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Description
House Finance, Ways, Means & Committee- February 8, 2022- House Hearing Room 1
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A
quorum,
thank
you,
madam
clerk.
Are
there
any
personal
orders
or
announcements
seeing
none?
I
would
like
to
take
this
opportunity
to
introduce
our
committee
staff,
as
we
have
not
done
that
during
the
session.
So
far
we
have
our
legislative
budget
director,
jessica,
himes,
who
stepped
out
she'll,
be
back.
A
We
have
fiscal
review
director,
christilie
carson,
that
I
know
all
of
you
know
already
our
attorneys
joel
hayes,
doug
garrett
and
anastasia
campbell
and
right
now,
they're
leaving.
Oh,
we
have.
We
have
one
in
the
house,
so
we
are
not
without
legal
advice.
Thank
you.
My
administrative
assistant
miles
buehl,
I'm
not
sure.
If
he's
still
here
and
research
analyst
man
attorney
two
I'm
gonna
get
that.
A
A
A
A
All
amendments
have
to
be
filed
with
the
full
committee
through
the
corresponding
outlook
distribution
list.
This
process
will
automatically
request
a
fiscal
memo
in
your
behalf,
so
you
don't
have
to
do
that
separately
and
in
the
past
again,
no
change
finance
committee.
We
do
not
accept
verbal
amendments
in
this
committee
and
the
deadline
to
submit
proposed
committee
amendments
is
monday
at
10.
Am
so
again
nothing
new
just
a
reminder
of
how
we
have
normally
done
our
business,
also
just
as
a
kind
of
order
of
business,
so
everybody
will
know
what
to
expect.
Today.
A
We
do
have
two
bills
on
the
calendar
we're
going
to
be
taking
those
up,
then
we're
going
to
be
hearing
from
the
department
of
health
and
the
department
of
human
services
following
those
presentations.
We'll
also
have
just
a
brief
hearing
on
their
budget
expansion
requests
which
have
been
submitted
so
without
further
ado.
We
will
get
underway.
The
first
item
on
our
calendar
is
house
bill.
14.
C
Thank
you
chairman
and
committee
house
bill
1392
is
is
a
a
very
simple
bill.
It's
a
it's
a
statewide
bill.
It
simply
authorizes
local
governments
to
regulate
entertainment,
transportation.
It
defines
entertainment.
Transportation
is
a
motor
vehicle
for
hire
that
provides
entertainment
and
transportation.
A
D
D
It
leaves
the
vagueness
about
whether
those
existing
businesses
could
be
discriminated
against.
In
my
opinion,
they've
put
out
capital
they've
been
working
in
this
space
for
some
time
now
they
have
contracts
for
advertisement.
They
have
bookings
at
certain
prices
and
if
the
locals
decide
to
put
more
restrictions
on
them,
then
they
shall
issue
the
permit
if
they
answer
all
those
questions
and
and
provide
the
insurance
and
do
all
the
things
that
are
requested.
That's
all
it
does.
It's
simply,
in
my
opinion,
a
bill
that
protects
private
businesses
from
in
an
unregulated
space.
E
F
F
D
Thank
you,
madam
chair.
This.
The
amendment
as
it
is
written
is
to
address
only
the
existing
businesses
in
that
space.
So
if
they
decide
in
the
future,
if
the
locals
decide
in
the
future
that
this
one
is
enough
or
this
10
is
enough,
whatever
there
is
right
now,
then
they
certainly
can
restrict
those.
It
would
not
have
any
effect
on
those
in
the
future.
C
C
C
The
the
bill
came
back
on
transportation.
At
the
beginning
of
the
year,
passed
out
of
transportation
went
through
finance,
saab
passed
out
of
finance
sub.
We
are
now
sitting
here
at
the
full
finance
committee,
with
an
amendment
being
put
on
the
bill
that
does
nothing
or
says
nothing
about
the
it's
it's
a
date
of
april.
First,
it
leaves
the
the
possibility
that
an
operator
could
go
out
and
get
100
permits.
C
200
permits,
500
permits
and
the
city
would
have
no
ability
to
to
to
to
to
limit
to
to
to
the
point
of
my
colleague
a
second
ago,
the
number
of
vehicles
on
the
road.
We
had
an
event
last
weekend
with
a
large
a
fast
food
restaurant
was
in
town,
6,
000
people.
They
had
a
bunch
of
buses
parked
on
the
road
it
literally
shut
down
the
city.
C
People
could
not
operate,
they
couldn't
move
around
the
city
if
we
are
not
able
to
to
limit
the
number
of
buses
and
and
on
the
road
at
any
given
point
it's
a
it's
a
safety
hazard,
heaven
forbid
somebody
has
a
heart
attack,
downtown
and
or
a
bar
restaurant
catches
fire.
We
will
not
be
able
to
get
life
safety
there,
and
you
know
I
have
been
working
this
bill.
I've
probably
talked
to
everybody
in
this
room
more
than
once
it's
very
important
for
my
community.
C
It
will
be
very
important
for
you,
your
community
very
soon,
and
I
ask
everybody
to
not
support
the
amendment
support
the
bill,
as
is
it
couldn't
be
simpler.
It's
a
very
straightforward
bill
that
gives
local
authority
to
regulate
a
local
issue,
and
with
that
I've
asked
for
you
to
not
support
the
amendment,
I'm
not
sure
what
the
exact
policy
or
what
do,
I
need
to
say.
Yeah
vote
vote,
no
yeah!
G
Thank
you,
madam
chair,
and
to
the
amendment
sponsor.
I
appreciate
the
the
the
effort
to
protect,
I
would
say
new
business,
but
I
do
think
and
I'll
agree
with
the
bill
sponsor.
They
need
the
ability
to
regulate
this
industry
and,
in
essence,
I'm
afraid
that
your
amendment
would
grandfather
certain
businesses
in
place
and
actually
lower
the
bar
that
we're
going
to
put
on
this
industry.
So
I'm
just
afraid
that
your
amendment
might
have
unintended
consequences
but
I'll
rest.
Thank
you.
H
Thank
you,
representative
freeman.
I
I
appreciate
your
work
as
it
relates
to
this
very
important
topic
in
your
district
I'll,
be
supporting
chairman
todd's
amendment.
The
reason
why
I'm
supporting
chairman
todd's
amendment
is
because
these
people,
that
would
be
impacted,
if
we
don't
grandfather
them,
will
not
be
able
to
operate
their
businesses,
there's
no
guarantee
that
they
would
they've
gone
out
and
made
great
investment
invested
in
this
community.
There's
argue
there
could
be
argument,
they're,
good
actors
or
bad
actors,
but
this
your
bill
would
still
regulate.
H
Those
folks
and
regulation
is
what
you
wanted.
I
think
that's
what
everybody
on
this
committee
wants
to
do
is
to
regulate,
but
the
concern
is:
is
metro.
Nashville
council
has
a
history
of
running
people
out
of
business
because
with
their
permits
process
all
it
says.
If,
if
they
want
to
be
a
good
actor,
then
they
shouldn't
have
a
problem
with
doing
this,
and
so
I
can
appreciate
the
concerns
I
think
they're
the
posture
in
this
this
this
amendment,
maybe,
would
give
us
an
opportunity
to
have
a
further
discussion
about
it,
but
I
don't.
H
I
don't
understand
why,
if,
if
they
really
cared
that
this
business
was
grandfathered
in,
why
oppose
the
amendment
all
it
does?
It
says
the
number
of
people
that
are
registered
now
or
these
vehicle
registrations
that
are
purchased
they'd,
be
able
to
currently
operate
their
business,
and
so
to
me
it
seems
like
by
the
it
is
an
admission
that
you
want
to
run
these
people
out,
not
you
personally,
but
that
the
municipality
wants
to
run
this
one
entity
out
of
business
because
they
won't
grandfather
the
men.
H
D
Thank
you
chair.
This
certainly
does
not
grandfather
any
existing
business
in
from
the
standpoint
of
the
new
regulations
of
the
new
permit
process.
It
just
says:
if
you
jump
through
all
the
hoops
at
the
municipal
lays
out
in
their
permit
process,
then
you
shall
be
issued
a
permit.
That's
all
it
says
so
that
they
cannot
just
indiscriminately
put
that
company
out
of
business
or
those
companies
that
exist.
D
C
Thank
you
and-
and
I
again
appreciate
the
intent
this
this
whole
thing
is
a
pro-business
bill.
It's
supporting
a
business,
getting
it
into
a
safe,
regulated
space
that
they
that
people
know
are
going
to
be
able
to
get
to
get
off
the
the
bus
at
the
end
of
the
trip,
and
it's
it's
a
safe
space,
the
the
the
comment
of
they
may
or
may
not
issue
the
permits.
C
C
We've
got
to
be
able
to
regulate
the
number
of
buses
on
the
roads
and
and
if
this
passes,
we
can't
do
it,
and
I
know
that
you
are
willing
to
change
the
date,
but
I
mean
we
have
been.
We've
been
dealing
this
with
this
for
a
year
and,
if
you're
willing
to
change
a
date
to
me,
that's
an
admission
that
there
is
maybe
a
not
so
perfect
solution
in
front
of
us
with
this
amendment.
So
again
I
ask
that
you
vote
no
for
the
amendment.
I
Thank
you,
madam
chair.
This
legislation
has
been
heavily
blobbing
for
lack
of
a
better
word
and
I'm
still
a
little
bit
confused
on
it.
But
I'm
curious-
and
I
don't
know
if
this
is
for
chairman
todd
or
for
representative
freeman
with
the.
If
the
amendment
goes
on
the
legislation,
are
we
talking
about
one
company
being
affected
or
is
it
the
entire
industry
representative
williams
mentioned?
D
Thank
you,
madam
chair,
my
answer
to
that
we
would
be.
I
don't
know
how
many
people
are
in
this
space
right
now.
I
don't
even
care
at
this
point.
They're
operating
and
metro
is
looking
at
putting
regulations
on
them
and
a
permit
process
in
place,
and
the
bill
before
it's
amended
says
that
we're
allowing
metro
and
and
other
municipals
to
put
those
regulations
right
now
they
can't
do
that
they
can't
regulate
them,
so
we're
allowing
them
to
regulate
and
I'm
not
opposed
to
the
bill
at
all.
I
just
wanted
to
say
for
those
existing
businesses.
D
However,
many
there
are,
if
it's
1
or
50.,
I
don't
know,
don't
care
that
we're
fair
to
them,
we're
going
to
treat
them
fairly
and
say
if
you
jump
through
all
these
permit
hoops
you're
going
to
get
a
permit.
That's
all
I'm
saying
that
we're
not
putting
somebody
out
of
business
unfairly.
I
think
it's
unreasonable
to
change
the
rules
in
the
middle
of
the
game
without
giving
them
a
fair
opportunity.
That's
all
this
is
about.
C
C
I
ran
this
bill
last
year
because
there
was
confusion
agreed
to
roll
it
to
this
year.
So,
from
the
end
of
last
session
to
january,
we
have
been
working
to
to
finesse
the
the
what
this
ordinance
would
look
like
and
at
no
point
along
that
process
was
there
any
fear
conversation
about
this.
I'm
I'm
afraid
that
that
this
is
some
some
some.
C
You
know
people
within
the
industry
that
just
they
they
want
to.
They
don't
like
the
regulation
and
so
they're
trying
to
so
confusion
again,
you
were
initially
confused
over
what
we're
doing.
I
ask
that
everybody
vote
against
the
amendment.
Let's
pass
a
very
simple,
straightforward
piece
of
legislation
that
simply
gives
municipalities
the
ability
to
regulate
this.
It's
a
state
licensed
vehicle
and
the
the
municipalities
need
our
approval
to
be
able
to
regulate
them.
That's
all
I'm
asking.
H
They,
some
of
these
people
could
have
bought
two
buses.
Some
people
could
have
bought
15.,
but
if
they
go
through
this
permit
process
of
regulation,
of
which
we
all
want
statewide,
then
what
could
happen
is
that
metro,
council
or
severe
county
or
whoever's
doing
it
could
say
no,
we,
we
know
you
had
10
before,
but
we
only
want
you
to
have
two.
H
If
the
the
bill
sponsor
may
give
me
some
comfort
if
he
wanted
to
say
that
the
metro
council
has
done
a
study
as
it
relates
to
their
ordinance
and
they
feel
like
only
10,
buses
are
appropriate.
At
least
we
could
have
a
window
into
what
it
is
there,
how
many
they're
wanting
to
regulate,
but
we're
not
saying
this,
and
as
it
relates
to
working
on
this
a
year,
there's
no
doubt
he
has
worked
very
very
hard
on
this.
H
Next
thing
you
know
the
the
the
governing
body
decides,
they
don't
want
to
issue
permits,
even
though
they
met
their
requirements
in
the
ordinance,
and
so
it
really.
It
is
really
concerning
for
me,
and
so
I
think
that
whoever
the
business
is
they,
if
they're
operating
now,
they
should
be
able
to
operate
tomorrow,
and
that
the
new
growth
and
the
existing
business
should
be
regulated.
J
Thank
you,
chair,
lady
and
just
kind
of
I
guess
piggy
backs
on
what
the
chairman
williams
was
just
talking
about
so
and
chairman
todd
just
a
hypothetical.
So
if
I'm
an
owner-
and
I
have
15
of
these
entertainment
buses
so
right
now,
there's
no
limit.
I've
got
15
an
ordinance
changes.
It
says,
okay,
you
can
only
have
more
than
you
can't
have
any
more
than
five.
So
at
that
case,
what
what
would
this
amendment
do
to
me?
I
guess
if
I've
got
15
the
ordinance
changes
to
five,
then
what
happens?
D
Thank
you,
mr
chair.
If
you're
in
business
right
now
prior
to
april
1st
this
year,
then
you
would
have
to
comply
with
all
of
the
permit
requirements
that
the
city
council
passes.
That
goes
into
effect
on
april
1st,
and
if
you
do
that,
then
they
shall
issue
a
permit
for
what
you
currently
have.
I
think,
if
you
add
any
more,
my
intention
would
be
that
we're
not
adding
any
more
people
to
this
space.
Necessarily
from
the
standpoint
of
of
this
grandfathering
in
and
the
grandfathering
is
only
from
the
standpoint
of
current
permitting.
D
You
know
well
current
operation,
not
permitting
that
if
you're
operating
now
they're
not
going
to
put
you
out
of
business,
that's
the
main
issue
here
is
they
shall
issue
the
permit,
not
may
issue
the
permit.
I
just
don't
want
to
leave
it
up
to
their
discretion
to
pick
winners
and
losers
from
a
space.
That's
that's
already
there
from
businesses
that
are
already
operating
that
have
customers
booked
that
have
advertisers
booked
for
part
of
this
year.
C
C
Municipalities
have
got
to
be
able
to
regulate
how
many,
how
many
of
those
party
buses
are
on
the
road
at
any
given
point
I
I've
said
over
and
over
again
and
I'll
say
it
again.
I
have
no
interest
or
desire
to
put
anybody
out
of
business,
but
that
same
business
could
be
a
bar
downtown
and
if
you
can't
a
restaurant
downtown
and
if
you
can't
get
to
that
bar
restaurant,
that
bar
restaurant
goes
out
of
town.
C
K
I
think
we
need
to
support
freeman
on
not
accepting
this
amendment,
because
I
think
we're
going
to
be
tying
their
hands
and
there's
going
to
be
some
unintended
consequences
by
doing
so.
So
I
would
ask
that
you
just
vote
against
the
amendment
and
just
let's
just
pass
it
clean
and
allow
the
locals
to
first
off
get
a
hold
and
manage
what
we
have
and
then
start
charting
of
course
forward.
L
L
L
And
one
more,
madam
chair,
so
I
the
concern
I
have
with
the
amendment
is
the
date.
So
if,
if
we
put
the
amendment
on,
is
there
anything
within
the
within
your
amendment
to
keep
those
business
owners
from
immediately
doubling
their
fleet
taking
additional
steps
for
expansion
until
april
1st,
which
creates
a
larger
issue
for
davidson,
because
these
entities
have
expanded
beyond
what
their
current
operation
is?
With
the
expectation
of
april
1st.
D
Resident
todd-
thank
you,
madam
chair.
This
doesn't
address
the
number
of
units
any
company
has
now
or
will
have
in
the
future.
So
any
of
them
right
now
before
this
ordinance
goes
into
place
april.
1St
can
add,
as
many
units
as
they
want
to
all
we're
doing
with
the
bill
is
allowing
them
the
ability
to
pass
that
ordinance
and
make
it
go
into
effect
april.
1St.
D
The
amendment
says:
if
you
do,
that
any
business
that's
currently
operating
then
doesn't
address
how
many
units
they
have,
but
and
and
it's,
but
they
would
still
be
able
to
operate.
If
they
comply
with
the
permit
process,
they
shall
be
issued
a
permit.
That's
all
it
says
for
the
sponsor
to
to
bring
this
and
say
that
he's
worked
on
this
for
over
a
year,
but
not
even
know
how
many
businesses
are
operating
in
this
space
is
kind
of
odd
to
me.
If
we've
got
that
big
of
a
problem,
that's
created
this.
D
I
would
think
there's
some
number
that
there's
a
number
known
by
the
city
council
that
they've
been
advertising
to,
say
you
know,
we've
got
a
hundred
and
we
should
only
have
ten,
but
that
hadn't
been
communicated.
So
apparently
we
don't
have
an
issue
right
now,
except
they're
not
regulated,
and
this
the
bill.
D
Anybody
on
this
committee
that
is
pro-business
that
understands
what
it
is
to
run
a
small
business
to
make
an
investment.
I
don't
see
how
you
could
be
against
this
amendment.
It's
it's
really
straightforward.
It
just
says:
if
you
comply
with
the
permit
process,
which
we
would
allow
with
the
bill,
you
shall
be
issued
the
permit,
that's
it,
but
you
have
to
comply.
L
Thank
you,
madam
chair,
and
so
I
support
I
support
the
structure
of
in
the
intent
of
the
amendment.
My
concern
is:
what's
going
to
happen
to
the
market
between
now
and
april
1st
and
as
someone
who's
I'm
on
finance
full.
I
have
not
seen
this
legislation
or
this
amendment
until
I
read
it
today
and
I've
been
lobbied
by
both
sides.
So
if,
if
this
committee
is
willing
based
on
this,
I
think
we
could
probably
find
some
common
ground,
because
just
based
on
the
discussion
we're
having
just
right
up
here
in
the
split
on
the
amendment.
C
C
I
do
know
that
we've
we've
talked
to
most
of
them
most
of
the
industry
and
the
the
number
of
buses
is
the
real,
the
real
question-
and
I've
said
this
again
and
again,
if,
if
metro
overreaches,
which
I
don't
believe
they
will
or
if
knox,
county,
overreaches
or
shelby
county
reaches
I'll,
be
the
first
person
to
come
back
and
and
do
something
to
fix
this,
but
we've
got
it,
we've
got
to
give
them
the
ability
to
do
it.
So
thank
you.
A
A
A
We
will
continue
with
budget
hearings.
First
up
will
be
the
department
of
health,
and
I
must
make
a
correction
earlier.
We
I
mentioned
that
we
would
go
straight
from
the
department's
presentation
to
their
expansion
request,
but
we
did
not
put
that
in
our
notice,
so
we
will
hold
that
expansion
request
hearing
at
a
later
time.
So,
but
if
you
will
please
come
forward
and
we'll
begin
with
telling
us
about
your
budget,
dr
piercy.
M
M
The
largest
line
item
is
that
for
our
dental
services
pilot
program.
You
have
probably
heard
me
and
others
talk
about
that.
In
the
past
we
convened
a
stakeholder
work
group
of
about
22
or
24
folks
that
met
multiple
multiple
times
throughout
spring
summer
and
into
the
fall
mostly
from
dental
schools,
private
sector,
private
dentist,
rural
areas
and
came
up
with
a
recommendation
for
a
multi-year
way
to
address
the
significant
shortage
of
dentists
and
access
to
dental
care
in
tennessee.
The
original
proposal
is
five
years
and
94
million
dollars.
M
What
you
have
here
on
the
screen
represents
the
first
year
of
that
at
just
shy
of
11.9
million
dollars.
The
overall
proposal,
including
this
first
year,
is
about
two-thirds
to
the
dental
schools,
to
increase
their
class
size
and
the
other
third
would
be
administered
by
the
department
for
recruitment
to
rural
areas.
Loan
repayment,
as
well
as
some
ancillary
services
for
the
underserved
like
prosthodontics
things
like
dentures,
etc.
M
M
M
These
are
primarily
clustered
in
middle
tennessee
and
sevier
county
we've
had
significant
growth
in
our
restaurants.
A
typical
caseload
should
be
around
800
right
now.
Those
guys
are
handling
between
thousand
and
twelve
hundred
on
their
caseloads
apiece.
So
this
would
be
to
even
out
that
workload
and
respond
to
the
increased
demand
for
restaurant
inspections
in
those
two
areas.
M
Number
four
is
for
two
positions
in
our
board
of
nursing,
they're,
administrative
positions
that
have
been
filled
with
contract
employees.
It
is
now
to
the
point
where
that
is
costing
us
more
than
it
would
be
to
employ
them,
so
that
does
add
to
ftes,
but
that
is
in
replacement
of
contract.
Employees
numbers
five
and
six
are
in
our
licensure
and
regulation
department
or
division,
and
this
is
also
just
the
increased
workload
and
increased
caseload.
This
is
to
speed
up
throughput
and
be
better
responsive,
more
responsive
in
a
timely
manner
to
our
licensees.
M
Both
of
these
amounts
are
covered
through
board
fees,
but
those
are
recognized
as
state
income,
and
so
I
just
wanted
to
make
that
note,
for
you
number
seven
is
our
suicide
prevention
director
position
that
is
currently
filled,
and
but
it
has
been
filled
with
short-term
funding
this,
which
it
expires
this
next
year,
and
so
this
would
just
be
to
solidify
that,
with
recurrent
funding
for
a
very
crucial
position.
Very
important
work.
M
M
So
if
you've
ever
heard
of
a
variant
for
any
type
of
infectious
disease-
and
there
are
variants
in
other
diseases
other
than
coping-
that
work
is
expanding
very
very
rapidly.
Actually,
I
had
the
pleasure
of
taking
chairman
watson
on
a
tour
of
the
lab
yesterday,
and
that
was
one
of
the
things
that
my
staff
brought
up
to
him
right
off
the
bat,
which
is
how
much
our
genomic
sequencing
work
has
increased.
M
In
many
many
conditions,
they've
already
had
to
expand
that
space
into
conference
areas
and
double
up
other
spaces,
and
so
we
need
a
bioinformatics
technician
to
be
able
to
run
that
work.
Number
nine
is
an
additional
attorney
in
our
office
of
general
counsel.
As
you
probably
can
guess,
we
are
inundated
with
records,
requests
and
lawsuits
and
all
of
the
things
pertaining
to
what
we've
been
through
over
the
last
couple
of
years,
and
so
this
is
a
another
reclassed
position,
not
adding
an
fte
but
asking
for
recurring
state
funds
for
an
additional
attorney
position.
M
The
biggest
item
on
here
is
our
15
million
dollar
request
for
a
lars
upgrade
lars
is
the
software
system
that
is
done
for
our
licensees.
We
license
over
300
000
tennesseans
in
hell
across
multiple
health
professions,
and
lars
has
served
us
relatively
well.
You
know
that
was
our
first
attempt
at
going
from
somewhat
of
a
paper
system
to
an
electronic
system.
M
It
does
not
have
all
of
the
if
you're
familiar
with
the
terms
ui
and
ux
as
it
pertains
to
software,
that
our
licensees
need
and
want
particular
to
to
be
able
to
do
that
in
a
user-friendly
way
on
mobile
devices
and
in
tablets,
and
so
this
would
be
coming
from
dedicated
board
reserve
funds.
So
this
is
not
out
of
the
state
budget.
This
is
out
of
our
board
reserves.
M
The
last
few
items
are
also
not
pertaining
to
ftes,
but
some
smaller
amounts
for
operational
needs.
Number
11
is
to
improve
our
data
analytics
in
our
office
of
informatics
and
analytics.
This
is
primarily
our
overdose
and
substance
use
data,
but
it
also
encompasses
many
other
things
throughout
the
department
and
they
need
some
additional
funding
to
help
streamline
that
work.
M
Number
12
is
something
for
to
add
to
our
routine
lab
equipment
replacement
cycle,
so
we
came
to
you
last
year
and
you
were
very
gracious
to
allow
us
500
000
a
year
to
replace
our
root
in
our
routine
replacement
of
lab
equipment.
This
is
adding
another
500
to
that,
so
we
will
be
on
a
fully
funded
routine
equipment
replacement
cycle
in
the
lab,
as
you
can
imagine
that
laboratory
equipment
has
been
used
quite
a
bit
lately
and
it's
very
expensive.
M
Finally,
the
last
one
is
a
payroll
realignment
in
our
office
of
informatics
and
analytics.
This
is
this
has
been
federal
funding
going
to
the
payroll,
but
the
grants
related
to
this
federal
funding
are
very
restrictive
in
what
we
need
to
be
able
to
do
so.
We're
requesting
to
shift
the
payroll
functions
to
stay
to
the
state
dollars
and
keep
that
federal
funding
and
use
it
for
other
purposes.
So
we
don't
have
to
work
under
those
restrictions
of
those
federal
grants.
M
The
next
slide
is
something
that
this
committee
had
asked
us
to
bring
forth
and
it's
essentially
which
non-recurring
funds
are
going
to
expire
after
this
year.
So
on
the
state
side,
we
are
going
to
have
three
million
dollars
in
the
safety
net
in
non-recurring
safety,
net
funding,
expire
and
I'll.
Take
the
the
privilege
of
editorializing
for
about
15
seconds
here
on
this
safety
net
funding
is
extraordinarily
important.
That
is
how
we
take
care
of
our
uninsured
and
underserved
tennesseans.
M
M
M
M
M
I
was
making
the
point
earlier
that
some
of
this
was
through
crf.
The
total
has
been
about
170
million,
maybe
just
a
little
shy
of
that,
but
120
of
that's
from
arp.
The
rest
is
from
crf
the
reason
we
changed.
The
name
is
because
we
are
expanding
that
not
only
to
hospitals
but
now
to
include
nursing
homes
and
long-term
care
facilities.
M
The
second
bullet
point
is
one
that
I'm
really
excited
about.
Your
local
mayors
are
really
excited
about
because
they
they
call
very
often
with
with
gratitude,
and
you
should
be
proud
of
it
as
well.
This
is
just
shy
of
130
million
dollars
for
improvements
in
local
health
departments
and,
if
there's
anything
that
public
health
does
well
is
maximize
services
with
little
resources,
and
so
we
want
to
make
sure
that
our
facilities
are
up
to
par
and
up
to
the
standards
that
our
patients
and
tennesseans
expect.
M
So
with
this,
nearly
130
million
dollars
we're
going
to
be
able
to
make
available
a
minimum
of
450
000
to
every
single
health
department
of
our
rural
health
departments
in
the
state
and
17
of
our
rural
health
departments
are
going
to
be
fully
replaced.
We
were
able
to
undertake
a
facilities
review
from
our
internal
facility
staff
and
we've
had
kind
of
a
wish
list
for
several
years
now.
M
I
mentioned
that
chairman
watson
and
I
toured
it
yesterday
if
you'd,
like
a
tour
of
it,
it's
one
of
my
favorite
places
to
go.
I'm
happy
to
take
you
out
there.
It's
a
really
neat
space,
but
what
you
will
see
it
was
built
in
1950
as
an
old
tuberculosis
hospital,
and
so,
as
you
go
through
the
building,
what
you
see
is
not
only
is
it
sort
of
inefficiently
laid
out
because
you've
got
all
of
the
patient
rooms
you
so
they've
taken
out
the
walls,
but
you
can
see
where
the
patient
rooms
used
to
be.
M
It's
also
no
longer
efficient
for
the
the
innovative
technology
that
we
have.
It
there's
lots
of
machines
that
connect
to
each
other
people
that
need
to
work
with
each
other
on
this,
and
so
this
has
been
a
200
million
dollar
replacement
facility
in
the
same
general
spot
out
in
east
nashville,
close
to
tbi
and
where
the
state
medical
examiner's
office
is,
and
so
we
are
really
looking
forward
to
that.
M
M
M
So,
on
the
prevention
side
of
things,
these
are
actually
our
strategic
objectives.
In
our
strategic
plan
you
can
see
there
are
five
on
the
prevention
side,
so
one
is
improve
local
health
metrics
by
doing
what
that
local
community
needs,
the
mechanism
by
which
is
accomplished
through
county
health
assessments
administered
by
county
health
council,
so
supporting
them
and
moving
them
along
their
journey.
Recognizing
that
the
fact
that
lawrence
county
and
knox
county
do
not
have
the
same
needs.
M
You've
heard
us
talk
many
times
about
our
objective:
to
decrease
tobacco
use.
That
is
not
only
trying
to
prevent
that
upstream,
primarily
in
youth
and
as
it
pertains
to
electronic
cigarettes,
but
also
offering
cessation
services
to
everyone,
particularly
pregnant
women,
where
we
know
outcomes
are
better
when
they
stop
smoking
during
pregnancy.
That's
through
the
baby
and
me
tobacco-free
program,
but
also
other
cessation
services
like
the
quit
line
and
and
services
for
adults.
Decreasing
substance
misuse
is
certainly
one
of
our
priorities.
M
One
of
our
very
strong
programs
that
that
is
evidence-based
has
it
in
the
name
evidence-based
home
visiting,
as
well
as
a
trauma-informed
training
to
people
in
our
communities
to
know
how
to
respond,
and
then,
if,
if
you
caught
on
to
the
prevention
and
access,
you
might
have
thought
of
health
and
health
care.
We
are
a
public
health
agency,
but
we
also
support
the
health
care
side
of
things,
particularly
as
it
pertains
to
those
uninsured
populations.
M
We
we
have
about
56
primary
care
clinics
across
our
system,
but
we
also
want
to
do
what
we
can
to
support
those
others.
You
heard
me
reference
earlier:
the
safety
net,
so
for
those
patients
that
we
serve
ourselves
across
tennessee,
we
want
to
be
as
clinically
efficient
and
high
quality
as
just
as
any
other
provider.
Every
tennessean
deserves
that,
and
so
we
want
to
be
able
to
make
sure
we're
doing
that,
just
as
if
they
were
to
get
services
anywhere
else.
M
Likewise,
we
want
to
support
external
access
to
primary
care
and
other
services
to
health
care
for
all
tennesseans,
particularly
in
those
underserved
areas
in
our
rural
areas.
The
dental,
the
dental
proposal
that
we
put
forth,
certainly
addresses
that
and
then
one
one
strategic
objective,
that's
a
bit
more
conceptual
versus
practical
or
actual,
is
how
we
leverage
innovation.
M
So
how
do
we
take
what
we
see
and
what
we
know
and
help
inform
decisions
not
only
on
the
state
level
but
on
the
federal
level
to
innovate,
on
our
delivery
models
and
our
reimbursement
mechanisms
to
make
sure
that
we
broaden
access
and
do
it
in
the
most
cost,
efficient
and
affordable
way
chairman?
I
think
that
is
it
for
us
and
we
are
happy
to
take
questions.
A
A
Can
you
help
me
understand
exactly
what
we're
doing
in
that
arena,
because
it
seems
to
me
that
I
see
more
and
more
people,
particularly
younger
people,
vaping,
and
I'm
not
sure
that
we
have
a
really
good
idea,
sometimes
of
what's
even
in
the
what
material
it
is
that
that
they
are
taking
into
their
bodies.
So
how
are
we
addressing
that
issue?.
M
That's
a
an
excellent
question,
because
it's
something
that
we
have
certainly
seen-
and
there
appears
to
be
a
mentality
that
electronic
cigarettes
are
vaping,
is
somehow
safer
than
than
combustible
tobacco,
which
we
all
know
is
not
I'll.
Ask
dr
mcdonald
to
speak
to
some
of
our
efforts
on
both
the
youth
prevention
side,
as
well
as
adult
cessation.
N
Sure
I'm
happy
too
and
chairman
you're
right.
The
incidence
of
youth
vaping
is
certainly
increasing
across
the
country
we've
seen
pre-pandemic
and
then
during
pandemic
women,
one
in
four
one
in
five
high
schoolers
has
vaped
in
the
last
30
days,
and
so
we
have
actually
partnered
with
youth
across
the
state
and
a
number
of
youth
youth-driven
efforts
to
both
engage
them
in
that
messaging.
You've,
hopefully
seen
some
billboards
across
the
state
really
featuring
them
and
their
work,
because
we
feel
like
very
strongly.
A
Right,
thank
you
and
then
on
to
my
broader
question,
the
your
department
received
over
a
billion
dollars
in
coveted
relief
as
of
december
of
last
year.
Can
you
just
kind
of
since
we
last
met
here
in
november?
Can
you
kind
of
tell
us
how
those
dollars
have
been
allocated
and
give
us
some
updates
on
how
that
funding
is
being
used
or
directed.
M
Hats
is
not
quite
as
impactful
in
someone's
life
as
providing
hospital
care
when
somebody's
dying,
and
so
we
have
to
get
our
hospitals
and
our
long-term
care
facilities
staffed
appropriately,
because
the
consequences
are
too
high
not
to
do
that,
and
so
when
hospitals
particularly
have
been
faced
with
these
staffing
challenges,
they
go
to
their
typical,
well
I'll,
just
use
a
contract
agency.
Well
when
the
contracts
rate
contract
rates
are
three
and
five
and
seven
times
higher
than
what
they
have
been,
then
they
find
themselves
in
a
completely
unsustainable
situation.
M
So,
in
order
to
try
to
mitigate
the
hit
that
hospitals
have
been
taking,
we've
been
supporting
them
with
staffing
assistance.
It's
been
our
first
and
foremost
important
work
with
that
money.
We
will
continue
doing
that.
The
other
funds
support
all
of
the
other
things
that
we've
been
doing
through
the
response,
which
is
testing
contact,
tracing
vaccine
marketing
of
all
of
those
and
then
the
other
things
that
you
saw
on
there
related
to
our
health
departments
and
our
lab
john.
You
want
to
fill
something
in.
O
O
J
A
H
H
M
Thank
you.
Thank
you
for
the
question
chairman
because
there's
been
an
interesting
turn
of
events,
literally
in
the
last
couple
of
weeks
on
that
so
you're
correct
in
that
the
extend
contract,
expired,
131
and
then
we've
been
in
a
procurement
process
for
the
last
several
weeks
in
order
to
select
a
new
vendor,
and
that
has
already
that
bid
has
been
awarded.
M
The
interesting
thing
that
has
happened
in
the
meantime
is
that
I
don't
know
how
many
five
six
seven
of
the
national
associations
have
come
out
and
said:
universal
contact
tracing
isn't
a
isn't
relevant
anymore.
You
need
to
focus
your
contact,
tracing
efforts
on
high
risk
settings
like
nursing
homes
and
specialized
outbreaks,
so
john
may
want
to
fill
you
in
a
little
bit
more
if
you're
interested
but
we're
having
those
negotiations
with
the
new
vendor
now
to
say
this
bid
that
we
put
out
for
you.
M
M
H
O
What
we've
done
is
we've
awarded
the
contract
or
we've
we've
made
the
award,
we're
not
decreasing
the
services
that
were
part
of
the
award,
we're
leaving
it,
as
is
with
most
contracts.
The
state
is
not
required
to
do
a
minimum
amount
of
work
for
anyone
and
we're
just
reiterating
that
fact.
Okay,
thank
you.
A
M
E
Thank
you
for
what
you
and
your
team
have
done,
especially
over
the
last
couple
of
years.
I
know
when
you
were
first
asked
by
the
governor
to
be
commissioner.
You
did
not
anticipate
to
be
in
the
midst
of
a
pandemic,
so
that's
correct
literally.
Thank
you
very
much
for
your
work
and
for
your
team's
work.
It's
been
a
very
difficult
journey.
E
So
with
that
in
mind
throughout
the
pandemic,
and-
and
you
mentioned
this
a
while
ago-
our
safety
net
funding
and
our
providers-
there
have
been
extremely
important
if
you
could
detail
just
a
little
bit
and
I've
got
a
couple
of
follow-up
questions
about
them
chairman.
If
I
may,
what
is
our
safety
net
funding
this
year
for
those
those
clinics
that
you've
already
said
are
so
important,
and
then,
how
is
that
provider
rate
increase?
What
is
it
and
how
is
it
going
to
incorporate
into
that
mission?.
M
N
E
And
then
manager
may
go
back
and
forth
a
bit.
Thank
you
chairman.
So
if
you
have
a
number
available
on
that,
I
mean
how
many
uninsured
or
underinsured
tennesseans
take
advantage
of
these
clinics,
and
does
that
number
that
you've
mentioned?
I
mean
the
22
million.
Obviously,
that's
a
large
amount
of
money,
but
in
the
grand
scheme
of
what
we
spend
on
health
care,
it
is
a
tiny
drop
in
the
bucket
compared
to
the
number
of
individuals
that
are
accessing
these
clinics.
N
E
Okay,
yeah,
if
you
could
give
me
some
details
on
that,
that
would
be
wonderful
and
then
what
more
can
we
do
to
assist?
Specifically
with
that
and
that's
because
we
we
have
these
services
and
they're
extraordinarily
critical
to
those
that
are,
but
we
all
many
times
being
poor,
those
that
are
trying
everything
they
can
they're
working
hard
they're
climbing
the
ladder
they're
either
entry-level
employees
they're
employees
that
have
left
a
job
and
are
transitioning
to
something
else.
E
It
it's
folks
that
many
times
are,
they
need
transitionary
care,
but
before
they
get
into
a
job
that
may
have
full
benefits.
The
current
systems
that
are
out
there
many
times
are
not
nimble
enough
to
do
that,
except
for
these
rural
healthcare
safety
net
clinics,
which
are
so.
How
are
we?
How
are
we
accomplishing
the
mission
now
and
what
more
can
we
do.
N
That's
a
loaded
question.
I've
been
a
good
one
and
one
that
we
spent
a
lot
of
time
thinking
about,
particularly
with
those
safety
net
clinics
and
the
organizations
that
represent
them.
I
think
to
dr
piercy's
point
having
that
as
recurring
funding.
So
when
there
are
increases,
so
there's
not
a
lot
of
up
and
down
it's
predictable,
what
they
can
budget
for
the
coming
year
and
obviously,
as
we're
able
to
increase
the
number
of
clinics
that
are
out
there,
you
know
again
maintaining
a
stable
reimbursement
for
those
clinics.
N
We've
also
been
working
with
them,
a
fair
bit
on
quality
improvement.
How
can
we
build
their
infrastructure
so
that
they
can
measure
outcomes
we're
not
just
paying
for
an
encounter
or
paying
for
a
service
that
they're,
proud
of
providing
that
people
really
are
are
seeking?
So
that
is
a
partnership
that
we've
had
on
going
with
them
for
the
last
couple
of
years
and
we
expect
to
be
finalizing
over
the
next
couple
of
months
and
in
that
quality
improvement
process,
also
working
through
things
like
care
coordination.
N
So
as
you're
you're
saying
really
partnering
across
health
care
and
social
service
entities,
how
do
we
make
sure
that
we're
addressing,
maybe
not
just
the
blood
pressure,
but
also
the
access
to
food,
healthy
food
that
is
driving
that
blood
pressure,
access
to
work
and
insurance
as
well?
So
a
lot
of
work
going
on
into
that.
E
Madam
chairman
last
question
so
of
the
karzak
dollars,
literally
the
billions
of
dollars
that
we
have
leveraged,
how
much
of
that
has
gone
towards
rural
healthcare
clinics,
both
both
for-profit
and
nonprofit.
Quite
frankly,
any
idea
as
to
how
much
of
that
has
been
leveraged-
and
I
keep
hammering
on
this
because
we
talk
about
insurance,
a
lot
and
that
may
catch
a
large
number
of
people,
but
you
are
always
going
to
have
folks
that
are
outside
of
the
insurance
market
that
need
actual
health
care.
E
It's
one
thing
to
have
insurance,
it's
another
thing
to
actually
receive
the
health
care.
I've
always
tried
to
focus
much
more
on
the
actually
receiving
the
health
care.
So
how
have
we
done
as
far
as
cares
act,
funds
and
federal
funds
in
general
that
have
come
down
to
be
able
to
leverage
those
toward
these
clinics.
N
Yeah
there
have
been
some
direct
provider
relief
funds
that
have
gone
from
hersa,
largely
to
providers
and
in
to
some
extent
of
qhcs,
but
also
other
clinic
types
and
again
that's
direct
direct
from
the
federal
government
to
those
providers,
and
then
we
early
on
before
that
started,
we
had
some
designated
funding
from
crf,
in
particular,
to
support
testing
and
safety
nets,
first,
ppe
and
safety
net,
and
also
revenue
loss
within
the
safety
net.
So
I
think
that
was
around
six
million.
Johnny
may
have
a
mortified
number.
E
A
And
I
would
just
add
that
safety
net
hospitals,
it's
not
just
a
rural
issue
and
in
the
urban
area
I
live
in,
we
have
volunteers
in
medicine
we
have
a
number
of
ways
to
get
health
care
to
those
who
are,
you
know,
there's
a
difference.
The
access
is
there
in
terms
of
physical
geographic
access,
but
having
financial
access
is
a
different
story,
so
those
are
those
are
important
in
urban
areas
as
well
as
rural.
Next
on
the
list,
chairman
whitson.
G
Thank
you,
madam
chairman,
and
dr
piercy
good,
seeing
you
and
your
team
and
again
I
just
want
to
express
my
appreciation
and
respect
for
you
and
your
team,
and
all
that
you
have
done
for
our
state
and
our
citizens
over
the
past
two
years
has
been
out
a
very
difficult
but
great
job
that
y'all
have
done.
Thank
you.
G
My
question
has
to
do
with
suicide
prevention
and
in
the
tennessee
suicide
prevention
program
that
we
created
in
2018
and
first
I
want
to
thank
you
for
updating
us
on
the
status
of
the
suicide
prevention
director
and
and
where
you
are
moving
forward
on
that.
My
question
has
to
do
with
in
2020
the
centers
for
disease
control,
for
comprehensive
suicide
prevention,
awarded
the
department,
a
grant
of
750
000
per
year
from
2020
to
2025.,
and
and
just
can
you
give
us
an
update?
What
how
the
department
plans
to
utilize
this
grant
for
suicide
prevention.
M
N
Just
to
reiterate,
there
was
both
the
state
legislation
that
created
the
suicide
prevention
program
and
then
that
enabled
us
to
be
positioned
to
receive
a
federal
grant
that
does
end
in
2025
some
of
the
work
that
has
happened.
This
is
largely
a
coordinating
role,
so
department
of
health
you're
familiar.
We
have
a
lot
of
the
data
that
that
informs
action,
both
suicide
itself,
as
well
as
er
data,
so
kind
of
we
it's
a
surveillance
system
that
we
actually
look
at
youth
and
adult,
but
largely
use
suicide
rates
in
emergency
departments.
N
And
then,
when
we
see
an
increase
in
a
region,
we
can
notify
schools.
We
can
notify
the
local
tspn
network
to
act
there.
So
that's
been
a
lot
of
that
infrastructure.
That's
been
built.
We
also
coordinate,
obviously
with
department
of
mental
health
and
multiple
other
veterans
affairs,
multiple
other
state
entities
and
in
a
large
stakeholder.
N
Group
that
meets,
I
believe,
quarterly
and
issue
a
number
of
reports
on
the
activities
of
that
committee,
and
then
this
grant
funding
has
been
community
based,
but
also
school
work
in
suicide
prevention,
bullying
prevention,
so
kind
of
those
upstream
suicide
prevention
efforts.
That
again
has
been
in
coordination
with
stakeholders
across
the
state.
L
Thank
you,
madam
chair
good
afternoon,
commissioner
piercy
good
to
see
you
guys,
quick
question
related
to
the
upgrades
to
the
license
and
regulatory
systems
in
which
you're
going
to
be
using
the
health
board
reserves.
Can
you
tell
us
how
you
determined
the
utilization
of
those
reserves,
because
some
some
balances
were
negative,
all
the
way
up
to
nine
million
dollars?
Can
you
just
elaborate
on
that?
Please.
L
O
I
Thank
you,
madam
chair,
commissioner,
your
team,
we
appreciate
you
very
much.
We
were
commissioner
ely
was
able
to
borrow
mr
webb
yesterday
to
give
us
some
conversation,
and
I
want
to
go
a
little
back
a
little
bit
to
yesterday.
We
talked
about
the
the
new
county
health
centers
that
we're
talking
about
and
replacement
of,
17
county
facilities,
and
I
think
you
said
you
offered
up
john.
If
we
want
to
know
if
our
county's
in
there,
where
they
could
be,
but
could
you
off
the
top
of
your
head?
I
I
Should
fulfill
the
request,
that's
great
and
just
a
second
question
as
well
and
we're
flying
a
little
bit
blind
up
here.
We
don't
have
the
powerpoint
on
our
on
our.
What
you
call
it
of
dashboards.
Excuse
me!
So
can
we
go
back
to
the
first,
the
when
you
talked
about
some
of
the
improvements
to
the
budget
there
you're
talking
about
dental
services
and
part
of
that
was
was
new
dental
residency
programs,
bringing
new
dentists
into
the
state
and
I'm
and
I'm
going
to
ask
out
of
somewhat
naivety.
I
M
Thank
you
for
the
good
question
chairman
I'll.
Try
to
I'll
try
to
answer
you
as
best
I
can.
The
key
thing
to
note
is
that
dental
residencies
and
medical
medical
residencies
are
funded
entirely
different,
and
so
this
this
initiative
actually
does
not
contemplate
dental
residencies
that
may
help,
or
that
may
ultimately
result
what
this
proposal
contemplates
about.
Two-Thirds
of
not
only
this
year's
line
item,
but
the
overall
package
is
to
increase
the
actual
dental
class
size.
M
It
might
surprise
you
how
few
dental
school
slots
we
have
in
tennessee,
so
ut
memphis
has
a
hundred
slots,
I'm
using
round
numbers
100
slots,
30
of
which
have
to
be
for
arkansas
residents
so
70,
because
arkansas
does
not
have
a
dental
school,
so
only
70
ut
slots
are
available
for
tennesseans
and
obviously
those
aren't
exclusively
for
tennesseans.
Then
mahari
has
about
60,
maybe
just
north
of
60
slots
in
their
program.
M
Lmu
is
starting
a
dental
school
next
summer.
They
have
not
matriculated
any
students,
yet
it's
my
understanding
that
they
plan
to
offer
80
slots.
So
this
part
of
this
proposal
increases
the
number
of
dental
school
slots
in
both
ut
and
mahari,
and
then
eventually,
if,
if
lmu
gets
into
that
same
situation,
they
would
be.
It
would
be
amenable
to
that
as
well.
I
Thank
you,
madam
chair,
and
it
sounds
like
we're
we're
attempting
to
cover
the
grand
division.
So
thank
you
very
much
in
terms
of
dental
services.
I
know
we're
trying
to
get
dental
care
inside
our
county
health
departments
as
much
as
we
can
in
many
areas.
If
we
can,
is
there
any
other
dollars,
we
can
leverage
to
do
that
as
well
and-
and
I
and
that'll
be
my
final
question.
Thank
you,
madam
chip.
Absolutely.
M
Some
of
the
nicest
dental
clinics
I've
ever
seen
much
nicer
than
the
ones
I've
personally
been
to
the
problem
that
we
have
is
at
least
a
third
of
those
and
sometimes
up
to
half
of
those
are
completely
dark,
because
we
can't
staff
them
and
we
have
a
deficit
of
700
dentists
in
the
state
right
now,
and
so
when,
because
they're
in
such
high
demand,
when
dentists
come
out
of
school,
they
have
some
pretty
lucrative
opportunities
awaiting
them.
So
it's
difficult
to
recruit
to
public
health
dentistry.
M
Likewise,
we
know
that
there's
probably
going
to
be
about
1300
dentists
that
are
currently
practicing
that
are
eligible
for
retirement
in
the
next
10
years.
So
this
is
why
we
really
felt
the
need
to
get
upstream
and
start
putting
more
out
in
the
pipeline,
but
that's
not
all
that
that
proposal
does.
It
also
helps
on
the
back
end
to
recruit,
retain
through
loan
payment,
loan
repayments
and
other
incentives
to
get
people
to
get
dentists.
M
Instead
of
going
to
practice
in
a
suburban
high
income
area
to
actually
incentivize
them
for
rural
and
underserved,
because
we
know
there
is
a
very
direct
link
not
only
with
dental
health
and
physical
health,
but
also
dental
health
and
economic
prosperity,
because
if
people
they
don't
feel
good,
if
they're
not
healthy,
and
they
don't
have
that
confident
air
about
them
because
they
have
poor
dentition,
they
are
most
likely
not
to
be
working
at
the
top
of
their
license.
Either.
B
Thank
you,
madam
chair,
commissioner.
Thank
you,
so
much
for
being
here
really
appreciate
all
the
effort
that
your
department's
done
for
us
over
the
last
couple
years.
This
is
a
question
you
might
not
have
the
answer
to
right
now,
but
I'd
love
to
just
hear
something
right
now
and
then
get
back
to
me
at
a
later
time.
B
There
are
a
lot
of
whether
it
be
lpns,
rns
doctors,
lots
of
people
in
the
healthcare
industry
that
I'm
hearing
or
going
from
maybe
a
hospital
setting
or
a
private
practice
setting
to
say
a
skin
care,
or
you
know
botox
things
like
that.
Does
the
department
tr
and
I
think
a
lot
of
that
has
to
do
with
burnout
and
things
like
that
of
the
last
year
and
a
half
two
years
or
so.
M
We
don't
see
that
in
massive
droves,
it's
absolutely
happening,
but
the
rest
of
my
response
will
be
a
bit
self-serving
because
we
don't
have
any
way
in
our
current
licensure
system
to
say
well
what
kind
of
practice
are
you,
for
example,
my
license
just
says:
md,
it
doesn't
say
I'm
a
pediatrician
and
it
doesn't
say
that
I
don't
practice
full-time
anymore.
It
just
says
I'm
a
licensed
md,
so
the
self-serving
part
is.
M
If
we
are
able
to
upgrade
our
licensing
system,
we
will
be
able
to
do
better
data
collection
because,
for
example
like
when
we
were
trying
to
get
out
tests
or
get
out
vaccines,
we
might
shoot
a
communication
out
to
every
physician
or
every
nurse,
but
we
don't
know:
if
are
they
in
primary
care
practice?
Where
is
their
primary
practice?
You
know,
or
are
they
practicing
in
multiple
spots?
So
the
short
answer
is
we
don't
know
because
we
don't
collect
that
data,
but
that's
something
that
a
new
system
would
really
help
us
do
better.
J
Thank
you,
chair,
lady
and
commissioner
good
to
see
you
again,
you
and
your
staff
representative
hall
kind
of
stole
a
little
bit
of
my
thunder
what
I
want
to
talk
about,
and
it
was
the
expansion
of
the
dental
services,
so
it
this
is
year
one
of
the
pilot
program.
How
many
years
will
that
be
in
total?
Do
you
foresee.
M
Yes,
sir,
the
work
group
suggested
a
five-year
pilot.
We
put
out
a
report
in
october
and
I'll
write
myself
a
note
to
get
you
that
full
report,
because
it
lines
out
by
year
the
different
actions
and
the
budget
per
year,
and
if
that
can
be
accelerated,
we're
amenable
to
that.
But
this
is
certainly
a
multi-faceted
and
multi-stakeholder
approach.
J
I
appreciate
you
saying
that
and
I'd
love
to
see
that,
and
I
know,
there's
three
line
items
so
I
know
the
first
one
says:
contract
with
course
ut
and
harry.
What
what
will
that
look
like
when
that's
carried
out?
How
will
that
money
be
dispersed?
I
think
it's
6.6
million
dollars
so,
and
you
can
just
briefly
tell
me
how:
how
will
that
money
be
sent
to
those
institutions.
M
M
That's
the
loan
repayment
and
incentives,
the
recruitment
incentives
that
is,
can
be
modeled
or
even
wrapped,
into
a
program
that
we
already
have
called
tennessee
state
loan
repayment
program,
also
known
as
teeslurp,
which
incentivizes
providers
after
some
time,
commitment
to
practice
in
rural
areas.
And
so
that's
that
is
just
expanding,
that
to
dentists
and
making
sure
we
can
get
them
into
those
underserved
areas
and.
J
M
That's
a
couple
of
big
big
buckets,
one
is
prosthodontics,
is
fancy
word
for
dentures,
so
prosthodontics
for
the
uninsured.
Obviously,
we've
already
talked
about
chewing
food
and
being
healthy
and
having
a
good
smile,
and
the
uninsured
certainly
deserve
that
as
well.
Another
big
bucket
of
that
is
a
program
we
call
smile
on
65
plus,
which
is
essentially
a
case
management.
Dental
case
management
for
the
elderly,.
J
Well
again,
I
appreciate
seeing
this
in
the
budget.
I
I
do,
and
I
also
something
else
you
said
also
caught.
My
eye
was
the
fact
that,
when
you
mentioned
the
dental
schools
you
did
mention
lmu
lmu
is
going
to
be
coming
on
board.
I
think
it's
actually
in
august,
I
think,
will
be
their
first
cohort
and
so
here's
what
I
care
about
at
the
end
of
the
day,
I
appreciate
ut
being
on
board
because
they're
going
to
be
in
my
neck
of
the
woods.
J
I
appreciate
my
harry
being
on
board
because
they're
going
to
serve,
who
they're
going
to
serve
but
lmu,
I
think,
is
right
there
as
well.
So
I
just
quite
frankly,
I
don't
care
what
emblem
is
on
that
lab
coat.
I
just
want
those
people
serving
my
folks
back
home
serving
tennesseans
across,
so
I
would
encourage,
as
we
get
further
deep
into
this
since
lmu
is
right
there
or
any
other
stakeholder
for
us
that
goes
etsu
with
their
dental
hygienist.
J
M
You
thank
you,
sir.
I
did
have
a
really
good
zoom
meeting
with
the
new
dean
at
lmu
a
couple
of
weeks
ago
and,
and
she
certainly
emphasized
the
focus
that
they're
going
to
have
in
serving
the
rural
community.
Likewise,
dr
nolan
at
etsu,
he
has
a
big
dental
hygiene
program
and
I've
been
able
to
connect
him
with
some
other
folks
to
talk
about
how
we
can
even
expand
services
in
their
area.
A
And
just
to
add
to
that,
I
visited
with
some
other
legislators
a
few
months
ago
at
south
college
they're
here
they're
in
nashville
and
knoxville
and
perhaps
looking
at
other
locations,
and
you
it's
great
to
have
dentists.
We
need
them,
but
you
have
to
have
dental
assistants
and
hygienists
and
all
of
those
things
to
make
it
operationally
feasible,
and
they
too
are
graduating
a
number
of
those
folks
along
with
pas,
and
so
I
think,
we'd
we're
in
the
position
of
needing
to.
A
As
chairman
hicks
has
said,
we
don't
really
care
about
the
source.
We
care
that
they're
well
trained.
We
care
that
they
know
what
they're
doing
and
they're
able
to
take
care
of
tennesseans,
but
we
just
need
to
get
these
folks
out
in
practice
in
our
state,
so
anything
that
we
can
do
to
speed
that
along
representative
lynn,.
F
F
Where
I
work,
there
is
a
woman
whose
daughter's
boyfriend
just
got
diagnosed
with
schizophrenia,
and
he
was
using
delta
aids
and
when
he
was
diagnosed
at
the
hospital
they
said
they're
seeing
increasing
numbers
of
young
people
who
use
delta
eight
getting
diagnosed
with
schizophrenia
and
whether
or
not
it's
permanent.
Yet
it's
hard
to
tell
what
are
we
doing
about
emerging
issues
like
that?
And
how
do
we
make
people
aware
of
that?
Because
happening
of
the
smoke
shop
is
still
selling
the
product?
F
M
B
Thank
you,
madam
chair,
commissioner.
Thank
you
all
for
being
here.
You
said
it
earlier
health
department.
You
do
much
more
responsible
for
much
more
than
than
covert
19..
It's
been
some
great
questions,
and
but
I
just
want
to
go
back
to
the
billion
dollar
investment,
and
I
don't
know
if
I'm
personally
overconfident
but
I'm
or
just
following
the
crowd.
B
M
Everybody
is
seeing
this
sustained
decrease.
I
would
like
to
sit
here
and
tell
you
that
we're
done
with
covid,
but
we're
not
it's
not
done
with
us.
We
may
be
done
with
it,
but
it's
not
done
with
us
what
we
have
seen,
though
that
has
been
different
over
the
last
two
to
three
months,
so
during
the
omicron
surge
versus
all
the
other
surges.
M
Is
this
much
talked
about
concept
of
moving
from
pandemic
to
endemic?
Last
time
I
was
testifying
in
a
committee
I
was
asked
to
define
endemic
and,
and
that's
a
difficult
definition,
because
there's
not
one
day
that
you're
going
to
wake
up
and
say:
okay,
it's
over
or
it's
endemic
or
everybody
go
home.
M
There's
nothing
left
to
see
here
it's
going
to
be
with
us
for
a
very,
very
long
time,
but
what
we
saw
during
omicron
is
that
the
percent
of
vaccinated
people,
as
well
as
those
with
natural
immunity,
really
decreased
the
number
of
severe
illnesses
and
deaths.
Yes,
there
were
still
hospitalizations,
yes,
they
were
still
destined.
I
don't
ever
want
to
minimize
those,
but
as
a
society
we
have
been
able
to
much
better
integrate
this
into
our
daily
lives
and
you're,
starting
to
see
that
around
the
country
of
we're
not
going
to
disrupt
our
day-to-day
living.
M
Now
that
doesn't
mean
we
should
go
out,
and
you
know
just
have
a
big
coveted
party
or
do
whatever
we
want
to.
We
still
need
to
be
smart,
particularly
when
the
virus
surges
and
so
you're,
starting
to
see
things
like
you
know,
continued
campaigns
of
hand,
washing
and
and
removing
oneself
from
close
environments,
but
the
days
of
universal
masking
all
the
time
everywhere
for
the
general
population
are
over.
M
If
you're
in
a
high
risk
category,
you
absolutely
should
still
consider
that,
and
just
because
you
know
you
don't
have
to
in
some
places
anymore
doesn't
mean
if
you
feel
safer,
doing
that
you
shouldn't
but
I'll
end,
that
that
diatribe
with
thing
that
I
will
say
every
single
time.
Vaccination
is
the
single
best
thing
you
can
do
to
protect
yourselves
and
those
around
you.
M
It's
your
lucky
day:
you
have
two
pediatricians
sitting
in
front
of
you
and
we
we
deal
with
adverse
childhood
experiences.
All
the
time.
You've
probably
heard
me
say
before
I
am
a
child
abuse,
pediatrician,
that's
my
training,
and
so
I
deal
with
traumatized
children.
That's
that's
what
my
career
has
been
about
and
what
you
see
is
you
don't
make
it
it's
sometimes
not
intuitive
to
make
that
link
between
how
sexual
abuse
at
age,
four
or
eight
can
result
in
hypertension
and
obesity
at
age
45.
But
there
is
a
direct
correlation.
M
You
can
you
can
kind
of
fast
forward
and
think
about
self-medicating
self-medicating
with
food
self-medicating
with
substances
because
of
the
trauma
that
wasn't
identified
and
and
treated
early
on
so
I'll.
Ask
dr
mcdonald
to
give
you
a
brief
overview
of
how
we're
doing
that
in
the
department.
One
of
the
programs
that
we're
most
proud
of,
and
that
is
most
effective-
is
our
evidence-based
home
visiting
program.
I
saw
a
little
teddy
a
little
bit
about
that.
A
All
right,
dr
piercy,
we
thank
you
for
your
patience
and
waiting
through
our
business
earlier,
and
we
thank
you
for
the
presentation
you
and
your
team
today
and
most
of
all,
we
thank
you
for
all
of
the
hard
work
that's
been
done
by
your
department
and
so
many
other
people
in
navigating
through
a
very
difficult
situation.
So
we
do
appreciate
your
work.
We
all
know
we're
always
looking
for
ways
that
things
can
be
done
better,
but
we
know
that
very
difficult
circumstances
and
I
think
your
department
has
performed
admirably.
M
No
no
worries.
Thank
you,
madam
chair,
and
thank
you
committee
and
and
to
the
general
assembly
at
large.
We
have
felt
nothing
but
support
and
help
all
along
the
way,
and
so
we're
grateful
for
that.
It's
meant
a
whole
lot
to
both
my
executive
staff,
but
also
my
field
staff,
to
know
that
that
you've
got
our
backs.
So
thank
you
for
that.
A
And
through
no
fault
of
your
own,
we
are
running
way
behind,
so
I'm
gonna
ask
if
you
can
to
be
as
brief
as
possible
in
your
presentation
and
give
us
some
time.
You
know
for
questions,
and
I
do
apologize
for
that,
but
it's
we
had
some
business
to
take
care
of
that
took
a
bit
longer
than
perhaps
we
expected.
So
with
that.
I
would
just
go
directly
into
your
presentation.
If
you
will.
P
Madam
chair
and
members
of
the
committee,
my
name
is
clarence
carter,
commissioner
of
the
tennessee
department
of
human
services,
and
am
pleased
to
present
our
our
2022-2023
budget.
I
am
joined
today
at
the
table
by
my
deputy
commissioner
for
programs,
cheryl
campbell
street
deputy
commissioner
for
operations,
melissa,
hux
and
our
budget
director
wins
shires.
P
So
let
me
let
me
dive
right
in
and
and
with
just
a
a
a
couple
of
highlights
in
in
fiscal
21.
We
we
serve
through
our
child
care
assistance
program.
We
serve
21
000
children
with
our
pandemic
child
care.
We
serve
more
than
fifty
eight
thousand
children
and
in
our
partnership
with
the
ymca
we
served
about
twenty
seven
thousand
children
in
our
pandemic.
Employment
in
our
pandemic
emergency
benefit
transfer,
we
served
oops.
P
I
need
to
get
a
little
bit
closer
sorry
about
that.
We
passed
out
benefits
of
more
than
800
million
dollars
in
our
summer
food
service
program.
We
served
six
million
meals
and
one
of
the
numbers
I'm
particularly
proud
of.
In
our
child
support
program.
We
served
more
than
one
million
tennesseans
collecting
over
630
million
dollars
for
for
for
tennessee
children
from
their
non-custodial
parents.
Okay,
briefly
touch
on
our
tanf
opportunity
act.
P
P
P
We
have
three
three
budget
items.
The
the
first
is
that
or
three
increases.
The
first
is
a
1.6
billion
dollar
increase
in
our
snap
benefit
program.
This
is
100
percent
federally
funded
and
it
is
based
on
the
recalculation
of
the
food
and
nutrition
service
on
the
benefit
amount.
So
this
does
not
open
new
eligibility.
It
is.
It
expands
the
amounts
available
for
existing
existing
individuals
and
families,
and
in
that
regard,
we
don't
need
additional
state
are
not
serving
a
broader
population.
P
We
believe
that
everybody
who
can
work
should
work.
We
simply
in
this
instance,
need
to
provide
more
of
a
hand
holding
to
help
individuals
work
in
the
context
of
the
mental
health
challenges
they
have,
and
so
this
is
a
collaboration
between
us
and
mental
health
and
substance
abuse,
which
makes
this
available.
This
is
very,
very
exciting
and
and
and
and
finally,
the
child
support
as
assistant
district
attorneys,
step
increase
of
129
000.
P
So
our-
and
what
I
just
wanted
to
highlight
here
is
that
dhs
is
almost
96
percent
federally
funded
and
the
the
what
we
use
in
state
funds
are
used
to
draw
down
the
federal
funds.
We
will
be
in
22
and
23,
a
four
billion
dollar
agency,
which
is
which
is
double
the
amount
of
of
our
operating
budget
traditionally.
P
A
B
Thank
you,
madam
chair.
The
department
recently
requested
permission
to
use
federal
funds
to
hire
some
additional
folks
in
positions
for,
I
guess,
disability
determination
claims.
I
was
just
wondering
if
you
could
give
us
an
update
on
how
many
positions
were
filled
and
to
what
extent
that
has
relieved
some
of
the
backlog
in
the
state.
P
And-
and
so
I'm
going
to
give
you
the
headline
on
this
and
then
ask
my
deputy
for
programs
to
fill
in
so
these
are
positions
that
are
funded
by
the
social
security
administration
and
they
have
complete
authority
over
when
we
can
hire,
and
so
we
simply
we
we
simply
got
permission
to
be
able
to
hire
a
new
cadre,
and
so
that's
what
we
are,
what
what
what
we
have,
what
we
have
done
and
now
any
other
issues
attended
to
that
sherelle.
You
wanna.
K
K
Oh
I'm
so
sorry,
representative
haley,
you
think
I
would
know
this
by
now.
Sorry,
I'm
sherelle
campbell
street,
I'm
the
deputy
commissioner
for
over
programming
services
at
the
tennessee
department
of
human
services
and,
as
commissioners
stated,
our
disability
determination
services
is
a
100
percent,
federally
funded
program
as
a
partnership
between
us
and
the
social
security
administration.
K
That
program
has
people
are
identified
as
disability
claim
examiners,
and
they
make
the
determination
for
medically
they
make
the
medical
determination
for
people
who
will
receive
disability
services.
We
are
somewhat-
and
I
I
say
this
with
affection-
we're
sometimes
at
the
mercy
of
social
security
to
on
how
we
fund
and
support
those
positions
they
have
a
different
each
year
they
have
a
different
focus
and
so
based
on
the
focus
area
that
they
they
have
an
abundance
of
claims.
G
Thank
you,
madam
chair,
thank
you,
commissioner,
for
being
here
today
and
all
the
great
work
y'all
do.
The
governor's
proposal
includes
expansion
of
funding
to
dhs
for
a
placement
of
individuals
with
severe
mental
health.
Obtain
employment
will
will
the
expanded
funding?
Will
it
expand
the
areas
where
we're
doing
that?
Or
will
this
enhance
where
we're
actually
helping
now.
P
No,
this
won't
enhance
the
areas
or
where
we
are
doing
it,
it
will
provide
for
additional
support.
Counselors,
if
you
would.
This
is
a
very
labor-intensive
intervention,
because
the
individuals
that
have
these
kinds
of
significant
mental
health
challenges
really
do
need
a
significant
amount
of
hand-holding.
So
it
will
increase
the
number
of
individuals
that
we
have
to
be
able
to
provide
that
very
case.
Intensive
support.
I
I
I
I'm
watching
it
thank
you
for
the
recognition
on
tanf
and
the
great
work
that
has
been
done
and,
and
so
many
folks
chairman,
terry
chairman
smith,
so
many
folks
have
done
some
good
work.
Representative
love
has
done
some
good
work
too.
So.
Thank
you
very
much
as
we're
talking
about
tanf
april
7th
is
a
big
date
for
the
tennessee
opportunity,
grant
the
opportunity
planning
grant
folks.
Can
you
talk
a
little
bit
about
the
april
7th
date
and
what
will
happening
then.
P
Sure
what
will
happen
is
we
currently
have
17
planning
grant
awardees.
So
these
are
organizations
that
submitted
to
us
compelling
proposals
for
how
their
community
collaboration
will
approach
this
idea
of
growing
capacity
to
reduce
dependency.
So
on
april
7th
we
are
asking
for
presentations
in
almost
a
shark
tank
format.
P
And
it's
from
that
and
then,
of
course,
the
paper
review
that
the
family's
first
advisory
council
will
make
decisions
on
those
of
seven
pilots
and
again
there
will
be
two
pilots
in
each
of
the
three
grand
divisions
and
a
seventh
one
which
the
department
of
human
services
will
operate,
but
that
april
7th
is
a
big
day
for
for
tennessee.
In
that
regard,.
I
And
I'm
cautiously
asked
to
be
recognized
again
by
the
chair,
lady.
Now,
the
the
opportunity
act
also
increased
the
the
monthly
cash
allotment
for
for
recipients
to
387
a
year.
Have
we
been
able
to
quantify
that
in
the
budget
yet
has
that
have
we've
been
able
to
to
see
where
we
are
month
to
month
tomorrow
on
those
those
allowances.
B
A
I
Thank
you,
madam
chair.
Thank
you
all
for
being
here.
We
appreciate
you
briefly
mentioned
the
snap
funding
and
understand
that
that
waiver
is
ending
and
just
to
talk
about
a
little
bit.
What
we're
gonna
do.
Does
the
department
think
the
increase
in
snap
allotments
will
expire?
Will
you
think
it'll
be
continued
indefinitely.
P
No
because
the
way
the
way
the
snap
benefit
works
is
we
move
that
benefit
based
on
what
the
eligible
amount
is
to
the
individual
or
family,
and
so
it
is
off
our
books.
So
there
isn't
anything
for
that
would
be
returned.
If
something
is
unexpended,
it
would
be
unexpended
on
the
card
that
that
individual
or
family
has
it's
not
something
that
would
return
revert
to
the
federal
government.
L
Thank
you,
madam
chair
good
afternoon,
commissioner
and
team
commissioner.
Even
before
the
pandemic,
we've
had
some
challenges
as
a
state
related
to
child
care.
Affordability,
since
the
pandemic
that
has
just
increased
exaggerated
that
issue
related
to
workers
and
then
families
being
able
to
provide
adequate
child
care.
Can
you
speak
to
just
briefly
the
relationship
with
ecd
regarding
rural
areas
and
trying
to
grow
the
child
care
opportunities
and
then
just
how
we're?
P
So
let
me
go
in
just
a
couple
of
different
directions.
The
first
is
that
the
the
legislature
created
a
child
care
advisory
task
force
for
just
this
reason
to
look
at
the
the
broad
issue
of
child
care,
affordability,
availability
and
in
quality,
and
and
so
that
that
that
committee,
which
chair
hazel,
would
sits
on.
We
are
progressing
in
trying
to
get
our
heads
around
that
issue,
but
there
are
a
couple
of
things
that
we
know.
There
are
some
significant
child
care
deserts.
P
We
don't
have
enough
quality
and
affordable
child
care
in
tennessee,
and
so
we
have
got
to
be
more
innovative
about
how
we
go
about
doing
that,
and
so
in
a
in
a
couple
of
different
directions.
You
mentioned
one.
We
are
working
with
ecd
in
that
in
in
one
instance,
they
are
able
to
provide
money
for
bricks
and
mortar
which
our
child
care
and
development
fund
can't.
So
we
are
collaborating
on
doing
the
programming
where
they
will
actually
build
the
facility.
Okay.
P
So
what
we
are
trying
to
do
is
to
encourage
that
partnership
with
employers,
because
this
is
such
a
this-
is
so
important
to
both
employer
and
employee.
So
we're
trying
to
go
in
several
different
directions
to
address
this
issue
of
accessibility,
affordability
and
quality
of
child
care
in
tennessee.
L
D
Thank
you,
madam
chair.
As
I
understand
it,
the
department
has
received
a
little
over
three
and
a
quarter
billion
dollars
as
of
a
couple
of
months
ago,
in
covid
relief
money.
Has
the
department
had
success
in
getting
those
funds
out
to
tennesseans
in
need,
or
will
some
of
the
funds
likely
have
to
be
returned.
P
B
No
sir,
so
no
federal
funding
should
lapse
outside
of
any
admin
money
and
that's
just
administration,
because
we
have
done
a
great
job
of
maximizing
our
current
staff
with
the
current
grants
as
far
as
distribution,
and
we
do
not
expect
any
too.
We
are
still,
as
commissioner
stated,
ongoing
with
child
care
grants
going
out
delivering
those
to
facilities
to
help
based
on
the
previous
question,
with
pandemic,
ebt
and
so
forth.
So
we
still
have
several
months,
if
not
a
year
a
year
and
a
half
to
expand
the
funding
that
we've
received
thus
far.
Q
Thank
you,
madam
chair,
and
thank
you,
commissioner
staff.
For
being
here.
We
were
talking
all
my
colleague
here
was
we
were
talking
about
the
pilot
program.
Yes,
sir,
the
seven
pilot
programs
from
april
the
seventh
seventh:
can
you
elaborate
a
little
more
in
depth
on
what
your
primary
goal
is
through
this
pilot
program
and
who
will
be
the
overseers?
I
assume
in
terms,
and
how
often
will
you
get
reports
as
to
how
well
this
pilot
may
be
doing
in
these
different
grand
divisions?
So.
P
P
So
so
what
is
our
hope
is
that
we
will
learn
from
these
seven
pilots
and
what
we
learn
from
these
pilots
will
actually
result
in
our
being
able
to
adjust
our
programming
so
that
we
bake
this
into
how
dhs
and
the
communities
operate
going
forward.
So
no,
we
we
don't.
We
don't
anticipate
100
success.
What
we
do
anticipate
is
a
hundred
percent
of
learning
learning
how
with
intention
you
grow
people
beyond
their
vulnerability.
R
I
think,
commissioner
commission,
I
just
wanted
to
to
read
a
quote
that
you
said
if
it's
okay,
I
liked
it
for
far
too
long,
government
programs
have
focused
on
the
outputs
rather
than
the
outcomes
of
the
lives
who
have
been
served.
We
aim
to
change
the
way
vulnerable
tendencies
are
served
by
partnering
with
public
and
private
organizations
who
recognize
public
support.
Should
it
mild
be
a
should
be
a
mile
marker
and
a
life
journey,
not
a
destination
unto
itself.
So
I
appreciate
your
quote.
R
I
wanted
to
ask
about
about
child
care,
dr
love,
in
the
in
the
back
back
there,
and
I
happened
to
be
talking
after
session
the
other
day,
and
we
were
talking.
It
was
one
of
the
clerk's
employees,
I'm
not
going
to
say
her
name
and
somehow
I
got
talked
to
her
about
child
care
and
she's
paying
1300
a
month
in
child
care.
It's
like
whoa.
How
do
you
afford
that?
R
You
know-
and
I
think
dr
love
said
he
had
a
bill,
but
I'm
trying
to
address
them
at,
but
I
guess
my
question
is
what
are
we
doing
as
far
as
partnering
with
faith-based
organizations
or
other
non-profits,
and
is
there
any
drawdown
from
tenant
funds
to
help
with
some
of
these
improvements
to
some
organizations
to
kind
of
help?
This
offer
some
relief
and
partnership.
P
So
so
the
the
the
the
fact
is
that
built
into
the
tanf
structure
is
an
allowability
to
transfer
some
of
it,
ten
percent
of
it
into
the
child
care
and
development
fund.
But
we
we
we
find
that
we
have
and
an
overabundance
of
resources
in
the
child
care
and
development
broad
grant
that
we
simply
have
to
execute
more
efficiently.
P
So
so
we
are
trying
to
use
those
dollars,
but
absolutely
partner
with
all
sectors
of
tennessee
to
help
us
address
this
issue.
One
of
the
big
challenges
of
the
way
our
system
is
designed
is
that
we
are
very
government
centric,
as
if
the
government
is
the
principal
problem
solver,
and
so
we
have
crowded
out
the
community
of
faith,
academia,
the
private
sector,
okay,
philanthropy
from
being
a
part
of
the
problem
solving.
P
So
what
we
believe,
one
of
our
roles
is
to
serve
as
a
catalyst
to
literally
call
all
the
rest
of
tennessee
to
this
issue,
because
we
believe
that,
while
the
resources
are
bigger
than
any
one
program
or
agency,
it's
not
bigger
than
all
of
tennessee.
We
can
make
the
whole
greater
than
the
sum
of
its
parts
and
solve
this
problem.
R
Chair
lady,
for
good
this
morning,
I
was
with
a
music
therapy
therapist
at
a
church
in
in
franklin,
probably
an
ogle's
district,
and
it's
a
partnership
with
the
church.
It's
working
with
parkinson's
patients.
It
was
just
impressive
listening
to
them
and
trying
to
just
learn
about.
You
know
how
it's
helping
with
parkinson's
a
couple
weeks
ago,
I
had
a
church
that
called
me.
They
were
being
threatened
to
be
locked
up
the
the
doors
as
a
temporary
permit.
R
They
had
river
of
life,
made
a
video
about
it
on
youtube,
just
type
in
the
river
at
smyrna.
People
don't
believe
this
exists
in
america,
but
I
noticed,
while
I
was
there
with
the
with
the
pastor
families
coming
in
with
the
children,
and
I
said
what's
going
on
here,
he
says:
well,
we
have
a
mother's
day
out
program
like
well.
Is
this
mandatory
that
you
have
to
be
a
member
of
the
church?
Oh
no!
R
No,
I
don't
think
they're
charging
right
and
I
remember
I
got
a
phone
call
from
the
mayor
because
he
seen
the
video
that
I
made
and-
and
I
said,
look
at
the
good
work.
These
folks
are
doing
a
lot
of
times.
I
think
people
miss
the
boat
that
the
faith-based
partnerships
can
offer
so
much,
and
we
often
forget
to
to
leverage
that
and-
and
I
appreciate
them-
gary
farley
mary
beth
gribble
with
state
fire
marshal
for
helping
me
with
that
with
that
church.
R
P
K
I
just
wanted
to
recognize
representative
spark
for
your
unwavering
support
of
the
tennessee
rehabilitation
center
in
smyrna,
and
I
think
you
would
be
very
happy
to
know
that
one
of
the
ways
that
we
are
actually
the
commissioner
is
really
big
on
us
being
one
dhs,
a
moniker
that
we
started
a
few
years
ago.
But
how
can
not
only
the
you?
K
That
would
be
state
recognized
for
students
to
go
through
to
learn
how
to
become
child
care
workers
in
licensed
child
care
facilities.
So
that's
one
way
that
we're
trying
to
really
assist
in
some
of
the
vacancies
that
we
see
in
this
area
and
I'm
very
excited
to
they're
doing
some
research
now
on
a
national
level
to
see,
if
that's
something
that
we
can
do
here
and
also
working
with
tcat.
So
we're
really
excited.
I
want
it
again.
Thank
you
for
your
support
of
trc.
P
Okay,
now
that
one
trillion
dollars
doesn't
count
a
penny
of
the
intervention
of
that
church
that
you
talked
about
or
anything
else,
it
just
depicts
federal
and
state
government
money.
My
argument
is,
we
don't
need
more.
We
have
to
leverage
and
align
what
we
have
more
effectively
to
achieve
our
objectives.
A
A
But
we
sincerely
do
thank
you
and
all
the
folks
in
your
department
for
all
that
that
you
do,
and
especially
over
a
very
trying
time
for
families
across
the
state.
I
know
that
you
all
have
provided
that
safety
net
in
many
cases
that
have
kept
families
afloat.
So
we
thank
you
for
the
hard
work.
That's
gone
into
that,
and
we
really
appreciate
the
words
that
you
said
earlier.
I
think
you
know
we
have
the.
I
think
we
have
the
resources.
I
think
we
have
the
will-
and
I
think
we
have.