chairman will be in soon and maybe you'd like to discuss that further with him because we have class 2s which covers students who desire to complete their college education class 1s also covers high school students under the provisions of the law high school students are deferred until they graduate until they reach 20 years of age or until they drop out of school whichever is the soonest now we have class 1w those are the conscientious of what objectors who are now serving in the certainness approved civilian positions now here we have class 2 that covers the registrants who are deferred because of their essentiality in certain positions including agriculture and study now we have class 3 that is for the registrants who are deferred because their entry into the armed forces would create an extreme hardship on their dependent now class 4 covers certain registrants who have had previous service the sole surviving son of a family whose son son or sons have been killed in the service certain elected officials divinity students and ministers now class 4f covers those registrants who are found physically mentally or morally unfit for service now all registrants after they passed the age of liability are classified in class 5a now I have a list of those here maybe you'd like to take it along with you and read it thank you well this makes it pretty easy to figure out how everybody should be classified but say somebody thinks he should be in another classification than the one the board puts them in is there any way he can have the classification changed selective service provides for cases of this sort through the right of appeal for all classifications except for it when you receive your notice of classification you have 10 days in which to make an appeal this appeal may be in the form of a request for a personal appearance before the local board or if they refuse to change their classification a written appeal through the local board to your state appeal board if the state board votes unanimously against the appeal the classification stands but if one or more votes are cast in your favor the appeal may be taken to the presidential appeal board in Washington DC their classification based on the file submitted is final you even have someone to help you with your appeal he's the government appeal agent unpaid and appointed the same way local board members are usually a lawyer it's his job to look out for the rights of the registrant and those of the government there's a lot more to selective service than pulling names out of a bowl as we see here about 40,000 members work tirelessly to support our armed forces protecting both the welfare of the country and the rights of the individual these people are spread throughout a vast system of 56 headquarters located in states territories and possessions plus one each for New York City and Washington DC everywhere from large cities to small towns in rural areas and of course the national headquarters in Washington selective service provides for the future as well as the present as we see in the policy of deferment for certain students in order to maintain educational levels now what would you like to know well I'm planning on starting college but it looks as if the draft is going to throw a monkey wrench into the works do you just registered with us yes sir that means you won't be called for a while you could start college yeah I know but I hate to get pulled out halfway through but you wouldn't have to be I hear something I'd like to have you think over you take this with you so he went on to tell me about deferments and how to go about making applications did he make any suggestions no we just said that if I was going to school when I was called I could get deferred until the end of the year that is provided I was going full-time and was passing everything well what about after the years up with then well then I could apply for another type student deferment by taking a qualification test if I could pass the test or keep in good standing in my class I could probably stay on right until graduation or so another way to do it would be to join an ROTC unit and after I finished that during school I'd go on active service for two years no matter what I do I still have that two years active service well then it's not a question of whether or not you go into service but when and how you do it right and I can enlist right up until the time I received my induction notice that is if I want to how do you feel about the whole thing I don't know that's a tough thing to decide but but I think I just as soon go in now and get it over with what do you know how long you'd have to wait before your number comes up didn't they tell you that no I asked the same question but they said they could only guess you see they don't know themselves until about two months ahead of time just how many men they have to send so I might have to wait quite a while but you can volunteer to go sooner though you can sure then they can give you a good idea of when you might go you see by volunteering you go right to the top of the list that might be the best thing to do I'm beginning to think so I just want to get started on something and not waste time and as far as the army goes I might get a job that would teach me something I could use in civilian life seems like there might be a good chance of that with all these modern things they have in the army today sure now some of the guys who would in a while ago wrote and said they're doing just about everything under the sun I always thought there wasn't much to do in the army except march around and carry a gun but like you said but with all these modern things atomic weapons and guided missiles need a lot more training and it doesn't make any difference in which branch of the service you're put because there are hundreds of difference of jobs in each branch I over 600 in the army alone and if you asked me now what I wanted to major in in school I couldn't tell you it might be that the army will get me interested in one particular thing so then I could go to a special school for that when I got out instead of going just anywhere I'm glad to see you feel that way I saw so many people when I was in the service who figured they'd gotten a raw deal and they just didn't make any effort to help themselves or the service oh I don't think it's a raw deal if it isn't a lot of guys have gotten one so as I'm concerned there's a good reason for it that's right when there's a war going on everyone realizes why they're going in it's just a little bit harder to understand now but that still doesn't mean there isn't a good reason for it maybe you won't use any or all of the experience you get in service but you're certainly not wasting your time as long as you're learning I know I learned a lot when I was in the service a lot about getting along with all kinds of different people and situations a lot to help me grow up and it's ready what's the big discussion talking about the draft I think it's a shame the way these boys are having their lives interrupted you don't want to be a soldier do you know making soldiers out of all these babies don't worry you know how mothers are about losing their sons come on let's get some home cooking you'll be missing it soon enough like students certain people in particular jobs are deferred this is done in order to balance the requirements of civilian life with those of the service since physically fit young men have to serve sooner or later the deferments merely adjust each man's induction date so it'll be at a time the draft board thinks is best people who need time to finish essential jobs and those who can't be replaced right away are the kinds of people that are deferred in some skills it's been recognized that we have shortages the president has designated a number of these skills as being short and in need of apprentice trainee programs to select and train unskilled workers here again members of certified training programs may be deferred farmers are also considered when weighing civilian and military needs no army or any service for that matter could do without food therefore some farmers are deferred to keep the farms producing what all these deferments boil down to is that during a man's period of liability he'll be used when and where he can do the country the most good notice in hand I reported from my pre-induction physical there was a good size group there the first thing they did was to tell what we'd have to do during the day we discovered what they mean when they say in the army it's hurry up and wait seem like most of the day was spent in lines waiting for something to happen but actually by the time the day was over we'd accomplished a lot to begin with we took our mental test it was one of those multiple choice deals pretty interesting test current events and practical application of things I'd learned in school I wanted to myself what would happen if I failed it I know the army doesn't want morons but when it came right down to what I try just as hard as I could and it seemed as though everybody else was doing the same thing after everybody finished the papers were passed in corrected and the marks read off I got a fairly high mark would surprise and please me once we finished that we lined up for our physical examination they certainly gave us a thorough physical they carefully checked everything I could think of and more eyes ears heart lungs by the time I got to the end of the line I felt as though I was in pretty good shape and so did they for they said that as far as the army was concerned I was physically fit you know right now the army is the only one that is taking draftees but all the services can and did during World War two when lunch was over we went back to finish up the processing which consisted of filling out some papers loyalty certificates and so forth about mid-afternoon we were through and they let us go outside a bunch of us got together and decided we would like to volunteer to go right away so off we went to the draft board and down at the draft board they had us all signed volunteer statements and told us that they would let us know as soon as possible when we were to go sure enough I got the notice in a couple of weeks since I was waiting for it and was all set to go I was happy when it came but mom and Anne and my girl were upset they make you feel like you're going away and never coming back they mean well but they just don't understand sometimes it's true I didn't understand all I could think about was that it was unfair to me I complained and I was sullen but thank heavens bill is a clear thinking wonderful guy and he finally got it through my foolish head that thanks to selective service he was going to benefit the country was going to benefit and so was our future bills and mine even had a party thrown for me all the gang was there and we had a great time although I couldn't help feeling a little sad because I realized that I was leaving something that I could never quite come back to again a lot like moving away from your old neighborhood and leaving all your friends behind oh I've been to parties of the same kind for pals of mine who left before it sure makes a difference when you're the guy that's going I guess it's times like that when you realize you're growing up and it hurts a bit well time was short after that what was saying goodbye to friends and relatives and getting things in shape to leave I said goodbye to the folks at the house the morning I left and went down to where we were supposed to meet by myself I hate goodbyes and I didn't like the idea of doing it in front of everybody as it was most of the fellas did the same thing some of the members of the local board were there to see us off I thought to myself they must have seen a lot of fellas leave here month after month some that didn't come back theirs is not the easiest job in the world by a long shot it was only a short ride to the induction center where we had a quick physical inspection and then we were sworn into the army I'll have to admit I got a funny feeling when we stepped forward for the swearing in I guess I just felt this was it I was finally in the army there was an army sergeant there a nice pleasant looking fella not much older than myself but there was no fooling around when he hustled us on to the bus it wasn't far to the army camp and I realized as we entered the gate that selective service had done its job and delivered us signed and sealed so here I am after two weeks training I still feel pretty much like a civilian but I'm beginning to feel a lot like a soldier too that's to be expected feeling like a soldier not only feeling like one but looking like one acting like one for the army has a great and dedicated interest in every one of its men it gives them the best that American resources can offer in clothes he's the representative of good taste of appearance in food it may be k rations in time of battle emergency but the soldier at all times is sumptuously catered to by dietitian cook and the quartermaster general in health the surgeon general's vast staff of specialists keep him fit then comes the training putting an iron grip into manpower and military preparedness in today's army so great is the need for excellence that to be adequate is not enough a man must be good the soldier's mind must be alert he must reason he must figure he must be an individual not just a mechanical cog taking orders and that calls for mental as well as physical development maybe all the things that the American soldier expects out of the army don't materialize but this much he can depend on he can depend on becoming a vital part of his country's strength he works he learns and he plays and what does he take back with him into civilian life and the awareness of responsibility toward home family and country an opportunity to establish a firm foundation for building toward a secure future through the fair and orderly process of selective service the soldier helps give meaning to the terms manpower and military preparedness we have seen the selective service system in operation and we feel you have gained a clearer understanding of its purpose and methods this is sergeant stewart queen inviting you to be with us again next week for another look at your United States Army in action on the big picture the big picture is a weekly television report to the nation on the activities of the army at home and overseas produced by the signal core pictorial center presented by the US Army in cooperation with this station you can be an important part of the big picture you can proudly serve with the best equipped the best trained the best fighting team in the world today the United States Army


Oshun State Police Command has debunked the insinuation that it is giving preferential treatment to the owner of a hotel in Ife, Raman Adedoyi, who was arrested over the death of a postgraduate student of the Obafemi Awawe University Ileife, Timothy Adegoke. The State Police Command also confirmed to journalists that the audio message that went viral with Raman Adedoyi's voice was not done in the command cell as alleged. 2. A clever statement on what prompted the police, public relation officer Oshun, who is here in Iseapalana, to esteal the 10 members of the public that there was nothing to show any form of litigation in the body of the deceased, one exiled from the shadow grift. This is contrary to what witnesses who were at the site of the insinuation claim. 3. The police need to clear the hearing on the perpetrated prevention and VIP treatment being accorded to the owner of the hotel, Mr. Raman Adedoyi. The detention of suspects is a normal process in the police investigation. 4. The autopsy was done yesterday and I can lightly tell you that cis pathologists were present at the hospital where the autopsy was carried out, including the pathology from the victim, from the deceased family. We were told that within one week or two weeks, we should be expecting the result of the autopsy. Hello, hope you enjoyed the news. Please do subscribe to our YouTube channel and don't forget to hit the notification button so you get notified about fresh news updates.


Hey everyone, this is Gabrielle with Oxma. I agree we're here at Oxma Toyota today. I have Chuck Schumann here with us I guess now today. We're actually gonna do a comparison on a 2017 Sienna versus a 2017 Kia Sedona, so Chuck's gonna just touch bases on a few different different. I guess pieces of information So check why don't you go ahead and start us off? Absolutely, and of course Gabby I'm biased in Toyota Chuck, but I think just stylized the Sienna's a better look than what the Kia is, right? It's I mean, that's all you know based on your personal preferences, but that's how I feel But then the things that you can measure are things like the engine like our The Sienna has a new transmission new engine 2017 actually gets more horsepower than the Sedona does It also gets better fuel efficiency as well So they've really improved all of that and so you get better performance out of the Sienna And you know with Toyota's the reliability is there that last for forever, right? The other cool thing the Toyota Sienna comes with all-wheel drive where that's not even an option You know in any other minivan. We're the only one that has that and so that's really cool feature Especially around here in the wintertime, you know with the snow and all of that But then also the reason you get a minivan is for space you haul a lot of people you want to be comfortable You take this on road trips the Puzzle the passenger the drivers position all have more headroom or legroom It's just bigger better space and then I think our console and everything's laid out a bit a little bit more Just intelligently it's very you know user-friendly It is and then big space back here as well in the passenger side and then the cargo because you're gonna be hauling a lot of stuff Bigger cargo space back here by about six cubic feet. Okay compared to the Sedona. So you see that real deep well Good, you know space back there as compared to the space here in the Sedona. So Right Better space bigger engine better fuel efficiency Available all-wheel drive really cool features and then the reason that you get a Toyota They hold their value really well resell value of the Sienna much higher than the Sedona Residual on that's just much higher. So if you're looking for a long-term investment short-term investment can't go wrong


Hi, welcome back. This is week five of our course on philosophy, on Marxist philosophy, I should say. And this week we'll be discussing the law of the transformation of quantity into quality, which is extremely important for Marxist philosophy. Now we've discussed up to now that everything changes and that Marxist philosophy is all about understanding the fact that everything changes. However that by itself doesn't really tell us very much. It's necessary to understand how and why things change. And actually it's a bit one-sided just to assert that everything changes because in fact that's not really true. And after all, dialectics is all about understanding opposites and the necessity of opposites. And therefore just clinging to one side of opposites such as change is always going to end up being one-sided and ultimately false. And this problem was understood by a pupil of Heraclitus. Now Heraclitus is an ancient Greek philosopher and he is really the father of dialectics and he built his whole philosophy around the idea of change, that everything changes and that is the essence of all things. In fact he's so important that Hegel actually said and I quote, there is no proposition of Heraclitus which I have not adopted in my logic. Now Heraclitus famously stated that you can never step into the same stream twice, meaning that the stream will always have changed the next time you come to step into it and thus it isn't really the same stream. According to Aristotle one of his pupils took this further and kind of absurdly said what actually can never even step into a stream once because in fact it's already changed. There is no such thing as a stream or anything for that matter because everything that you can think of has always already changed, become something completely different. Now this seems like an obviously absurd thing to say and why would he say this and what's the meaning of it and how do we answer it? Well the truth is that this reveals the fact that just asserting that things change is actually a bit more on the side because actually things don't just change, they do also stay the same. Everything stays the same because if they didn't stay the same of course as this example shows it would be everything would have already fallen apart. For anything to exist it means it must sustain certain qualities, right? It must sustain a quality of being, for example in the case of a stream coming from a certain source, flowing to a certain mouth and obviously having water. And for anything to exist they must sustain certain qualities such as that over a period of time. And therefore things can actually say that everything stays the same. For anything to exist it must stay the same, must have a certain conservatism to it if you like. And yet we also know of course that everything does change, that is absolutely fundamental. So we need a bridge essentially, a category of dialectical logic which serves as a bridge between status and change and explains how the one becomes the other rather than for us just to be stuck in the assertion of one and not the other. And this problem of how we explain something going from being one thing to then suddenly being a different thing is a very important one for philosophy and it is expressed in a couple of famous examples such as the heap of grain and the bald man in which for example the bald man you are in this hypothetical scenario you are plucking hairs off someone's head who obviously is not bald but eventually if you keep on doing that they will obviously become bald. Now how do we just determine at what point they've become bald and why is that the case? And the same for a heap of grain, if you start out with just one grain then obviously that's not a heap. If you add another one it's still not a heap but at a certain point it becomes what you would call a heap. And why is that and how does that change take place? This is a deep philosophical problem which has bamboozled philosophers for literally thousands of years. And I think that the law of the transformation of quantity and quality is really the answer to this problem and it provides this bridge between stasis and change and is therefore extremely useful and important. I would go too fast to say that all change ultimately takes place in some way through this law. You cannot understand change ultimately without understanding this law. And it's such a widespread phenomena, in fact like I said it applies everywhere, that it is expressed in several famous idioms such as the straw that broke the camel's back or something being more than the sum of its parts. The basis for this is the fact that all things are organised. Any phenomena be it a state of affairs or a particular object, they are composed of parts which are self-organised, which stand in definite relations to one another. So the parts of something are not indifferent to one another, right? They're not just sort of like blocks of wood in a bag jumbling about, but they have definite relations towards one another. Now take the classic example of a body of water and alternatively ice. Now these are made up of the exact same parts clearly and yet they're totally different. In fact ice really has in many respects far more in common than it does with other solids, such as I don't know a rock, than it does with itself when it is in liquid form. Solid ice and liquid water completely different in terms of the way they behave and yet they're made of the exact same stuff. So this shows that the character of the inner relations of something is absolutely essential to understanding the overall quality that it has, the way in which it behaves and hence the phrase more than the sum of its parts. So organisation is absolutely vital to understanding any given phenomena. This is also understood and well expressed by a famous quote from Napoleon discussing his army. And he says the following. Two Mamaluks were undoubtedly more than a match for three Frenchmen. 100 Mamaluks were equal to 100 Frenchmen. 300 Frenchmen could generally beat 300 Mamaluks and 1,000 Frenchmen invariably defeated 1,500 Mamaluks. And essentially what he's saying is that even if the individual parts of one army, otherwise the soldiers, are more skillful than another, if the other one is better organised, then once you have enough of them, in other words, it's not just one V1, but once you have hundreds or thousands, then that organisation will ultimately count and it will be what causes victory. So yes, organisation is absolutely fundamental to understanding and the self-relation of the parts of something, if you like, is absolutely fundamental. And I'd like to point out how this differs from two mistakes, if you like, of thought, which you find particularly in science, but also in philosophy. One would be gradualism, which is basically the sort of assumption. It's usually an assumption that you're not usually actually stated. But the assumption that all change takes place is constantly in a linear way, in other words, just a sort of step by step drip, drip, drip of change, rather than going through leaps and then periods of stasis. That's one idea and that often crops up in science or in people who study society. And I'll give an example of that in a moment. One example of science is Darwin, who of course was a genius, but his original idea of evolution was that it was just constant change rather than animals being settled on species for a long period of time before much more rapid periods of evolution. But another related mistake that is very common, I think, in science, especially in the bourgeois mindset of science that you have, is reductionism. Reductionism essentially treats the parts of something as indifferent to one another. It reduces things down just to their parts. Now, again, it's not usually explicitly stated that that's what they're saying, but it is implied in how they understand things. And the problem with this is really expressed with Heraclitus' people's point, which is that if all things change constantly, then how do you explain the different definite qualities that things have and if all things are just made up of their parts that aren't in definite relations to one another, that form definite qualities, then how do you explain the phenomena of these qualities in society, in nature? So with reductionism, a famous example with reductionism is biological determinism, which is still quite common, I think. And what it basically attempts to do is to explain human nature, to reduce human behaviour to just the genes that make us up. So it appears on the surface to be very scientific, very materialist, because it's saying that we're caused by our genes. And you'll sometimes hear this. You'll see maybe you'll see like an article in the news or in a newspaper that says, oh, scientists think they've discovered the gene for theft, you know. And once we've found that maybe then we can sort that problem out by eliminating that gene or something. Now, this is absurd and completely unscientific, in fact, precisely because it reduces us to our parts without understanding the relations in which they stand. Genes, of course, do not code for specific behaviours generally. Like you don't have one gene for a very specific behaviour that just sort of stands in isolation from all other genes. In reality, genes obviously code not for behaviour, but for how to build our body. And then our behaviour is an expression once a whole body is built of the mutual interaction of all of the parts of our body and not only that, but ultimately the interaction of our bodies as a whole with society and the general environment in which we live. And that's the only way to explain behaviour. It's not, of course, the fundamental basis for this is our genes. Without that, we wouldn't even exist. But nevertheless, you can reduce these things and understand them by doing that. This mistake is unfortunately extremely common. Marxists are sometimes accused of being it through our economic determinism as people see it, but I don't have time to go into that. But that is a caricature of Marxism. In fact, dialectical philosophy, dialectical materialism really explains why reductionism is false and what the real alternative to it is. This also helps us to understand that the problem once again of the heap of grain, the idea that things are internally related. Well, if that's the case, then the reason a heap emerges as a quality of so many grains is because they stand in relations to one another. And when there is enough of them, those relations produce that overall quality. Similarly with liquidity or wetness, you know, a body of water or any other liquid is you would call it wet. But you can't find that quality in any one of its molecules, even though it is made up of nothing but those molecules. So that does that mean it sort of somehow comes from outside of the body of water, some sort of spiritual force, which of course some philosophers in the past would have argued. No, it is thoroughly based on those parts, but on in the relations of those parts. So anyway, we have to come back to this idea of quantity and quality because I haven't fully finished describing that. This, as I said, explains how change takes place. Now it is true that change is happening all the time. However, most of the change that takes place is not sufficient to alter the overall qualities, which, as I said, are a product of the relations of the parts. Again, to go back to our example of a body of water. It works because it's very simple and we understand water quite well. So the quality of, let's say, liquidity of liquid water is more or less identical between the temperatures of 0.1 degrees Celsius and 99.9 degrees Celsius. Of course, the water will feel more hot or cold, but ultimately it is a liquid and it behaves as a liquid within that spectrum. So no matter how much you add or subtract temperature, it remains qualitatively fundamentally the same. But at certain points, in other words, at 0 and at 100 degrees Celsius, the quantity of heat energy is sufficient or insufficient to hold it in that set of relations, if you like. And that specific set of relations is burst asunder. New relations are now created and that gives rise to a very different quality overall. And that's what we call quantity transforming into quality. There's sufficient of a quality to change the overall quality. And until that point is reached, the quality stays more or less the same. And this, I would say, as I said, it is across nature, this law holds and society. And I'll come on to that in a moment. But the last thing I want to say about this is that this also helps us to grasp that change can be very sudden, that qualitative changes can appear as if they come out of nowhere. To give an example of a strike or a revolution, it can be understood by most people that everything is normal, everything is staying the same, nothing is, there's not going to be a revolution or anything weird like that. And then suddenly a strike or a revolution can take place quite often as a result of a fairly incidental thing. To give a relatively recent example, the Tunisian revolution was sparked by a man setting himself on fire in protest at basically being unable to sell fruits and being punished by the police for doing so. But people were doing that all the time in Tunisia and many other similar countries for a long time. Why exactly at that point that enraged people so much that they created a revolution? Of course, we can't know the details. But what we can know is that that obviously was not just a completely random or bizarre thing that happened, but it somehow, in the eyes of Tunisians, it expressed the enormous discontent and the injustice of society and it was enough for them to feel that they had to do something. And then, of course, that takes on the logic of its own and it changes history. And this brings me on to the political value of this kind of discussion. We don't have these discussions just because they're interesting or because it allows us to understand certain scientific questions, but also because it makes us better revolutionaries. We have to have the long view of history. Marxists are not fighting for this or that reform or just to make this or that country a bit better for a while. We are fighting to change human history, to really liberate humanity from capitalism and from class society in general. So that's a rather large undertaking clearly. And if we allow ourselves prejudices, if we allow ourselves to be distracted or to be seduced by apparent shortcuts to victory that in reality are actually going to be disastrous, if we do that then we will fail ultimately and revolutions have failed many, many times of course. So we need to understand in a very clear and sober headed way the real processes at work and have the long view of histories so that we don't get demoralised by this or that setback or overrode by some temporary change. And the law of quantity and quality helps with that. Before 2008, if you were a Marxist, you would often be considered quite bizarre and your ideas were completely discredited. And you can understand why people thought that. And everything seemed in capitalist society to be very predictable and basically all the problems had been solved more or less. And yet if you looked underneath the surface, in other words if you didn't just look at the overall quality that was on the surface, but you looked at the inner relations of society by for example studying the rate of inequality which was increasing for year after year after year or the level of indebtedness for example. Personal, private and corporate and also state deficits. If you looked at those things you would begin to see a different picture. You would begin to see that in other words, contradictions, inner contradictions were developing and quantitative tensions you could say were developing. Of course this all exploded in the 2008 financial crisis which people did not foresee but that event was if you like a qualitative rupture which really has changed human history, has changed consciousness and has made Marxism much more obviously relevant to people although it was always relevant but it has made it far easier to explain. And so that's why it's important for this to understand this law and other dialectical laws but I would particularly emphasise this law for grasping the process of change in society and for not getting demoralised because at the moment perhaps not very much seems to be happening. Anyway that concludes our discussion on quantity and quality. Next week we will be discussing another going into more detail in another law of dialectical change which is contradiction and the unity of opposites which is equally essential to understanding how and why things change. So I'll see you then. Lenin stated that without revolutionary theory there can be no revolutionary movement. Without a revolutionary theory we are bound to take in the ideas that surround us. Under capitalism these are ideas that ultimately defend the status quo. In Wellread's upcoming book on the history of philosophy Alan Woods looks at the development of philosophical thinking from the ancient Greeks all the way through to Marx and Engels who brought together the best of previous thinking to produce the Marxist philosophical outlook which looks at the real material world not as a static immovable reality but one that is constantly changing and moving according to laws that can be discovered. Through this we can learn how philosophy becomes an indispensable tool in the struggle for the revolutionary transformation of society. Pre-order your copy now at www.marxist.com.hop