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From YouTube: House Finance, Ways, & Means Committee- March 16, 2021
Description
House Finance, Ways, & Means Committee- March 16, 2021
A
B
B
C
D
D
E
E
I'd
like
to
call
the
finance
ways
and
means
committee
to
order
for
march
16th
2021..
Mr
clerk,
would
you
please
call
the
roll.
E
Thank
you,
mr
clerk.
Are
there
any
personal
orders
or
announcements.
E
Seeing
none
will
go
directly
into
our
calendar,
which
will
be
followed
by
a
budget
presentation
from
health,
but
we
do
have
nine
bills
on
our
calendar
today.
The
first
item
on
the
calendar
is
house
bill
94,
I
believe,
that's
being
presented
by
representative
bowie.
H
Thank
you,
madam
chairman
of
committee
house,
bill
94
is
an
administration
bill.
It
makes
four
different
changes
to
existing
workers
comp
law.
The
first
is
that
any
sort
of
post
settlement
or
post
judgment
hearing
the
employee
bears
the
burden
of
proof
and
the
preponderance
of
evidence
is
on
the
injured
worker
section
two
and
three
deal
with
the
next
step
program,
which
is
a
vocational
assistance
program,
and
it
allows
injured
workers
to
re-enter
the
workforce
workforce
and
be
retrained
to
a
different
job.
H
E
C
Thank
you,
madam
chairman,
and
thank
you
committee.
This
we
passed
this
bill
last
year,
but
the
language
in
it
was
a
little
convoluted
and
it
was
causing
problems
with
clerks
across
the
state
county
clerks.
C
A
Thank
you,
madam
chair,
mr
sponsor.
This
is
the
bill
dealing
with
the
votes
allowing
them
to
get
taxed
so
that
they
can
transport
through
the
various
states
without
having
to
pay
a
fee
or
be
fined,
or
something
like
that.
C
That's
exactly
correct:
we
have
five
boat
manufacturers
in
the
state
of
tennessee.
You
don't
have
to
have
a
tag
on
a
boat
trailer
here,
but
they
hire
people
to
transport
them
all
over
the
country
to
deliver
them
as
soon
as
they
leave
the
state.
They
start
getting
tickets.
So
yes,
this
is
the
tag
to
stop
that.
A
And
there
was
a
problem
with
the
lettering
for
the
tags
and
we're
fixing
that
problem
with
this
bill.
Chairman
halsey.
C
E
E
C
Please,
thank
you.
Madam
chairman.
Hb
92
is
brought
to
me
by
tdot.
It's
administration
bill.
Tennessee
law
currently
requires
tdot
to
notify
utilities
by
certified
mail
before
starting
a
project,
so
utilities
can
provide
where
their
facilities
are
located
within
the
project
limits.
This
bill
will
allow
tdot
to
send
notices
by
email.
C
E
I
I
know
thank
you,
mr
chairman,
and
to
your
exceptional
board.
It's
an
honor
to
be
here
with
you
all
today
and
it's
my
first
time
so
I'm
bringing
to
you
house
bill
62
and
what
this
bill
does
is
it
deletes
the
advance
notice
registry
contact
veto
registry
and
revises
provisions
related
to
the
ceiling
of
adoption
records.
The
advance
notice
registry
allows
an
individual
15
days
notice
before
an
adoption
record
is
released
to
their
to
their
biological
child.
I
This
advanced
notice
registry
has
been
under
utilized
with
only
32
individuals
and
no
recorded
hits
on
the
registry.
Eliminating
this
process
will
save
the
department,
time
and
resources.
I
F
Thank
you.
Thank
you
for
this
this
bill.
I
do
have
a
quick
question
and
I
just
want
to
make
sure
that
I
understand
this
is
not
doing
away
with
us
keeping
a
record
of
the
of
the
addresses
and
contact
information
from
these
folks.
It's
it's
literally
the
contact
veto
that,
if
they
don't
want
to
be
reached
that
that
we
get
rid
of.
I
Absolutely
it
is
not
doing
away
with
that.
It's
simply
they're
already
doing
that,
and
this
is
also
doing
that.
But
this
this
way
is
not
people
are
not
using
it.
So
it's
kind
of
just
cleaning
it
up
and
to
cut
out
an
extra
step
that
the
employees
are
doing
great.
J
One
thank
you
for
carrying
this
bill
for
the
administration.
You
know
you
started
off
on
the
wrong
foot
there
in
two
regards
really
by
by
saying
it
was
your
first
bill.
You
probably
should
never
admit
that,
but.
J
And
then
you
really
have
to
go
through
chairman
hazelwood
and
we
were
all
kind
of
wondering
which
board
we
were
talking
about
here.
So
I
know
you
come
from
a
certain
other
elected
body,
but
I
seriously
I
I
was
going
to
give
you
grief
over
this
bill
because
it's
your
first
bill,
but
it
is
a
really
good
piece
of
legislation.
I
appreciate
you
carrying
it
and
we
will
reserve
any
amount
of
grief
for
the
floor
or
possibly
chairman
zachary's
committee
and
or
you
really
seeking
to
be
recognized
after
that
comment.
E
We
have
a
question
on
the
bill
and
I
would
just
as
an
aside
represent
character.
You
may
have
opened
yourself
up
for
tough
time
ahead,
but
we
will
let
you
deal
with
that
at
the
appropriate
time,
question
has
been
called.
We
are
voting
on
house
bill
62
all
in
favor,
please
signify
by
saying
aye
any
opposed.
F
You,
madam
chair,
I
appreciate
that
members.
The
last
year
we
passed
the
dynamic
accessibility
act
and
it
kind
of
cleans
this
up
that
we
avoided
a
physical
note
last
year
saying
that
we
can
update
the
signs
based
on
whether
or
not
they
were
damaged
or
the
renovation
going
on
had
a
couple
of
agencies
last
year
that
wanted
to
update
on
their
own
resources,
but
the
law
wouldn't
allow
it.
F
E
Members
you've
heard
the
explanation
from
the
sponsor
are
there
questions
question
has
been
called
we're
voting
on
house
bill
99
by
representative
jernigan,
all
in
favor,
please
signify
by
saying
aye
any
opposed
seeing
none
eyes
have
it
representative
jernigan
your
bill,
moves
on
to
calendar
and
rules.
Thank.
E
B
Thank
you,
madam
chairman.
This
is
administration
bill
from
the
division
of
tenncare
and
what
it
does
is
right
now,
if
someone
is
receiving
tenncare
services
and
they
pass
away,
tenncare
has
a
lien
by
operation
of
law
against
that
estate.
That's
eventually
opened
up
and
right
now,
there's
absolutely
no
statute.
Limitations
on
that
lien.
This
this
bill,
which
I
congratulate
the
division
for
pointing
out,
requires
a
four-year
statute
limitations
on
recoveries
against
an
estate
by
the
division
of
tenncare.
B
D
B
In
in
a
in
a
lot
of
sense,
the
ways
when
activities
include
in
the
collection
world-
I
I
do
practice
law
and
I
do
do
some
collection
work
after
a
certain
period
of
time,
you
simply
have
to
write
off
some
of
those
bills,
some
of
that
monies
that
might
be
out
there,
so
they're
spending
a
lot
of
resources
on
claims
that
could
be
6,
8,
10,
12
years
old.
That
are
pretty
much
going
to
be
uncollectible
anyway.
B
So
what
we're
hoping
to
do
is
that
tenncare
can
can
concentrate
on
these
claims
that
are
much
younger
that
are,
hopefully
will
be
more
collectible.
There
will,
therefore,
we
may
collect
even
more
money
than
we're
anticipating,
but
these
claims
get
so
old,
they're,
almost
not
even
worth
sticking
around,
but
they
do
clog
up
someone's
real
property
for
the
lean
purposes,
that's
out
there
by
operation
of
law,
so
it
kind
of
clears
up
any
title
issues.
We
might
have
some
folks
if
that
four
year
passes.
B
D
President
shaw,
just
briefly:
do
you
think
this
is
gonna
help
the
citizens
think
it
will
help
citizens.
B
I
absolutely
do
because
I've
had
a
couple
of
cases
in
my
law
practice
where
the
actual
real
property
is
tied
up
in
for
title
purpose:
title
insurance
purposes,
because
there's
that
actual
lien
on
it,
that
is
uncollectible
we've
got
to
get
a
release
of
that
lien.
So
I
absolutely
do
think
it's
going
to
help
the
citizen.
E
J
Lamberth,
thank
you,
my
representative.
Thank
you
for
carrying
this.
It
happens
to
be
an
administration
bill
and
and
representative
gatineau
later
again,
and
I
both
appreciate
you
carrying
it,
but
I
will
tell
you
this
actually
predates
to
representative
shaw's
question.
I
had
a
lawyer
in
my
district
call
me
a
very
good
friend
of
mine,
we've
known
each
other
since
childhood,
who
had
this
exact
issue,
and
it
was
years
after
he
had
handled
an
estate
for
a
family
that
they
get
a
notice
seeking
to
recover
from
the
estate
the
assets
had
been
distributed
to
family
members.
J
I
mean
it
was
a
horrible
situation
and
it
was
years.
So
if
you
can
imagine
your
loved
one
passes
away,
you
think
you've
handled
any.
You
know
debtors,
you
think
you've,
you
know
closed
everything
out
and
then
all
of
a
sudden,
the
state
of
tennessee
sends
you
a
notice.
I
I
really
commend
really
the
governor's
office
and
the
state
in
saying
look:
we're
going
to
put
ourselves
on
a
time
limit
and
it's
going
to
be
four
years
if
they've
not
filed
within
four
years
and
quite
frankly,
I
hope
down
the
road.
J
K
Thank
you,
madam
chair
later,
sponsor,
give
me
an
example
of
of
a
claim
by
by
tenncare
against
a
tenncare
recipient,
okay,.
B
Travel,
I
want
to
make
sure
I
thought
I
was
traveling
since
it
kind
of
put
on
sub,
but
I
want
to
make
sure
I
didn't
need
to
move.
So.
Thank
you
for
that
clarification.
You
needed
an
example.
Here's
one
that
you've
got
someone
that
receives
tenncare
service
of
their
an
assisted
living
facility
and
they
qualify
for
tenncare
and
they're
receiving
those
ten
care
services.
B
Tenncare
basically
has
a
lien
by
operation
of
law
on
the
assets
of
that
estate,
so,
for
whatever
reasons
might
take
place
in
the
administration
of
the
estate,
if
they
don't
ever
transfer
the
property,
the
executor
doesn't
sign
the
property
over
deed.
The
property
over
this
lien
is
out
there
potentially
for
years
and
years,
and
it's
unlimited
so
if
they
ever
want
to
go
back
and
transfer
or
figure
out
what
the
title
is
to
this
property
in
10
years
have
gone
by.
B
This
lien
still
exists,
so
they
still
have
to
deal
with
tenncare
and
paying
10
care
back.
What
team
care
is
saying
is
that
we're
going
to
shorten
that
time
frame
that
the
lien
actually
exists,
so
they
can't
go
back
and
recover
from
estates
more
than
four
years.
I
hope
that
clears
up
that
question,
but
thank
you
for
the
question.
Yes,
thank
you.
Thank.
E
E
L
Thank
you,
madam
chair
president
law,
provides
that
if
the
commissioner
of
revenue
changes
the
department
of
revenue's
policy
as
to
the
taxability
of
any
privilege,
such
policy
change
must
be
applied
to
the
exercise
of
such
privileges,
occurring
after
the
date
of
that
policy
change
unless
otherwise
provided
by
law.
This
bill
adds
that
a
taxpayer
may
actually
rely
on
guidance
published
by
the
commissioner
revenue
concerning
the
taxability
of
a
privilege.
The
bill
further
specifies.
L
If
the
commissioner
changes,
the
guidance
taxpayer
who
relied
on
the
prior
guidance
is
not
liable
for
any
additional
tax
penalty
or
interest
accrued
before
that
guidance
was
changed
and
was
unpaid
because
of
the
taxpayers
reasonable
reliance
on
the
prior
guidance.
It
also
specifies
if
a
taxpayer
is
audited
or
request
specific
advice
from
the
department
and
receives
erroneous
audit
findings
or
advice,
and
the
taxpayer
is
not
liable
liable
for
any
assessment
of
additional
tax
interest
or
penalty.
L
This
just
the
nfib
has
worked
with
and
and
small
business
owners
have
worked
with
the
department
to
get
some
clarification
and
and
get
this
codified,
so
that
taxpayers
can
rely
on
the
information
that
the
department
puts
out
in
either
guidance,
or
they
have
in
audits
things
that
decisions
that
are
made
in
audits.
We've
we've
cleaned
up
a
few
things
like
that
in
the
last
couple
of
years,
where
there's
been
some
misunderstandings
and
and
maybe
audits
that
had
findings
in
one
part
of
the
state,
but
not
in
another
on
the
same
item.
L
So
this
just
further
protects
taxpayers
so
that
they
can
rely
on
the
information
that
the
department
is
is
providing
and
it
memorializes
certain
things
so
that
taxpayers
have
a
good
feel
for
what
they
can
rely
on
in
the
future.
E
G
Okay,
members,
we're
now
on
item
number
nine
house
bill
85
by
chair,
lady
hazelwood.
We
have
a
motion
and
a
second
chair,
lady
hazelwood
you're
recognized,
but
I
believe
we've
got
an
amendment.
It's
amendment
45-24,
okay
motion
and
second,
on
the
amendment
chair,
lady
hazelwood,
you
are
recognized
on
the
amendment.
E
Thank
you,
mr
chairman,
and
the
amendment
does
make
the
bill,
and
it
just
says
that
the
effective
date
of
the
stream
streamlined
sales
tax
agreement
we've
been
kicking.
This
can
down
the
road
every
two
years
for
quite
some
time
and
the
most
recent
extension
was
two
years
ago.
We're
deleting
this.
These
streamlined
sales
tax
agreement
provisions
permanently
and
removing
that
fiscal
impact
originally
estimated
for
the
agreement.
E
So
this
really
just
takes
us
out
we're
still
an
associate
member
of
that
organization,
but
rather
than
just
renewing
this
every
two
years
and
staying
an
associate
member,
we're
just
saying
this.
This
is
how
streamlined
sales
tax
is
going
to
work
in
tennessee.
With
that,
mr
chairman,
I
stand
ready
for
questions.
G
G
E
That
does
complete
our
calendar
for
today.
I
would
ask
that
our
folks
from
health
who
are
going
to
be
presenting
their
budget
today,
dr
piercy,
and
whomever
she
has
with
her.
If
you
would
come
down
front.
M
I
E
Dr
piercy
welcome
we're
glad
to
have
you
with
our
committee
today.
E
I
know
that
you
have
a
a
lot
to
tell
us
and
I
will
just
start
out
up
front
by
saying
thank
you
again
to
your
department
and
to
all
the
health
departments
across
the
state
who
have
just
risen
in
an
amazing
way
to
a
challenge
that
sitting
here
a
year
ago
today
we
would
never
have
anticipated
how
long
and
how
deep
and
how
tough
the
road
would
be
in
front
of
us,
but
you
guys
have
you
know
I
knock
on
wood
brought
us
through.
I
hope
to
the
other
side.
E
I
know
I'm
excited
my
number
of
my
family
members
have
gotten
their
first
and
some
even
second
vaccinations
and
I've
had
mine.
It
makes
me
feel
much
better,
so
I
I
just
want
to
start
out
with
a
thank
you
and
then
ask
you
if
you
would
just
go
straight
into
your
your
budget
presentation
for
us
today.
Thank
you.
N
Thank
you,
madam
chair
lady,
appreciate
those
kind
words
and
it's
the
people
to
my
right
and
left
and
all
the
ones
out
there
in
the
field
that
that
are
doing
the
heavy
lifting
speaking
of
those
to
my
right
and
left
on
the
far
side
is
dr
tim
jones,
our
chief
medical
officer,
ms
valerie.
Oliver,
who
is
our
assistant
commissioner
of
operations,
then
we've
got
to
my
right-
is
dr
morgan,
mcdonald,
our
deputy
commissioner
of
population
health.
N
So
I
wanted
to
start
with
an
overview
of
kovid
which
will
never
be
able
to
be
contained
on
one
slide,
but
I
did
want
to
highlight
a
few
things
for
you
just
since
we
made
this
slide
a
few
days
ago.
We
are
now
almost
up
to
2
million
vaccinations.
N
We've
done
almost
7
million
tests
in
the
last
year
and
then
another
thing
that
we're
particularly
proud
of
is
our
hospital
staffing
assistance
grants
that
was
administered
by
dr
mcdonald
and
and
her
team
really
helped
hospitals,
support
hospitals
with
their
staffing
and
other
needs.
During
the
pandemic,
and
then
something
else
that
I
wanted
to
highlight
off
of
this
was
our
work
in
long-term
care
facilities.
N
We
are
very
fortunate
that
our
death
rate
in
long-term
care
facilities
in
tennessee
is
about
30
percent
lower
than
the
national
average.
So
without
a
doubt,
the
work
in
these
facilities
have
saved
lives
that
had
those
residents
been
in
another
state,
they
may
not
have
survived.
E
Dr,
if
I
could
interrupt
you
my
oversight,
we
did
not
formally
go
out
of
session.
I
was
so
excited
about
thanking
you
and
bragging
on
the
great
job
that
you
all
had
done,
that
I
forgot
to
do
that,
so
we
are
officially
out
of
session.
Thank
you.
Should.
N
D
I
N
So
keeping
going,
you
know
a
lot
of
us
just
think
about
the
pandemic,
and
you
know
when
you
think
about
the
department
of
health,
you
think
well,
everything
else
must
have
just
stopped.
Well,
I
mean
clearly
things
had
to
slow
down
and
change
a
little
bit,
but
the
work
didn't
stop
and
the
progress
didn't
stop.
N
We
just
like
all
health
care
providers
have
had
to
shift
and
change
and
adapt.
We
were
able
to
consider
or
continue
our
wic
program
virtually
that
removed
a
lot
of
barriers
for
people
for
coming
instead
of
coming
in
an
in-person
visit.
We
also
did
a
lot
of
innovation
through
telehealth,
as
did
many
other
providers,
and
we
still
had
some
big
wins.
We
continued
to
see
our
nas
or
neonatal
abstinence
syndrome
rates
go
down
as
well
as
our
sleep,
related
infant
deaths.
N
Nas
is
down
27
over
the
last
four
years,
and
sleep
related
deaths
down
26
over
the
last
four
years,
so
getting
into
the
budget.
You'll.
Remember
that
our
funding
is
split
about
a
third
third
third,
with
state,
federal
and
other
funding,
and
it
is
primarily
comprised
of
the
large
categories
you
see
here
in
the
upper
right:
local
health
services.
That's
what's
delivered
at
the
local
health
departments.
N
You
some
of
those
are
self-explanatory.
Wic
is
a
big
portion
of
that
and
then
other
health
services
are
things
that
you
might
not
as
readily
think
about
our
public
health
lab,
our
communicable
disease
and
emergency
preparedness,
family,
health
and
wellness
and
several
other
programs
there.
N
I
also
wanted
to
remind
you-
and
this
is
just
as
much
of
a
reminder
for
us-
this
is
the
four-year
strategic
plan,
or
this
is
a
visual
representation
of
the
four-year
strategic
plan
that
we
did
a
little
over
a
year
and
a
half
ago
you
know
even
throughout
the
pandemic.
These
were
still
our
areas
of
focus.
N
This
was
still
our
mission
to
protect,
promote
and
improve
the
health
and
prosperity
of
people
in
tennessee,
and
I
could
probably
talk
for
an
hour
about
why
it
is
written
just
like
that,
but
I
hope
you
have
seen
us
live
that
mission
throughout
the
pandemic
and
then
you'll
also
notice.
Our
two
areas
of
focus
are
prevention
and
access.
N
I
want
you
to
remember
those
because
that's
going
to
come
into
play
when
we
talk
about
our
our
request
for
this
year,
but
even
throughout
the
pandemic,
again
focused
on
those
priorities,
so
we
have
four
cost
increases
to
propose
to
you
this
year.
These
key
initiatives
total
about
4.3
million
dollars
and
they
align
with
our
mission
and
strategic
priorities,
and
they
include
no
personnel
increases.
N
The
first
one
is
a
two
million
dollar
expansion
of
the
health
care
safety
net.
We
were
grateful
that
last
year
the
governor
and
general
assembly
made
the
largest
investment
in
safety
net
history
to
the
program
and
we
are
requesting
an
additional
2
million
recurring
for
that
to
take
the
base
funding
from
19.9
to
21.9
million.
N
This
is
primarily
the
way
that
uninsured
tennesseans
are
served
when
they
don't,
they
don't
have
medicaid
and
they
don't
have
any
other
types
of
insurance.
This
is
the
primary
mechanism
by
which
uninsured
tennesseans
get
care.
We
do
expect
that
number
to
grow
resultant
from
the
pandemic
and
the
economic
downturn
with
some
employers,
as
well
as
higher
unemployment.
We
do
expect
this
number
to
increase,
so
we
are
respectfully
requesting
an
additional
2
million
dollars
for
the
safety
net.
N
The
next
large
one
is
recurring:
two
million
dollars
for
tobacco
prevention
programs.
N
You
know,
I
think
smoking
is
so
ubiquitous
that
people
forget
about
how
dangerous
it
is
and
how
deadly
it
is,
particularly
in
our
state,
we're
43rd
in
the
nation
in
smoking
and
that's
not
43rd,
that's
not
good.
It's
50
is
the
worst.
We
continue
to
see
youth
initiation.
We
continue
to
see
tobacco-related
deaths
and
speaking
of
tobacco-related
deaths,
I'm
sure
you
can
all
quote
the
statistic
about
10
tennesseans
die
per
day
from
opioids
about
30
tennesseans
die
per
day
for
tobacco-related
disease.
N
N
This
is
a
just
an
example
of
some
of
the
youth-led
marketing
that
that
we
particularly
targeting
vaping-
and
this
is
part
of
the
work-
that's
funded
with
with
these
funds.
N
The
other
two
items-
one
is
a
retinal
scanner
retina.
I
don't
mean
to
insult
anybody's
intelligence,
that's
basically
the
back
of
the
eye,
and
it
is,
it
can
be
severely
affected
in
diabetics.
So
when
people
with
diabetes
have
uncontrolled
blood
sugar
for
a
long
time,
it
can
cause
retinal
damage.
That's
called
diabetic
retinopathy
because
we
are
such
a
large
primary
care
provider
throughout
the
state.
We
have
over
9
000
patients
on
our
patient
panel
that
have
diabetes
and
need
proper,
retinal
screening.
N
The
current
technology
that
we
have
is
out
of
date,
and-
and
this
is
a
very
cost-friendly
solution
that
we
can
put
in
our
health
departments-
it's
a
one-time
non-recurring
of
around
82
000
and
then
the
ongoing
licensing
and
software
is
another
12
000..
So
that's
a
total
just
shy
of
94
000.
For
the
retinal
scanner
and
then
the
final
request
is
for
an
integrated
data
system
for
250
000.
N
This
is
an
upgrade
to
the
system
that
we
currently
use
to
do
all
of
our
data
analysis
for
opioids
that
that
department
is
or
that
division
is
housed
in
our
department
and
so
now
with
we're
bringing
on
more
substances,
particularly
methamphetamine
and
stimulant
abuse.
Seeing
a
lot
more
of
that,
we
need
to
expand
our
software
systems
in
order
to
keep
up
with
that
and
then
on
our
efficiency
plan.
We
are
bringing
to
you
eight
million
dollars
in
reductions.
Those
are
all
for
revenue,
offsets
and
operational
efficiencies.
N
E
Thank
you,
dr
piercy,
for
being
moving
through
that
quickly
and
giving
us
time.
We
do
have
a
number
of
questions
and
just
a
small
one
that
I'll
ask
before
we
get
started
on
those
that
will
be
I'm
sure
much
more
in
depth,
but
you
mentioned
on
the
retinal
scanner.
Is
that
for
one
scanner
and
how?
How
is
that
going
to
serve
9
000
patients
across
the
state
help
me
understand
that
a
little
bit
no.
E
Thank
you,
chairman
hicks.
F
Thank
you,
chair,
lady
and
commissioner.
It's
certainly
good
to
see
you
and
your
staff
here
and
it's
good
to
hear
about
all
the
good
work
that
you
all
have
done,
and
I
know
I
have
called
you
a
couple
times
and
you've
always
been
very
cordial,
and
I
really
appreciate
that
and
your
office
is
also
very
responsive.
F
Talking
about
the
health
care
safety
net,
the
proposed
budget
includes
2
million,
a
new
recurring
funding
for
the
health
care
safety
net.
What
has
the
pandemic
or
how
has
the
pandemic
affected
utilization
of
the
safety
net
for
this
year?.
O
O
We
have
actually
put
a
number
of
measures
in
place
to
increase
flexibility,
so
the
availability
of
this
funding
is
now
available
for
telehealth.
In
addition
to
general
in
in
clinic
visits
and
then
with
the
appropriation
from
last
year,
we
were
able
to
issue
an
rfp
and
expand
our
clinic
footprint
to
be
able
to
fund
five
additional
primary
care
sites
and
12
dental
sites
and
then
also
have
put
into
place
expanded
access
to
specialist
care,
particularly
in
rural
regions
and
in
the
western
part
of
the
state.
O
And
so
you
know,
safety
net
clinics
just
like
non-safety
net
clinics
have
actually
seen
a
decline
in
volume,
just
fear
of
going
in
for
services,
and
so
they've
really
been
trying
to
to
think
of
creative
ways
to
make
sure
that
people
are
coming
in
for
particularly
chronic
conditions
that
could
go
unchecked,
as
well
as
acute
care
visits.
F
You
you
mentioned
last
year,
last
year's
budget
included
9.5
million
in
additional
non-recurring
funding.
That
is
only
partially
replaced
with
this
proposed
cost
increase.
Will
then,
will
the
decrease
in
funding
affect
availability
of
safety
net
services.
O
So
the
you're
you're
corrected
that
that's
two
million
converting
part
of
that
non-recurring
budget
to
recurring
by
two
million
dollars,
and
so
we
have
a
couple
of
incen
quality
incentive
programs
and
other
capacity
building
uses
for
the
non-recurring
piece
of
that
funding.
We
do
not
anticipate
that
that
services
will
decline
or
the
numbers
served
will
decline
over
the
next
year,
based
off
of
that
recurring.
Non-Recurring
distribution.
J
So
we
appreciate
that.
I
have
a
question
really
dealing
with
there's
about
63
million
dollars
that
were
reverted
back
and
was
that
due
to
federal
funding
that
came
in
that
allowed
for
that
reversion,
and
then
on
top
of
that,
you
know
where
exactly
that
go.
What
are
the
plans
for
that
going
forward?
I
think
it
was
about
63
million.
That
was
reverted
back
just
want
to
get
a
little
details
on
that.
If
we
can.
N
J
M
Thank
you,
madam
chair
lady.
I
have
a
couple
questions
about
the
vaccine
and
testing
I'm
from
the
bristol
area,
so
we
got
the
track
and
we're
doing
lots
of
them.
My
first
question
would
be:
is
there
a
possibility
or
that
the
state
can
we
can
get
more
vaccines
or
is
that
all
federally
regulated
on
what
we
get.
N
That's
a
good
question,
sir.
Thank
you.
We
max
out
the
order
every
week,
so
that
is
completely
controlled
by
the
federal
allocation.
The
supply
has
slowed
down
a
little
bit
more
than
what
we
initially
anticipated.
N
I
did
participate
in
a
white
house
briefing
this
morning.
That
said,
we
are
supposed
to
get
a
small
bump
the
week
of
the
29th
and
then
a
bigger
bump,
the
first
week
in
april,
and
so
otherwise
we're
just
at
the
mercy
of
whatever
they
send
us.
Okay,.
M
N
So
the
vaccine
and
all
of
the
supplies
needed
to
go
with
it
are
provided
at
no
cost
by
the
federal
government,
the
testing
we
would
have
to
get
you
the
pcr
number,
but
the
feds.
The
feds
also
provide
the
binax
now
rapid
test.
We
have
we've
received
over
two
million
of
those,
and
so
those
are
also
at
no
cost
it's
just
whatever
the
health
department
is
doing
from
a
pcr
standpoint
and
valerie.
Do
you
know
that
number
off
top
your
head
or
shall
we
follow
up?
M
N
Vaccine
supply,
yes,
no,
sir.
Okay.
We
but
that
look.
Let
me,
let
me
add
a
butt,
but
that
will
change
soon,
because
there
will
be
a
time
in
the
very
near
future,
maybe
in
the
next
two
to
four
weeks
where
supply
will
exceed
demand
and
demand
is
going
to
drop
off
because
the
people
who
want
the
vaccine
are
already
generally
in
the
process,
not
everybody,
but
a
lot,
as
well
as
we're
seeing
really
low
uptake
rates
in
our
rural
areas
in
rural
west
tennessee.
N
I
have
ninety
percent
of
all
available
appointments
open.
You
can
get
a
same-day
appointment
pretty
much
anywhere
in
rural
west,
tennessee,
east
tennessee
has
about
a
fifty
percent.
Fill
rate.
Middle
tennessee
has
about
an
80
fill
rate.
Those
are
the
rural
health
departments.
Metros
are
a
little
bit
different,
but
we're
seeing
pretty
low
uptake,
particularly
amongst
rural
areas,
communities
of
color
and
low-income
workers.
M
Thank
you
for
your
indulgence,
mrs
chair
lady.
My
final
question
would
be:
how
do
you
feel
like
we're
doing
as
a
state
as
far
as
making
things
available
for
just
those
areas,
you're
talking
about
those
rule
hard
to
get
to
places.
N
So
we
have
vaccine
in
over
700
locations
and
we
have
another
500
locations
that
what
we
call
are
onboarded
they're
ready
to
receive
they've
had
the
training
they've
had
the
certification,
they
just
don't
have
enough
product
to
go
around
yet.
So
I
think
people
get
in
the
habit
of
thinking
it's
just
at
the
health
department.
That's
actually
only
a
very
small
percentage
of
of
the
places
it's
available.
E
And
just
to
follow
up
on
one
of
the
questions
that
chairman
crawford
asked
it's
concerning
the
take
rate
in
these
rural
areas,
where
we've
seen
a
really
high,
you
know
covet
infection
rate.
So
what
plans
does
the
department
have?
How
are
we
going
to?
You
know
assume
that
education,
that's
marketing,
that's
all
of
the
above,
but
how
are
we
going
to
try
to
improve
those
take
rates
as
we
get
more
vaccine.
N
Yes,
ma'am
vaccine
hesitancy
is
something
that
the
department
has
been
dealing
with
for
years
well
before
covet
vaccine,
and
so
we
know
that
education
and
providing
that
education
through
trusted
voices
in
the
community
is
the
best
mechanism,
as
opposed
to
I'm
here
from
the
government,
and
you
should
trust
me
that
doesn't
work,
and
so
we
we're
engaging
with
those
trusted
voices
in
the
community.
N
But
I
will
tell
you
what
the
most
effective
thing
is
is
when
somebody
gets
theirs
and
then
they
tell
a
family
or
friend,
because
even
with
those
trusted
voices,
sometimes
it's
hard
to
see.
How
am
I
like
you
or
what
you
know,
what
makes
me
similar,
but
when
a
family
or
friend
gets
it,
then
the
the
person
in
their
tribe
is
more
likely
to
get
it
as
well.
I
will
also
add
that
the
hesitancy
is
not
a
is
not
unique
to
tennessee.
It
is
pretty
widespread
amongst
the
south.
P
Thank
you,
madam
chair,
dr
parislee.
Thank
you
so
much
for
being
here
before
I
get
to
my
question.
I
just
want
to
say
thank
you
so
much
for
everything
you've
done
as
we've
talked
before,
I
work
in
a
long-term
care
facility
and
y'all
just
done
an
amazing
job
with
that
population.
So
thank.
N
P
Moving
to
a
different
direction
here
this
year
in
the
budget,
there
is
a
proposed
two
million
dollar
recurring
fund
for
tobacco
prevention.
In
years
past,
it's
been
anywhere
between
five
to
four
and
anywhere
in
that
range.
Can
you
kind
of
go
in?
You
touched
on
a
little
bit
of
it,
but
can
you
go
into
what
kind
of
specific
programs
that
extra
two
million
dollars
would
get
that
we're
not
doing
now.
O
Thank
you.
I
also
appreciate
the
question
so
you're
correct.
We
have
had
some
non-recurring
funding
that
has
come
to
the
department
from
the
general
fund
directed
to
to
the
state.
There
was
a
15
million
dollar
settlement
allocation
that
was
between.
I
think
it
was
fiscal
years
14
to
16,
and
then
there
was
a
non-recurring
five
million
dollars
later.
O
It
was
funded
in
the
budget
last
year
and
then
was
removed
with
the
amendment
given
covet
and
the
uncertainties
that
we
had
going
forward
this
year.
So
we've
not
had
recurring
funding
in
the
budget
for
tobacco
prevention.
That
being
said,
we've
really
made
quite
good
use
of
the
funding
that
we
have
received
over
the
years
and
that's
included
over
the
last
five
years,
actually
a
38
reduction
in
youth,
smoking
and
then
a
20
reduction
in
smoking
during
pregnancy,
and
so
those
are
two
key
indicators,
obviously
of
long-term
health
outcomes.
O
We
would
propose
to
spend
this
funding
in
a
similar
way
really
community
engagement,
particularly
in
youth
prevention
and
prevention.
Around
vaping,
whereas
we've
seen
significant
declines
in
combustible
tobacco
use
in
youth,
we've
seen
significant
increases
in
vaping.
I'm
almost
25
percent
of
youth
high
schoolers
have
vape
within
the
last
30
days,
and
so
that's
concerning
certainly
for
a
number
of
reasons.
So
those
two
programs
certainly
would
target
that
with
local
grants,
as
well
as
with
some
statewide
initiatives
around
both
prevention
and
cessation.
P
P
O
F
F
It's
it's
a
learning
experience
for
all
of
us.
Thank
you.
If
I
could,
I
want
to
follow
up
on
a
question,
madam
chair,
that
chairman
crawford
asked
about
testing
and
then
go
to
another
question
as
well.
If
it's
okay
as
you're
talking
about
testing
two
million
available
tests,
are
we
testing.
F
N
Sure
that's
a
great
question,
so
there's
basically
two
kinds
of
tests.
One
of
them
is
the
traditional
pcr
test,
the
one
that
they
used
to
call
the
brain
tickler.
It's
not.
It
doesn't
have
to
go
up
so
high
anymore,
but
that
is
a
traditional
viral
test
where
they
actually
look
for
parts
of
the
virus,
but
it
is
specific
to
sars
cov2,
which
is
cova
19..
N
The
two
million
tests
that
were
provided
to
us
by
the
federal
government
are
the
abbot,
binax,
now
they're
the
rapid
tests
for
the
15
minute,
where
you
just
put
the
front
of
your
nose
and
then
you
do
it
right
there
on
the
on
the
card.
Those
are
testing
for
an
antigen
which
have
a
high
specificity
but
a
lower
sensitivity,
so
which
means
when
it's
positive
you
can.
You
can
pretty
much
bet
it's
positive,
but
if
it's
negative
it
doesn't
necessarily
mean
it's
negative
it
that
that's
the
difference
between
sensitivity
and
specificity.
N
So
you
have
a
trade-off
of
speed
and
convenience,
15
minutes
versus
sending
it
off
to
a
lab
for
a
day
or
two.
You
have
speed
and
convenience.
It
doesn't
pick
up
as
many
but
they're
they're
good
for
screening
or
what
we
call
surveillance
of
testing
large
populations
to
see.
Who
has
it
also
very
a
quick
turnaround?
Schools
have
used
a
lot
of
them.
Nursing
homes
have
used
a
lot
of
them
and
then
a
lot
of
industries
have
requested
those
from
us
as
well.
F
O
So
you're
correct
the
source
of
that
funding
has
been
traffic
fines
and
obviously,
as
people
are
driving
less
there's
been
less
revenue
that
has
come
in
for
the
program.
That
program
does
support
a
number
of
initiatives,
one
being
the
brain
injury
association
and
then
a
number
of
really
community
dwelling
for
individuals
with
traumatic,
brain
injury
and
care
coordination
for
services
for
survivors.
It
also
supports
the
tbi
registry
that
provides
data
around
tbi
in
the
state.
Q
There
you
go.
Thank
you,
madam
chair,
dr
pierce.
I
just
want
to
again,
as
many
of
my
members
have
said,
just
want
to
thank
you
and
your
team
for
what
y'all
done
during
these
extraordinary
times
and
in
the
army.
We
always
hold
the
commander
responsible
for
everything,
but
I
just
want
to
tell
you.
Your
leadership
and
expertise
has
been
extraordinary
and
the
people
of
tennessee
owe
you
and
your
team
a
lot
for
getting
us
through
this,
and
I
know
we're
not
at
the
end
but
we're
getting
close.
Okay,
and
thank
you,
sir.
Q
Q
My
question
has
to
do
with
teledentistry
program
last
year's
budget
had
a
737
thousand
dollar
hub
and
spoke
dental
pilot
program
for
west
tennessee,
and
it
was
not
funded
due
to
covid,
and
this
year
budget
you
requested
936
thousand
dollars
for
eight
positions
for
a
tele
dentistry
pilot
program.
Again
that
was
not
funded.
Q
N
Thank
you
for
that
question.
Teledentistry
is
something
that's
high
on
our
priority
list.
It
is,
though,
if
you
want
to
think
about
it,
one
of
those
nice
to
have
not
necessarily
have
to
have,
and
so
the
coming
year
will
be
a
rebuilding
year
for
us,
and
so
we
we
actually
already
implemented
some
of
that
in
our
upper
cumberland
region
and
we'll
continue
that
and
then,
as
funding
becomes
available.
N
Q
Majesty
chairman,
how
does
a
tele-dentistry
program
for
all
of
us
in
here?
How
does
that
work.
N
That's
a
great
question:
I
get
that
question
a
lot.
It's
actually
the
same
thing
through
telehealth
as
a
lot
of
people
are
familiar
with
telehealth
now,
which
is
basically
a
video
visit.
This
is
essentially
the
same
thing,
except
the
instruments
that
go
in
your
mouth
have
a
little
camera
on
the
end.
Really
not
maybe
it's
an
unpalatable
example,
but
it's
really
not
different
than
a
colonoscope
when
you
have
a
colonoscopy,
it's
a
little
tube
with
a
camera.
N
On
the
end
where
you
can
look
on
the
inside
same
thing,
with
the
dental
instruments,
it's
actually
called
mouth
watch,
and
so
the
hygienist
and
other
lower
level
practitioners
below
the
dentist
can
do
this
out
in
the
field
transmit
the
images
back
to
the
dentist
in
the
hub,
and
so
it
helps
stretch
our
dentist
out,
because
we
have
such
a
huge
dental
shortage.
Q
G
Thank
you,
madam
chair,
and
I've
commissioner
piercy.
I
also
want
to
add
my
thanks
for
the
work
you've
done.
We
had
an
issue
with
some
vaccines
in
rutherford
county
not
too
long
ago,
and
that
same
morning
you
had
all
the
representatives
for
rutherford
county
and
both
senators
on
the
telephone,
keeping
us
informed,
and
I
really
appreciate
your
efforts.
G
A
One,
no
sir,
it's
not
any
additional
federal
funding.
What
we
have,
what
we've
done
is
try
to
be
more
efficient
with
the
with
the
amount
of
federal
money
that's
coming
in,
and
so
we
went
and
did
an
analysis
and
we're
making
sure
that
the
federal
money
is
spent
before
the
state,
and
we
saw
this
as
an
efficiency.
G
D
Thank
you,
madam
chair
and
amen
to
all
that's
been
said
about
you,
commissioner,
is.
Is
there
any
studies
being
done?
I
know
there
are
a
lot
of
people
who
have
who
a
little
reluctant
about
taking
the
vaccine.
By
the
way,
let
me
say
I've
had
both
it's
really
cool.
I
mean
hey,
really,
the
coolest
vaccines,
I've
ever
taken.
D
So
I
would,
I
would
say
in,
and
everybody
ought
to
get
them
for
sure,
but
is
there
any
studies
being
done
that
you
know
of
by
health
officials
anywhere
as
to
what
kind
of
conditions
might
react
to
negatively
to
the
vaccines?
Because
maybe
this
will
help
some
people
who
don't
think
they
should
take
it.
N
Yes,
sir,
that's
a
great
question:
there's
actually
a
national
database
that
collects
that
information
that
everybody
can
access.
It's
called
vares,
it's
a
long
acronym,
but
it's
about
vaccine
adverse
events
and
so
anything
from
ranging
from
mild
soreness,
which
you
probably
had
that's
pretty
common,
all
the
way
up
to
severe
allergic
reactions
and
all
of
the
factors
that
might
put
one
at
risk.
For
example,
an
interesting
phenomenon
that
has
been
noticed.
It's
not
a
medical
condition,
but
some
people
receiving
vaccine
that
have
filler
cosmetic
filler
in
their
face
see
that
it
reacts.
N
And
so
that's
an
unusual
one,
there's
another
one
with
some
different
food
allergies
that
that
have
some
cross
reactivity.
So
all
of
that's
being
collected
and
then
once
it's
sort
of
substantive
enough
to
be
a
trend,
then
that
will
be.
D
Published,
I
think
that
would
be
good,
because
there
are
so
many
people
I
I
know
one
particular
case
where
a
lady
got
a
vaccine,
but
actually
she
just
was
afraid
of
taking
shots
and
she
fainted,
but
she
put
it
off
on
the
vaccine
when
actually
she
just
fainted
from
taking
the
taking
the
injections
yesterday.
D
And
when
those
kind
of
word
things
get
out
in
that
small
communities,
you
know
everybody
says:
oh
wait
a
minute.
That
thing
will
knock
you
out,
but
I
do
want
to
thank
you
for
what
you're
doing
in
west
tennessee,
and
I
will
tell
you
that
our
folk
in
hartleman
county
has
been
superb
and
and
doing
their
jobs
and
keeping
the
vaccines
up
for
us,
and
I
appreciate
it.
Thank
you.
Thank.
A
Thank
you,
madam
chair,
thank
you,
commissioner,
for
being
here,
and
I
appreciate
the
communication
and
you've
always
had
with
me
and
and
and
fun,
and
very
timely
whenever
I've
asked
you
a
question
or
for
research
or
anything
like
that.
My
question-
and
I
you
told
me
this
before,
but
I
just
would
like
to
get
it
on
the
record.
You
know
with
cover
19,
we
closed
a
lot
of
venues.
A
N
Thank
you
for
the
question.
We
have
no
statewide
restrictions
on
any
types
of
gatherings
or
venues
now
some
of
the
local
metros
do,
and
so
they
have
jurisdiction
over
that.
But
from
a
state
perspective
there
are
no
restrictions
there.
In
fact,
outdoor
venues
are
likely
very,
very
safe,
there's,
hardly
any
at
all
documented
transmission
in
outdoor
venues.
Okay,.
F
Thank
you.
Madam
chair
quick
question
on
the
on
the
uptake
that
you
were
talking
about
statewide
here
locally,
we
had
a
bunch
of
metro
teachers
that
were
traveling
all
across
the
state
to
get
to
get
shots
and
anecdotally.
F
I
I
hear
the
same
thing
repeated
that
you
know
such
and
such
has
an
appointment
in
you
know,
mcminnville
or
wherever
it
may
be.
How
how
nimble
are
you
in
the
distribution
of
the
shots?
Are
we
limited
by
state
plan
by
federal
mandate
on
the
counties
and
can
you
I
get
a
lot
of
questions
on?
Why
do
I
have
to
drive
to
such
and
such
to
get
a
shot
when?
Why
couldn't
I
just
do
it
here
sure.
N
That's
a
good
question
and
I
I
hope
those
days
are
almost
over
because
because
our
supply
is
increasing
and
the
big
rush
at
the
beginning
is
is
starting
to
loosen
up.
Actually,
it's
probably
to
answer
your
question:
it's
probably
a
different
reason,
and
that
is
the
vaccine,
storage
and
handling
requirements.
N
This
is
not
something
you
just
throw
in
a
yeti
and
drive
across.
You
know,
county
lines.
It
requires
significant
storage
and
handling.
It
has
to
monitor
the
temperature
on
the
way
you
the
place
where
it's
going
has
to
have
the
proper
setup
for
whatever
vaccine
you're
taking
there,
but
we
do
have
a
process
for
that
right
now,
we've
been
focusing
you've
heard
me
speak
repeatedly
about
equity
and
allocating
on
a
population-based
method.
To
each
of
these
counties,
we
want
counties
to
have
an
appropriate
amount
for
their
and
citizenry,
but
what
we
don't?
N
What
we're
not
seeing
is
when
we,
when
we
see
the
poor
uptake
in
some
of
these
rural
counties,
we
don't
want
it
to
sit
there.
We
want
it
to
go
somewhere
where
it's
going
to
be
used.
So,
very
soon
we
will
have
to
ramp
up
our
efforts
to
reallocate
it's
a
little
too
early
to
do
that
right
now,
because
not
everybody
has
had
the
opportunity
to
get
the
vaccine
in
each
of
these
counties,
but
we're
going
to
have
to
start
doing
that
pretty
soon.
N
At
this
point
you
know
what
you
were
describing
is
what
we
call
vaccine
tourism,
and
I
don't
want
anybody
to
have
to
cross
county
lines,
but
if,
if
they
live
close
to
a
county
with
low
uptake,
there's
oftentimes
same
day,
availability
in
that
in
those
appointments
and
if
they're
willing
to
drive
20
or
30
minutes,
they
welcome
to
go
over
there
and
get
it.
K
N
Yes,
sir,
so
it's
actually
higher
than
that
now,
since
these
slides
it's
about
1.94
or
1.9,
I
think
that's
close,
and
that
is
total
vaccinations
given.
So
that
is
also
reflective
of
about
1.265
million
tennesseans.
So
some
of
those
have
had
one
dose.
Some
of
them
have
had
two
doses
and
now
with
the
johnson
johnson
product.
N
That
is
a
one
dose
series,
and
so
we've
had
a
handful
of
folks
get
that
we've
only
had
about
50
000
doses
in
the
state
total
and
so
we'll
get
some
more
of
those
at
the
end
of
the
month.
Okay,
there's.
N
We
have
seen
that's
a
great
question.
We
have
seen
some
decrease
in
testing,
but
it's
holding
relatively
steady,
usually
between
16
and
20
000
a
day
is
a
good
average.
Compare
that
to
a
few
weeks
ago
it
was
about
25
000
a
day,
but
we
we
are
still
seeing
more
robust
testing
than
than
I
expected
actually
represented.
K
Miller,
I've
had
my
my
second
dose,
so
my
question
is:
should
I
possibly
take
another
test
and
there's
a
reason
why
I
asked
that
question
I
was
happened
to
be
walking
in
the
hall
today
and
I
heard
rumor
or
truth
that
a
couple
of
members
were
tested
positive
and
currently
they
are
quarantined
and
I'm
assuming
I've
been
in
contact
with
them.
There's
no
question
about
that.
N
So
I
have
good
news
for
you:
the
cdc
came
out
with
guidance.
I
think
it
was
monday
of
last
week
for
fully
vaccinated
people.
So
the
definition
of
fully
vaccinated
people
is
two
weeks
after
your
final
shot,
and
so
those
people
are
completely
exempt
from
testing
or
quarantine
if
they
come
into
close
contact
unless
you're.
Unless
you
have
symptoms
and
then,
if
you
have
symptoms,
you
should
talk
to
your
doctor
about
that,
but
you
don't
even
have
to
be
tested
or
quarantined.
A
Thank
you,
chair,
lady.
I'm
gonna
have
to
be
a
little
difficult
and
say
I'm
bringing
light
to
the
folks
who
don't
trust
the
vaccine.
I
don't
plan
on
taking
it
for
a
while,
if
take
it
at
all,
just
because
of
historical
distrust
of
vaccinations
and
what
they've
done
to
black
communities
and
historical
experimentations
and
a
lack
of
research,
but
I
do
want
to
know.
Have
you
seen
many
women
who
are
pregnant?
Take
the
vaccine?
A
If
so,
what's
the
impact
so
far
have
any
of
them
taken
a
vaccine
and
had
their
children?
How
are
their
children
doing
and
then
also
we
know
vaccines
have
a
correlation,
not
a
causation
but
correlation
with
autism.
Have
we
done
any
research
around?
Will
this
vaccine
correlate
with
children
getting
autism.
N
So,
thank
you
for
those
questions.
Let
me
take
the
latter
one.
First.
This
vaccine
is
not
approved
below
age
16
right
now,
and
it's
not
expected
anytime
in
the
near
future
to
be
below
12..
We
we
do,
expect
it
to
go
down
to
age
12.
So
that's
well
before
or
excuse
me
well
after
the
diagnosis
of
autism,
so
shouldn't
be
any
concern
there
related
to
pregnant
women.
We
actually
it's
been
newsworthy,
so
maybe
we're
one
of
the
few
states
that
have
done
it
have
added
pregnant
women
to
our
1c
high-risk
medical
conditions.
Category.
N
Even
though
the
vaccine
is
not
technically
approved
for
pregnant
women,
it
is
considered
safe.
The
american
college
of
obstetrics
and
gynecology
actually
recommend
it,
and
there
have
been.
I
believe
the
latest
number
is
over
20
000
people
in
the
clinical
trials,
who
became
pregnant
or
got
it
while
they
were
pregnant
and
did
just
fine,
so
it
it
is
a
risk
benefit
ratio.
We
we
do
have
to
weigh
that,
but
we
know
that
women
who
are
pregnant
and
get
infected.
N
They
have
a
higher
risk
of
morbidity,
mortality,
hospitalization
and
debt,
as
well
as
complications
of
their
unborn
or
newborn
child.
So
it's
it's
a
good
idea,
but
it
is
a
personal
choice.
A
Thank
you,
chair
lady.
You
also
expressed
that
the
intake
is
lower
in
west
tennessee
than
all
the
other
grand
divisions.
Can
you
explain
why.
N
In
west
tennessee,
it's
likely
because
that's
where
our
minority
populations
are
centered
in
rural
west
tennessee
and
then
just
in
rural
counties,
statewide
we're
seeing
it
a
pretty
low
uptake.
A
Representative
lamar,
thank
you
and
my
last
question
is
you
say:
you're
laying
off
100
jobs
to
bring
5
million
dollars
back
to
the
budget.
Could
you
talk
about
what
are
those
jobs?
If
you
I'm
sorry,
if
you
said,
and
I
missed
it,
but
what
are
some
of
those
jobs
and
what
are
the
primary
locations
of
those
jobs.
C
Thank
you,
dr
pierce.
We
appreciate
the
good
work
that
you
and
your
staff
been
doing
and
all
those
other
frontline
workers
appreciate
colleague
from
memphis
and
her
candor.
I
wanted
to
ask
about
flu
rates.
You
know
kind
of
what
happened
to
the
flu.
N
Well,
the
flu
we
didn't
have
a
flu
season
this
year
and
that's
a
good
thing,
because
in
all
seriousness,
it
would
have
been
devastating
for
our
hospitals.
We
did
a
lot
of
modeling
of
what
hospital
occupancy
from
flu-related
illness
is
in
a
mild,
moderate
and
severe
season,
and
when
our
hospitals
were
so
strained
back
in
november
december
january,
some
of
them
would
have
been
in
complete
crisis
standard
mode
if
they
had
flu
cases.
On
top
of
that,
it's
really
good.
We
didn't.
N
C
What
about
mental
health?
It
seems
like
on
this
frequent
on
this
study
united
health
foundation
report.
We
rank
47th
talk
about
the
mental
health
aspect
during
this
pandemic
and
what
you're
seeing.
N
Yeah,
I
think
we're
going
to
be
dealing
with
the
mental
health
fallout
of
the
pandemic
for
years,
and
you
know
if
you
just
think
about
even
the
healthiest
and
most
resilient
individuals,
we've
been
stressed
and
we've
had
grief
and
anxiety
and
lots
of
disruption
in
our
lives
and
then,
when
you
have
someone
who
doesn't
have
as
much
resilience
who
doesn't
have
stability
in
their
homes
and
lives
and
they
have
additional
stressors
poverty.
Unemployment,
we've
certainly
seen
a
rise
in
substance.
N
E
Dr
piercy,
I
don't
have
any
other
questions
on
my
list
unless,
when
I
see
no
hands,
I
want
to
thank
you.
I
spoke
too
quickly,
representative
miller.
We
were
so
close.
K
Thank
you,
madam
chair,
just
a
quick
question,
commissioner.
In
reference
to
to
shelby
county,
there
are
two
ways
that
individuals
can
can
to
get
an
appointment
either
online
or
there's
a
telephone
number
in
in
shelby
county
shelby
county
operating
both
online,
as
well
as
the
telephone
system.
N
E
You
know
problems
that
we
probably
will
be
seeing
in
mental
health,
and
you
know
from
what
I'm
reading
and
things
I've
been
told.
There's
some
long-term,
just
physical
health
problems
that
for
people
who
have
had
coveted
some
have
long
term
recoveries-
and
some
you
know-
are
continuing
for
months
and
months
to
deal
with
issues.
So
while
I
hope
the
the
height
of
the
pandemic
is
behind
us,
it's
certainly
coveted
19
is
not
something
that
we're
going
to
be
putting
in
our
rear
view,
mirror
totally
for
for
quite
some
time.
E
But
I
want
to
thank
you
again
and
we
spent
all
this
time
on
covet
because
it's
top
of
mind,
but
we
do
recognize
that
your
department
does
a
number
of
other
things
across
the
state
and
we
thank
you
for
taking
care
of
the
health
of
tennesseans,
and
I
want
to
take
this
opportunity
for
a
shout
out.
E
Hamilton
county
becky
barnes
is
our
director
there
and
I
just
think
they
have
done
an
amazing
job
with
you
know
in
very
trying
circumstances,
particularly
initially
when
there
was
the
first
dosage
and
it
was
advertised
and
they
were
absolutely
overwhelmed
with
people
who
wanted
it
and
managing
through
that
process
and
that
they
have
set
up
a
it's.
It's
very.
The
logistics
are
great
people,
you
know
go,
it's
happens
on
time
and
it's
it's
been.
E
You
know,
after
a
few
rough
weeks,
and
that
was
totally
because
of
the
unknown
quantity
of
supply
and
no
ability
to
control
who
showed
up
when
so.
I
just
want
to
give
them
a
shout
out
and
I'm
sure
that
other
members
here
feel
the
same
way
about
their
health
departments
across
the
state.
But
thank
you
again
for
all
that.
You
do,
and
we
thank
you
for
being
here
with
us
today.