As a mental health care professional that works predominately with teenagers, particularly those within the foster care system and within LGBTQIA+ population I can attest to the disservice of this bill. According to National Prevention of Youth Suicide, suicide is 3-5x more likely in youth in the foster system and up to 7x more likely for LGBTQIA+ youth than their cisgender peers. Often times DSS can take several months to return paperwork in order to enroll or continue in mental health services due to lowered labor in this field. And many adolescents have a difficult time talking to parents about their thoughts of suicide or self- harm. What we also know is that completed suicide can be contagious, especially among our teenage populations. Once a peer completes suicide, it can feel more accessible to others, creating a destructive chain effect in our communities. Therapists often times stand between the threat of suicide or self-harm of our teenage clients and finding relief, helping teens process through their difficult feelings and finding ways to speak to the adults in their lives about these concerns. To take away the anonymity of mental health services within our teen population is putting them at greater risk of the suicide epidemic.

I support this act.

I support this study. Please vote Yes!

We support actively dismantling the root causes of health disparities including systemic poverty and structural racism. Economic and racial disparities have life-threatening consequences for families. Meaningful actions must combat the cultural, operational and structural barriers that have created inequities that persist today in maternal and infant health. Black women are three times more likely to die from childbirth complications than White women and face a 70% higher risk of severe maternal morbidity than any other racial groups. According to Virginia’s Maternal Mortality Review Team, the majority (51%) of pregnancy-related deaths in Virginia result from provider-related factors—not underlying health conditions. Being in poverty can significantly reduce access to preventive health care and maternal care. Impoverished Americans are also more likely to have comorbidities due to their likelihood of living in a food or hospital desert. Health disparities span education levels, socioeconomic status, age and geography—pointing to underlying inequities and bias within the health care system that must be addressed systemically and across the life span—not just during pregnancy.

The academic medical community and various medical organizations has been addressing this over the last several years. Research on this is ongoing on what is fact vs. perceptions. I would suggest placing a expiration of five years on this legislation then revisit.

As a senior in high school, mental health is extremely important to me. Last year, my family started looking for a therapist for me. It was tough. We couldn’t find someone who could see me after school, or someone who could treat teens, or someone who was close enough in our insurance network. The longer it took to find a therapist, the worse my mental health got. It’s lowest point was August of 2022 when my grandfather died. The next day, school started. All my assignments piled up, work wouldn’t let me take time off, studying for my SAT became too much for me; I completely broke down. Even then, my family still couldn’t find a suitable therapist in our network until late November, almost three months later. Had this bill been law, I would’ve gotten the help I deserved before everything became too much for me. I am lucky to have a dedicated mother who worked tirelessly to find help for me, but not everyone has someone like her in their life. Not everyone will be able to find help. I am not exaggerating when I say that this bill will save lives. If you really care about your constituents, vote in support of HB1879.

My name is Ranger Balleisen, I'm 17, and I support the expansion of mental health resources. As someone who is intimately familiar with the mental health system, I am in full support of HB1879.

I think this law will be extremely useful to many people, as with this bill becoming law, there will be no excuses left for insurance companies making an individual travel 25 miles for a weekly therapy session, for instance. I do not have this specific experience, since our family has Kaiser and live in Fairfax County, however, travelling a long time for fairly regular essential help can be very painful. I hope this bill will help subscribers of smaller insurance and make mental healthcare a lot more affordable for people who may need it but see it as an inessential expense.

Simply put, this bill will save a lot of lives. I spent a year searching for an in network trauma centered therapist without a waiting list. In this time, my health deteriorated. I attempted suicide twice. I had no support network. But if I had been able to go out of network, this may have never happened. Other people are not as lucky as me as to survive once they have attempted. If this bill saves even one life, that's enough for it to be worth it.

It’s incredibly important to me that healthcare is accessible for everyone, including those facing mental health issues. It is already extremely difficult to find youth mental health providers as well as providers who are able to truly cater to who their patients are. As a young person, I have heard countless friends tell me they don’t believe there is a future for them or that they’ll make it past 18 because they cannot access proper healthcare for their mental health. If you care about the youth, please support them by allowing them to access necessary care.

I support bill HB1879. Mental health is so important and we really need to make sure people have access to the help they need.

I fully support this!

HB 2276 Immunization; immunization of children against COVID-19 Informed consent is the basis of medical ethics. Parents should make decisions regarding the health and wellbeing of their children. COVID-19 vaccines do not prevent viral transmission so there is no justification for requiring these vaccines as a requirement for school attendance. This bill specifies that parents shall not be required to immunize their children against COVID-19 in the same manner current Virginia law allows them to determine whether to give them the Haemophilus Influenzae Type b vaccine. In 2020, when the legislature considered and passed HB 1090, which dealt with the manner in which future childhood vaccines would be considered, legislators and their experts confirmed the legislature’s support for keeping parents in charge of their child’s vaccination schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to mandating the shot. Medical professionals around the world are in agreement that there is no scientific rationale for continuing any COVID-19 mandates in 2023 and beyond. HB 2280 Parental consent to surgical and medical treatment of certain minors This bill requires parents and guardians to consent to medical interventions concerning their children, including vaccination. It is important to amend current law to make it clear that parents are in control and make medical decisions for their children. Several cities have attempted to pass orders and laws that allow children as young as 11 years of age to consent to vaccination without parental knowledge! Please do not let this happen in Virginia. Please support this bill to send a clear message that in Virginia, parents are in control and they decide what medical interventions their children receive.

The City of Portsmouth supports this bill. It would provide consistent regulations across the Commonwealth. However, it our understanding that the Health Department already inspects the pools for compliance.

Working in the pool industry in both retail and distribution, also having used public pools, I feel HB1917 should be a definite yes.

As a long time industry professional I am writing in support of this bill. My company, AAA Pool Services, manages and operates almost 50 seasonal pools across all localities in the Tidewater area. We have to deal with multiple sets of codes and standards, and then pools in Suffolk have no codes or standards other than VHD code, which does not apply to these pools. I encourage a YES vote on HB1917 to begin to standardize public pool requirements for both ease of business and swimmer safety. James Durkee Vice President AAA Pool Services

I live in Alexandria and am concerned about the health and safety of our public swimming pools. I've heard that showering before entering a pool means germs are less likely to be in the water. My friends and family don't want to get sick when we're at the pool! And keeping the pool environment and equipment up to date is important. An inspection of a facility would make sure we're safe from harm due to lack of maintenance, or issues with handrails, electrical elements, fencing, diving boards or signs, for example. Please help us enjoy our pools.

Comments Document

Attached is a letter of support for the HB1917 Bill. As a pool builder, service provider and retail company in VA for 45 years we feel it is important for all commercial properties to meet minimum requirements for water quality and proper pool operation.

As a citizen of Virginia in excess of nearly 20 years, husband, a father of 4, grandfather of 11, thus far, and a swimming pool professional for these past 50 years I wish to express my full support of VA HB 1917. My aquatics career began in neighboring Maryland, at my local community pool. There I learned how to swim from certified Water Safety Instructors, was provided supervision during the summer months, after passing the pool test, by the licensed guard staff. It was my haven, my safe place to go. I later learned how regulated it was by the Health Department. In 73, I became a part of that staff and by the end of the summer was a lifeguard myself. Over the next four years I became a Water Safety Instructor, Swim Coach, Licensed Pool Operator, SCUBA Diver and eventually received 2 degrees in Recreation. My career spans Public Pool Management, Service, Renovation, Construction and now Design. At one point I held a management position for the largest Commercial Pool Builder in the mid-Atlantic, traveling 6 states and D.C.. It was there that I discovered the great disparity in state and local regulations on Swimming Pool, Spa, Waterpark and Splashground health and safety. Part of my job description was to determine what regulations and codes were in place that we needed to conform to in providing for our clients. Sadly to say, VA had and still does have the least health and safety regulations within this region and perhaps the country. What the Health Department does have, with reference to current regulations, is extremely outdated, circa 1962 and has very poor enforcement. Fortunately, the VA Building Dept, since 2014, now uses the ICC code, which replaced a mostly non existent design and construction code for swimming pools. This likely as part of the result of deaths and near drownings from poor design, construction, renovation and service practices that led to Federal Standards such as the VGB ACT of 2008. While working or vacationing in Virginia back then, I would be appalled at the unhealthy and unsafe conditions I would find at commercial aquatic venues in those jurisdictions without Health Department oversight. Certainly, a RED FLAG, was raised whenever my children wanted to swim in a manmade vessel. Today, I assist Design Professionals, with the mechanical, Building and Health Code compliance and amenity needs of existing and new aquatic facilities, in VA. Frequently, I am asked about conformance to Health Department regulations and find Developers, General Contractors, Designers and Consultants all shocked and in disbelief that most of VA does not have Health Department regulations like other states and jurisdictions. What regulations the Health Department does have are restricted to "Tourist Establishments". Unfortunately, for VA citizens including my grandchildren, VA has until this opportunity, found it more important to protect "tourists" than the citizens of the Commonwealth. Like vehicle safety, aquatic safety must be regulated for the good of the public. Profits would otherwise circumvent the need for seat belts and air bags, or proper filtration and sanitation. Can you imagine what might be served and what cleanliness conditions might be present, if restaurants were not regulated and inspected regularly by a qualified Health Department with adequate regulations. Public health and safety would be compromised. So is currently true in most of Virginia with their swimming pools.

Re: Consideration of House Bill 1917 – Public Pools; Board of Health to Adopt Regulations. We are writing to let you know that we, as the Central Virginia of PHTA, support the bill directing the Virginia Department of Health to promulgate regulations governing swimming pools and spas for public use. Our chapter covers most of the state of Virginia, from Virginia Beach to Jonesville, in the west, and north to Charlottesville. Our members have spent years upholding the standards on safety, operations, and maintenance of pools and spas. We believe strongly that HB 1917 will considerably increase the safety and welfare of public pools in Virginia and protect Virginia residents who use them. The Virginia Department of Health currently only has authority to enforce regulations for pools and spas at campgrounds, summer camps, and hotels. Additionally, only 20 local jurisdictions in Virginia have a code that regulates the operations, maintenance, and safety of public pools. Our members have an incredible relationship with the Virginia Department of Health, working with them on regulating the pools and spas they can enforce. As a chapter, we stand behind PHTA National Offices, in providing recommendations related to regulations to be adopted. We want to ensure that the residents of Virginia have safe public pools and spas to enjoy. On behalf of our many members, we respectfully request that you consider moving this important legislation out of your committee. Sincerely, Vicki Hudson Chapter President Centralva.apsp@gmail.com

Comments Document

Dear Chairman Walker: This bill, directing the Virginia Department of Health to promulgate regulations governing swimming pools and spas for public use is supported by the Pool & Hot Tub Alliance (PHTA). PHTA’s headquarters are established in Virginia and many of its employees are Virginians. Currently, the Virginia Department of Health only has authority to govern and promulgate regulations for pools and spas at campgrounds, summer camps, and hotels. Additionally, only 20 local jurisdictions in Virginia have a code that regulates the operations, maintenance, and safety of public pools. HB 1917 will begin the process to drastically increase the safety and welfare of public pools in Virginia and further protect Virginia residents. PHTA, its Virginia members, and other industry stakeholders have a tremendous relationship with the Virginia Department of Health and provide recommendations related to regulations required to be adopted. Additionally, this relationship has created an environment for industry leaders and the Virginia Department of Health to discuss current and best practices and opportunity for future collaboration. On behalf of the many Virginia pool and spa professionals represented by PHTA, as well as those in neighboring states that do business in Virginia, we respectfully request that you consider moving this important legislation out of your committee. Sincerely, Jason Davidson PHTA, Director of Government Relations jdavidson@phta.org About Us The Pool & Hot Tub Alliance was formed in 2019, combining the Association of Pool & Spa Professionals (APSP) and the National Swimming Pool Foundation (NSPF). With the mission to “Celebrate the Water,” PHTA facilitates the expansion of swimming, water safety and related research and outreach activities aimed at introducing more people to swimming, making swimming environments safer and keeping pools open to serve communities. APSP, now the PHTA, is the world’s oldest and largest association representing swimming pool, hot tub, and spa manufacturers, distributors, manufacturers’ agents, designers, builders, installers, suppliers, retailers, and service professionals. Dedicated to the growth and development of its members’ businesses and to promoting the enjoyment and safety of pools and spas, PHTA offers a range of services, from professional development to advancing key legislation and regulation at the federal and local levels, to consumer outreach and public safety. PHTA is the only industry organization recognized by the American National Standards Institute to develop and promote national standards for pools, hot tubs, and spas. For more information, visit PHTA.org.

I signed up to comment (if needed). the facilitator of the chat asked me to identify myself but my chat is disabled. My email is jae.benz@dbhds.virginia.gov from DBHDS and my phone number is 804-432-3326 if anyone is able to assist. thank you.

Available to answer technical questions

Chairman Walker: My name is Robert Sullivan. I live at 17341 Great Falls Circle, Moseley, Virginia. I am writing in support of Virginia House Bill 2073 "Interstate Medical Licensure Compact and Commission; created". My wife, Lori Sullivan, is suffering from Stage IV soft tissue sarcoma that has spread to her lungs and is inoperable. Sarcoma is a rare form of cancer that accounts for 1% of all cancers in the United States. Her form - malignant ossifying fibromyxoid tumor - accounts for about 1% of these. Hers is a very rare case. The cancer cannot be cured and we can only hope to delay its progress. She is receiving chemotherapy treatment at the Cancer Massey Center, Virginia Commonwealth University, in Richmond. VCU/Massey is a fine hospital and we are content with the treatment there. But because there is so little known about my wife's cancer we have twice traveled to MD Anderson Cancer Center in Houston, Texas, for additional evaluation and diagnosis. MD Anderson is considered to be the finest cancer center in the United States and has specialists familiar with Lori's particular type. Lori’s diagnosis was confirmed only after she was evaluated at MD Anderson. This was almost a year after being misdiagnosed locally . The latest course of treatment she is receiving at VCU has been under the direction of the specialists at MD Anderson. Although we have twice been to MD Anderson it is 1300 miles away from our home in Virginia. During chemotherapy it is normal to have further testing done and consultations with the treating specialists. For us this means traveling back and forth to Texas. It is a burden and expense we would prefer not to have. On top of the anxiety we're experiencing because of the illness, traveling such a long distance is getting even more difficult because of the toxic effects of her chemotherapy. Being able to confer with the MD Anderson doctors without having to travel there would be a great benefit to Lori. She has established a doctor-patient relationship in person already. Using telemedicine for these follow-up visits seems like a common sense approach given the circumstances. The doctors at VCU are personally quite understanding and are supportive of us conferring with the MD Anderson specialists via video conference. The Commonwealth of Virginia, however, prohibits this. I believe HB 2073 will eliminate one obstacle to my wife's treatment. I have been told that objections to this bill are that it has a large fiscal impact and that it is opposed by the Medical Society. As for the fiscal impact I cannot speak. I can say, however, that failure to pass this bill has a large fiscal impact on me and my wife. I believe a lot of Virginia residents would benefit from passage of this Bill. Regarding the Medical Society, I believe that there is strong public sentiment to remove barriers to access in many industries and that these barriers can often take the form of well-meaning restrictions. Rather than protect the public I believe these restrictions often serve only the self-interest of established centers of power. We inhibit innovation, fail to take advantage of technological changes, hide with the comfort of the status quo, at the risk of our development and that of future generations. The free enterprise system is the most productive supplier of human needs and economic justice.

HB 2276 Immunization; immunization of children against COVID-19 Informed consent is the basis of medical ethics. Parents should make decisions regarding the health and wellbeing of their children. COVID-19 vaccines do not prevent viral transmission so there is no justification for requiring these vaccines as a requirement for school attendance. This bill specifies that parents shall not be required to immunize their children against COVID-19 in the same manner current Virginia law allows them to determine whether to give them the Haemophilus Influenzae Type b vaccine. In 2020, when the legislature considered and passed HB 1090, which dealt with the manner in which future childhood vaccines would be considered, legislators and their experts confirmed the legislature’s support for keeping parents in charge of their child’s vaccination schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to mandating the shot. Medical professionals around the world are in agreement that there is no scientific rationale for continuing any COVID-19 mandates in 2023 and beyond. HB 2280 Parental consent to surgical and medical treatment of certain minors This bill requires parents and guardians to consent to medical interventions concerning their children, including vaccination. It is important to amend current law to make it clear that parents are in control and make medical decisions for their children. Several cities have attempted to pass orders and laws that allow children as young as 11 years of age to consent to vaccination without parental knowledge! Please do not let this happen in Virginia. Please support this bill to send a clear message that in Virginia, parents are in control and they decide what medical interventions their children receive.

My name is Kathryn Laughon, PhD, RN, FAAN. I hold a PhD in nursing and am a certified Sexual Assault Nurse Examiner. Thank you for allowing me to provide testimony today. I have been a nurse, specifically a forensic nurse, for over 20 years. I have cared for many hundreds of patients in the Commonwealth who were sexually assaulted, the vast majority were women of childbearing age. My highest priority as a nurse is ensuring the health and well-being of these patients. Research suggests that somewhere between about 2 and 5% of women who are sexually assaulted may become pregnant as a result of the assault, which has immense consequences for my patients. I have sat with many women who are terrified at the prospect of pregnancy in addition to the trauma of the rape. Fortunately, we have safe and effective ways to prevent pregnancy if administered within five days of the event. While Plan B (levonorgestrel) is well known and widely available, it is not effective for all women. Ulipristal or Ella, another emergency contraceptive pill, is somewhat more effective but available only by prescription and often more expensive than Plan B and its generic forms. The IUD is the most effective form of emergency contraception. Depending on the timing of the assault during the patient’s menstrual cycle and the patient’s characteristics, it may be the only effective method. It can cost $1000 or even more, small for the Commonwealth but potentially prohibitive for an individual woman. All women in the Commonwealth deserve access to the form of emergency contraception that they choose based on their wishes and the advice of their health care provider. This access has to be timely and free of cost and other barriers. Delegate Hudson's HB 2097 is an easy fix to ensure equitable access to the best care for all survivors of rape.

My name is Kathryn Laughon, PhD, RN, FAAN. I hold a PhD in nursing and am a certified Sexual Assault Nurse Examiner. Thank you for allowing me to provide testimony today. I have been a nurse, specifically a forensic nurse, for over 20 years. I have cared for many hundreds of patients in the Commonwealth who were sexually assaulted, the vast majority were women of childbearing age. My highest priority as a nurse is ensuring the health and well-being of these patients. Research suggests that somewhere between about 2 and 5% of women who are sexually assaulted may become pregnant as a result of the assault, which has immense consequences for my patients. I have sat with many women who are terrified at the prospect of pregnancy in addition to the trauma of the rape. Fortunately, we have safe and effective ways to prevent pregnancy if administered within five days of the event. While Plan B (levonorgestrel) is well known and widely available, it is not effective for all women. Ulipristal or Ella, another emergency contraceptive pill, is somewhat more effective but available only by prescription and often more expensive than Plan B and its generic forms. The IUD is the most effective form of emergency contraception. Depending on the timing of the assault during the patient’s menstrual cycle and the patient’s characteristics, it may be the only effective method. It can cost $1000 or even more, small for the Commonwealth but potentially prohibitive for an individual woman. All women in the Commonwealth deserve access to the form of emergency contraception that they choose based on their wishes and the advice of their health care provider. This access has to be timely and free of cost and other barriers. Delegate Hudson's HB 2097 is an easy fix to ensure equitable access to the best care for all survivors of rape.

Ii am a nurse practitioner and provide medical care to women of reproductive age . I am also a forensic nurse examiners. In both roles I provide care to survivors of sexual assault. In addition to providing medications to prevent sexually transmitted infections, emergency contraception is an essential part of care to prevent pregnancy due to rape. The most effective method or emergency contraception is Paragard IUD. There are two oral options that are less effective when ovulation is imminent or with weight above 165 pounds. All methods should be available at no cost to victims of rape.

Our organization strongly supports this bill. We work with hundreds of individuals who have lived experience who should be allowed to support others going through similar situations. For far too long, people with substance use history and/or in recovery have been barred from receiving certification. They are often times allowed to fulfill unpaid roles but often times, cannot work in the field because of the outdated laws around barrier crimes. Those closest to the problem are closest to the solution. As a Peer Recovery Specialist and Harm Reduction organization, we believe that no one can assess and fix the problem like a person who has overcome the problem themselves. The peer recovery support training is provided inside of Department of Corrections in the cognitive community and many of our staff and volunteers have had the honor of working alongside the individuals needing support. Virginia, like many other states, are dealing with an unprecedented number of overdoses and deaths. It is time to employ non-traditional means of addressing the crisis we are currently in. I believe in my fellow peer recovery specialists, especially those who have past convictions and/or past substance use history. Having guardrails in place is fine, but to not allow a person who has lived experience to serve others in these roles is a disservice to our neighbors who struggle with substance use.

I am a Certified Peer Support Specialist. I have a barrier crime for a charge I committed in 2014 was charged in 2016. I got clean 12/30/2015. I have completely changed my life and am not the person I was. I worked for NRVCS in Radford Va. I was a CPRS with a Qualified Mental Health Para professional. I worked primarily as a case manager. I trained some case managers that have college degrees, I applied for a position as a Peer Support Specialist Supervisor. The other agency really wanted to hire me and they did only to reject their offer due to my barrier crime. The then called me back 2 weeks later still wanting to hire me. They contacted NRVCS to find out how they hired me, hoping to find a loop hole. They could not. I now work for a non profit that the barrier crime is not a barrier at and I am grateful. My job at NRVCS was then in jeopardy due to being hired illegally. When trying to go through the process with DBHDS I was told by my supervisor at NRVCS that they did not want to rock the boat. I had already started the process however I had no back up to complete the process. This crime has held me back on many different career moves. If you have read this I appreciate you. Thank you! WE need some changes in this bill. I understand there should be some recommendations however it should not be this hard and stressful. Most addicts are going to have drug charges. Thats a given. That does not make me a bad person however my experience, strength, and hope have helped more people than most that do not. If you would like to talk with me my phone number is 5402504804.

HB 2276 Immunization; immunization of children against COVID-19 Informed consent is the basis of medical ethics. Parents should make decisions regarding the health and wellbeing of their children. COVID-19 vaccines do not prevent viral transmission so there is no justification for requiring these vaccines as a requirement for school attendance. This bill specifies that parents shall not be required to immunize their children against COVID-19 in the same manner current Virginia law allows them to determine whether to give them the Haemophilus Influenzae Type b vaccine. In 2020, when the legislature considered and passed HB 1090, which dealt with the manner in which future childhood vaccines would be considered, legislators and their experts confirmed the legislature’s support for keeping parents in charge of their child’s vaccination schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to mandating the shot. Medical professionals around the world are in agreement that there is no scientific rationale for continuing any COVID-19 mandates in 2023 and beyond. HB 2280 Parental consent to surgical and medical treatment of certain minors This bill requires parents and guardians to consent to medical interventions concerning their children, including vaccination. It is important to amend current law to make it clear that parents are in control and make medical decisions for their children. Several cities have attempted to pass orders and laws that allow children as young as 11 years of age to consent to vaccination without parental knowledge! Please do not let this happen in Virginia. Please support this bill to send a clear message that in Virginia, parents are in control and they decide what medical interventions their children receive.

My husband and I were barred from visiting our 44 year old son who was being treated in a hospital in Roanoke Virginia October/November 2021. He died after 3 weeks in ICU. He was admitted with symptoms of what was then called "COVID 19". We were not allowed to visit our son in person. We were able to see him and speak to him (he was unconscious and on a ventilator) via FaceTime. On his final day, when he was only being kept alive with drugs and machines, we were allowed in the room with him. His teen-aged children (ages 14 & 16) were only allowed to be with their father if we agreed to "comfort care" which meant agreeing to turn off the machines on the final day. They never got to be with their father before his actual death. I could tell when we entered his room on that final day he had passed away already. The safety requirements on this "COVID floor" must have been minimal as none of the staff wore PPE except for masks. We were also required to wear masks. What was the danger to ANYONE if we visited our son when he still had life in his body? It certainly wasn't danger of an infection. Had that been the case every doctor and nurse in the unit would have been covered top to bottom with PPE.

After 7 am meeting, then this one. HB 1689 - Please move to report. No one should die without benefit of spiritual help. *HB 1864 - No person should be required to input into their bodies something they don't want there, just to keep their job. We're not North Korea. *HB 1889 - Data shows that they are not at great risk of disease. HB 2057 - Why should people who have worked and paid thousands of dollars for decades, by denied Social Security because those who violated the law came here? Why shouldn't we put infrastructure and improve schools for African American communities FIRST BEFORE any others? Why do they deserve any thing before our veterans? Please PBI this bill. HB 2160 - In honor of those who lost family/friends & weren't allowed to see them at the end, please move to report. HB 2276 - The data is clear: children are not at risk of death from COVID. HB 2293 - https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/comparingdifferentinternationalmeasuresofexcessmortality/2022-12-20 Sweden and Norway were essentially tied for the lowest “[p]roportional all-cause excess-mortality scores” (which “measure[] the percentage change in the number of deaths compared to the expected number of deaths (based on the five-year average [from 2015 to 2019])” among the listed European countries, looking at data from Jan. 2020 to June 2022: Their excess mortality was up 2.7%, compared to, say, 5.2% for Denmark, 7.1% for Finland, and 11.8% for the Netherlands. They had the lowest all causes death rate since COVID arrived and didn't do these long, lengthy lockdowns. Sweden had lower rate avg. excess death percentages: https://reason.com/wp-content/uploads/2023/01/ERGExcessMortality.xlsx https://www.baconsrebellion.com/wp/covid-19-update-still-lots-of-idle-hospital-capacity/ noted on 4/25/2000 Roanoke Valley had 80 cases, 6 hospitalizations and 0 deaths compared to Arlington with 764 cases, 137 hospitalizations, 29 deaths. Elective surgery was banned in both, although the whole of Roanoke Valley had 0 deaths. HB2489 - Please move to report so that men can be given the support to become strong fathers.

HB 1689 - Please move to report. No one should die without benefit of spiritual help. *HB 1864 - No person should be required to input into their bodies something they don't want there, just to keep their job. We're not North Korea. *HB 1889 - Data shows that they are not at great risk of disease. HB 2057 - Why should people who have worked and paid thousands of dollars for decades, by denied Social Security because those who violated the law came here? Why shouldn't we put infrastructure and improve schools for African American communities FIRST BEFORE any others? Why do they deserve any thing before our veterans? Please PBI this bill. HB 2160 - In honor of those who lost family/friends & weren't allowed to see them at the end, please move to report. HB 2276 - The data is clear: children are not at risk of death from COVID. HB 2293 - https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/comparingdifferentinternationalmeasuresofexcessmortality/2022-12-20 Sweden and Norway were essentially tied for the lowest “[p]roportional all-cause excess-mortality scores” (which “measure[] the percentage change in the number of deaths compared to the expected number of deaths (based on the five-year average [from 2015 to 2019])” among the listed European countries, looking at data from Jan. 2020 to June 2022: Their excess mortality was up 2.7%, compared to, say, 5.2% for Denmark, 7.1% for Finland, and 11.8% for the Netherlands. They had the lowest all causes death rate since COVID arrived and didn't do these long, lengthy lockdowns. Sweden had lower rate avg. excess death percentages: https://reason.com/wp-content/uploads/2023/01/ERGExcessMortality.xlsx https://www.baconsrebellion.com/wp/covid-19-update-still-lots-of-idle-hospital-capacity/ noted on 4/25/2000 Roanoke Valley had 80 cases, 6 hospitalizations and 0 deaths compared to Arlington with 764 cases, 137 hospitalizations, 29 deaths. Elective surgery was banned in both, although the whole of Roanoke Valley had 0 deaths. HB2489 - Please move to report so that men can be given the support to become strong fathers.

Support as not all disabilities uses a dog, some can use a wheelchair.

HB 2276 Immunization; immunization of children against COVID-19 Informed consent is the basis of medical ethics. Parents should make decisions regarding the health and wellbeing of their children. COVID-19 vaccines do not prevent viral transmission so there is no justification for requiring these vaccines as a requirement for school attendance. This bill specifies that parents shall not be required to immunize their children against COVID-19 in the same manner current Virginia law allows them to determine whether to give them the Haemophilus Influenzae Type b vaccine. In 2020, when the legislature considered and passed HB 1090, which dealt with the manner in which future childhood vaccines would be considered, legislators and their experts confirmed the legislature’s support for keeping parents in charge of their child’s vaccination schedule. In 2021, the Virginia Department of Health proposed a regulation requiring the COVID-19 vaccine as a requirement for school attendance. More than 15,000 Virginians commented on the regulation, with overwhelming opposition (93%) to mandating the shot. Medical professionals around the world are in agreement that there is no scientific rationale for continuing any COVID-19 mandates in 2023 and beyond. HB 2280 Parental consent to surgical and medical treatment of certain minors This bill requires parents and guardians to consent to medical interventions concerning their children, including vaccination. It is important to amend current law to make it clear that parents are in control and make medical decisions for their children. Several cities have attempted to pass orders and laws that allow children as young as 11 years of age to consent to vaccination without parental knowledge! Please do not let this happen in Virginia. Please support this bill to send a clear message that in Virginia, parents are in control and they decide what medical interventions their children receive.

I’m Tamara Netzel representing the Virginia Cannabis Patients group. I have Multiple Sclerosis and I rely on having cannabis in my system all the time to be able to function. HB2368 would make packaging more readable for patients instead of important information like Keep away from children or ingredients in tiny print or not on the package at all in some cases. Also, the dosage of each piece clearly on the package rather than just the total THC for the whole package so patients don’t have to do math or use a magnifying glass to know how much they are taking. A lot of being a medical cannabis patient means figuring out what combination of ingredients works best on our own. This information needs to be clear, readable, and accessible online before purchasing and mandated. I support the bill. HB2369 would help more patients in Health Service Area 1 who don’t have any dispensaries. There are still elderly and people with disabilities car pooling to travel 50-100 miles to visit a state dispensary because growing their own or having a trusted source is not possible. Many who don’t have access buy unregulated and potentially unsafe cannabis or dangerous synthetic products thinking it’s safe. I support the bill.

Thank you to Delegate Adams for sponsoring both HB2368 and HB2369 and putting patients first. Thank you for reading my comments and taking them to heart in advance. Both of these bills personally affect me. I have a L4/L5 herniated disk, sciatica, and osteoarthritis of the lower back and SI joints. I'm 44, have a 9-year-old son and am happily married. Both my wife and I have professional jobs and possess master's degrees. My pain quickly came to life seven years ago while sitting in my office at work. I experience daily pain and oftentimes miss out on activities with friends and family, travel and playing golf or soccer with my son. I walk with him as a coach and caddie versus playing golf, and simply put, that is a stark reminder of my chronic pain. Living in Charlottesville, the closest dispensaries are in Richmond or Lynchburg, which are both an hour away. Several times I have had to drive to both cities to refill medicine when I have been in the middle of a pain flair up, and that is the last thing I want to do when I am in pain. Yet my wife is unable to pick up my medication for me. Albeit she can still go get medication for me at a local pharmacy, including opioids, which I cannot take due to my pain being chronic. Per my doctor, I would be an opioid addict if I used pain pills for my pain. No thank you. Simply put, cannabis is medicine for me and many others in Virginia. At times I have also had to ration medication because I did not want to make the drive because I knew driving several hours would lead me to be in pain for three days to a week. Yet I have had to do that because my district does not have a single dispenary thanks to a court case and politics. Each time I leave the dispensary, whether I am battling pain or not, I get very upset that I do not have a dispensary I can visit that is near my home. No dispensaries in this district most likely lead many medical cannabis patients to buy medicine on the black market, which is the last thing one wants to do. Admittedly I have had to do this a few times, and I immediately regretted it. We medical patients want tested and regulated products that are a affordable and easily assessible., not to be held politically hostage or deal with black market drug dealers. I ask you as elected officials that represent all Virginians, not just the ones who voted for you, to truly look at the human side of not allowing better access to cannabis. Whether that is adding more dispensaries in my district and around the Commonwealth or allowing a loved one to pick up medicine who is suffering. I encourage you all to visit a dispensary with a medical patient, hear people's stories and see what a dispensary visit is all about. Thank you for your time, attention and most of all caring about medical patients like me. Best regards, Michael Brink Charlottesville

Hello, my name is Sarah O'Hanlon, and I am a mother to a child with intractable epilepsy who benefits from cannabis medicine. I also have a Masters degree in Medical Cannabis Science & Therapeutics from University of Maryland, School of Pharmacy. I am writing to support HB2368, for the improvement of cannabis product labeling within our states medical cannabis program. Products labels containing complete descriptions of contents, dosage amounts/instructions for use, and related safety warnings are critical to the patient and caregivers in order to utilize their medicine as recommended by their Practitioner. It is also imperative that our Virginia dispensaries provide products that are specifically formulated for the medical cannabis patient. Cannabis derived products intended for medical applications often includes both CBD and THC as the primary cannabinoids for optimal therapeutic benefit to the patient. More emphasis on this formulation is greatly needed within our medical program. Additionally, it should not be necessary for a patient's Registered Agent to register with the Board of Pharmacy, when the Practitioner providing the Recommendation includes this information on the patient's written certification. Removing this extra step for patients unable to visit and purchase their own products will also permit a more efficient process for the patient with greatly reduced wait time (by days/weeks) to acquire their medicine. We must not delay the process for patients with added steps for those unable to visit/purchase medical cannabis products for themselves. Thank you, Sarah O'Hanlon

Hello. As a medical cannabis patient I think it is extremely important that the cannabis medicines be accurately & completely described. I would like to see ALL the ingredients included and the percentage of ingredient. And I would like to see improved clear child safety precautions. I also think that they labeling needs to follow a uniform standard among dispensaries. I support HB 2368. Thank you for listening.

I’m Tamara Netzel representing the Virginia Cannabis Patients group. I have Multiple Sclerosis and I rely on having cannabis in my system all the time to be able to function. HB2368 would make packaging more readable for patients instead of important information like Keep away from children or ingredients in tiny print or not on the package at all in some cases. Also, the dosage of each piece clearly on the package rather than just the total THC for the whole package so patients don’t have to do math or use a magnifying glass to know how much they are taking. A lot of being a medical cannabis patient means figuring out what combination of ingredients works best on our own. This information needs to be clear, readable, and accessible online before purchasing and mandated. I support the bill. HB2369 would help more patients in Health Service Area 1 who don’t have any dispensaries. There are still elderly and people with disabilities car pooling to travel 50-100 miles to visit a state dispensary because growing their own or having a trusted source is not possible. Many who don’t have access buy unregulated and potentially unsafe cannabis or dangerous synthetic products thinking it’s safe. I support the bill.

Thank you to Delegate Adams for sponsoring both HB2368 and HB2369 and putting patients first. Thank you for reading my comments and taking them to heart in advance. Both of these bills personally affect me. I have a L4/L5 herniated disk, sciatica, and osteoarthritis of the lower back and SI joints. I'm 44, have a 9-year-old son and am happily married. Both my wife and I have professional jobs and possess master's degrees. My pain quickly came to life seven years ago while sitting in my office at work. I experience daily pain and oftentimes miss out on activities with friends and family, travel and playing golf or soccer with my son. I walk with him as a coach and caddie versus playing golf, and simply put, that is a stark reminder of my chronic pain. Living in Charlottesville, the closest dispensaries are in Richmond or Lynchburg, which are both an hour away. Several times I have had to drive to both cities to refill medicine when I have been in the middle of a pain flair up, and that is the last thing I want to do when I am in pain. Yet my wife is unable to pick up my medication for me. Albeit she can still go get medication for me at a local pharmacy, including opioids, which I cannot take due to my pain being chronic. Per my doctor, I would be an opioid addict if I used pain pills for my pain. No thank you. Simply put, cannabis is medicine for me and many others in Virginia. At times I have also had to ration medication because I did not want to make the drive because I knew driving several hours would lead me to be in pain for three days to a week. Yet I have had to do that because my district does not have a single dispenary thanks to a court case and politics. Each time I leave the dispensary, whether I am battling pain or not, I get very upset that I do not have a dispensary I can visit that is near my home. No dispensaries in this district most likely lead many medical cannabis patients to buy medicine on the black market, which is the last thing one wants to do. Admittedly I have had to do this a few times, and I immediately regretted it. We medical patients want tested and regulated products that are a affordable and easily assessible., not to be held politically hostage or deal with black market drug dealers. I ask you as elected officials that represent all Virginians, not just the ones who voted for you, to truly look at the human side of not allowing better access to cannabis. Whether that is adding more dispensaries in my district and around the Commonwealth or allowing a loved one to pick up medicine who is suffering. I encourage you all to visit a dispensary with a medical patient, hear people's stories and see what a dispensary visit is all about. Thank you for your time, attention and most of all caring about medical patients like me. Best regards, Michael Brink Charlottesville

Hello, my name is Sarah O'Hanlon, and I am a mother to a child with intractable epilepsy who benefits from cannabis medicine. I also have a Masters degree in Medical Cannabis Science & Therapeutics from University of Maryland, School of Pharmacy. I am writing to support HB2369, to remove the requirement that a cannabis dispensing facility be owned, at least in part, by a pharmaceutical processor, and increasing the number of dispensary permits from 5 to 12. As a resident of the health district region that has yet to be provided with a dispensary local to us, it is vital to remove this requirement for the benefit of medical cannabis patients residing in ALL areas of the state. Thank you, Sarah O'Hanlon

Greetings. I live in HSA 1 and have been traveling long distances to obtain meds. Because of the distance it takes the better part of a day plus extra gas. I support HB2369 to open additional dispensaries and also permit changes so the issue with HSA 1 can be resolved. We need medical dispensaries for patients in this area. Thank you for listening.

"To date, only two hospitals in the country received fines for failing to comply with the federal price transparency standards, both of which were in Georgia. Northside Hospital Atlanta was fined $883,180 and Northside Hospital Cherokee was fined $214,320. After being issued fines, both hospitals reformed their price transparency policies and PRA has recognized both as compliant." - 8/18/22 https://www.thecentersquare.com/virginia/hospitals-patient-group-dispute-virginia-price-transparency-compliance/article_2a320b84-1f1f-11ed-8583-df44a918a34b.html

Comments Document

On behalf of Independent Women’s Voice, an organization that fights for women and their loved ones by advocating for policy solutions that enhance freedom, opportunities, and well-being, I urge you to pass HB 2427, the healthcare price transparency legislation.

The Roanoke Regional Chamber is concerned that HB 2427 could drive up healthcare costs due to it providing for a new civil cause of action against hospitals. Legislation that sought to remedy the issue of price transparency already passed the General Assembly in 2022 (in a unanimous vote), with an effective date of July 1, 2023. We believe that the private right of action in HB 2427 will open up hospitals - many still struggling from the pandemic - to the potential for additional financial burden, even as hospitals are already required to provide price transparency under state and federal law. We respectfully ask the committee to oppose the bill.

Patients should be able to get the correct information to make the choice on their health care.

"To date, only two hospitals in the country received fines for failing to comply with the federal price transparency standards, both of which were in Georgia. Northside Hospital Atlanta was fined $883,180 and Northside Hospital Cherokee was fined $214,320. After being issued fines, both hospitals reformed their price transparency policies and PRA has recognized both as compliant." - 8/18/22 https://www.thecentersquare.com/virginia/hospitals-patient-group-dispute-virginia-price-transparency-compliance/article_2a320b84-1f1f-11ed-8583-df44a918a34b.html