Facebook Live 1/6 Answers

Hi everybody. Sorry, we had some technical difficulties. I’m just going to let a few people get on here really quickly. Hi everybody. Thanks for joining me today. Session starts one week from today. We’ll be in and working. I wanted to take a few minutes… first of all is my volume ok? Let me make sure my volume is all the way up. I hope that’s better. I wanted to touch base and go over what I’m planning for Session and to give you a little idea about what’s going on. The first thing I’ll talk about is I think for COVID today… listen there is a legitimate increase in cases and in hospitalizations. Deaths have leveled off. All of those came down a little bit when I looked Monday. I haven’t had a chance to look today. I delivered a baby this morning. We definitely have an increase in the volume of cases. Same thing. No flu. All COVID and fewer people in the ICU than we had based on the numbers we were seeing earlier in the year because we're doing better treating them but it’s still deadly. It’s still an issue. It seems to me that a very reasonable solution to that issue is vaccinations, but we keep hitting hurdles. I look at examples like Israel, Israel is the size of Virginia and it is fully vaccinated because they were able to execute. It’s not enough to just have an idea. You have to come up with a plan for execution. I’m not sure what the powers to be were doing for the last many months when they had meetings about vaccinations and planning how to do this, but we’ve definitely hit some snags. I’ve talked to people at the Department of Health and we seem to have two issues that are affecting where we are in vaccination. One is that we have a terrible system for collating the data and that there are many vaccinations that have been given that have not been logged into the data and at this point in time we probably need to start manually tabulating the data to get any kind of accurate information. The data analysis of this is atrocious. So, we can’t even measure where we really are. I’ve been struggling. When I go on the Department of Health website, I can’t find anywhere what the vaccination plans are for 1B and 1C. 1A, as we’ve talked about before, is healthcare workers on the front lines, nursing homes and people who working in nursing homes. 1B gets down to essential workers which is anybody that is considered an essential worker, obviously including our teachers that we’re all so concerned about, and anybody that is on the essential work list as well as others that are elderly in the community and at risk with health problems. So, we haven’t even gotten to that yet, but we have to get through 1A first. I promised you last time we talked that we were going to post up there what 1B and 1C look like, but it is impossible for us to find. We do have a post from the CDC so you will know what the next tiers are as we go through those. As I understand it, we have got the vaccinations that we need to vaccinate 1A, but we are still lagging on how quickly we are doing that. The second issue seems to be the manpower and how we get the person who needs the vaccination to someone who can give it. I’ve been trying to solve that problem and I have reached out and tried to connect a few dots and make it happen and it hasn’t. So, I think that I am now entertaining the idea of legislation. I always think of legislation as almost as a sledgehammer. You know, if I can make things work organically in a community without using legislation that is my first choice but there are just too many hurdles to overcome and too much difficulty. I think if we had better advance planning, we would have it all worked out. We have resources. I think about medical student. I think about retired nurses. There are always liability issues and other things that are involved in that. It takes a long time to figure out how to solve that problem from a legislative standpoint without doing harm with legislation. That is going to be one of the issues that I legislate when I go to the General Assembly and I believe I'll be able to build something that’s bipartisan on that because people will want to overcome those obstacles. I'm going to work for us to get you vaccinated and everybody vaccinated as quickly as possible. The other things that are on my list that I think are imperative for this Session… this Session is an unusual Session. We’re just out of a long, almost 80-day, Special Session that really was not well executed and could have been done in a much shorter period of time. We’re looking at the Special Session and I think wisely there are a limited number of bills people can carry because we’ve just entertained an enormous number of bills. It’s costly for us to be in Session. We want to do what needs to be done but mostly we need to deal with the COVID crisis. One of the questions I had before we even started today was how do we limit the powers of this executive order that has us, you know kind of, in a situation where we have one arm of government making all the decisions? That’s the Governor and the agencies. You will see legislation, again, that I’m co-patroning that will limit the Governor's ability to execute on an executive order and persist with that for more than 60 days unless he brings the legislature in. It might be 45 days. It might be 30 days. I haven’t actually seen the bill yet. We had all of those different options when we were in Special Session and they were killed. We’re going to try and build bipartisan agreement on this. We're going to see if we can't limit those powers. So, to answer that it is what we will be looking at. One other interesting thing, I’ve talked to you before about, CARES Act money. That is money that the federal government distributes to the states to be implemented for different issues that are directly related to COVID. All of the money we got from last year had to be spent by December 16th or sent back. There is a new financial package from the federal government and they're sending money to Virginia. Your Virginia Constitution makes it extremely clear that the legislature must appropriate money in Virginia. The Governor executes on legislation and on what we legislate. There are certain powers that he has that he can implement with an executive order with limits. He cannot appropriate money. Now, the new money that is coming in will be coming in while we're actively in Session. I think that gives us the best opportunity to make the argument that the Constitution needs to stand which will allow us to determine where that CARES Act money goes. I will be very vocally advocating for that as we go into session. Bills that I’m carrying. Number one it’ll be no surprise to you that I’m carrying a bill to open schools. That schools in all school districts need to be offering in person education. So, let me be clear about that because it's not exactly opening schools. We have children in Virginia who are thriving in virtual education. I have always advocated for virtual education as you know. We also have children that are at risk or have family members at risk and for them virtual education is the best solution. People who are thriving in virtual education are those that maybe have resources at home and support and have the ability to thrive there. Other kids learn different ways. Some kids’ parents have to work. Some kids have jeopardy at home. They don't have adequate access to healthy foods. They may not be in a safe place if their parents have to be gone all day. All school districts will be asked to have in-person available as well as virtual. So, that’s one bill. The second thing is a diagnostic tool for your kids. We need, when we get back to school, to measure where our kids are. Doing an SOL at the end of the year doesn't accomplish that. The way SOLs are designed right now, it's more about the schools and whether or not they're meeting their bench marks. It's not about our kids. We need a diagnostic assessment of our kids to know where they are and if they're doing okay and more importantly what we need you to get and make up for whatever deficits they have after this incredible destruction of their learning. That diagnostic tool would have schools measuring how they're doing when they are coming in the fall. Measuring a diagnostic assessment again in December at the end of the first term. Then at the end of the year it would look at a progress assessment to see if we have moved them to where they need to be and what we need to be thinking about when they come back the next fall when they have another diagnostic assessment. So, that will be a piece of legislation. Individual Education Plans, IEPs. We had some problems in the state. I will be carrying legislation to modify the way that we provide IEPs, the oversight that is associated with IEPs, and making sure that across all school districts in Virginia kids that need help can actually get that help. There is a JLARC report if you want to look on the Virginia website. That's the Joint Legislative Audit and Review Committee (JLARC). You can see point there that talks about IEPs. I've heard about this from so many of my constituents. We have a real problem in not only determining what needs a kid has to succeed and, this is clearly delineated, that kids have obstacles to learning, and they might need services to help them overcome those obstacles. In that case they need an individualized education plan but it's hard to get one for your kid, it’s hard to go through the process, and then it's hard to get the services after you do get the IEP. That's the next bill that I'm talking about. School day services are what we talked about that are services that provide support for children so that they can overcome obstacles that they have in succeeding. That might be speech therapy. That might be behavioral help. It might be reading help. There are multiple things that it might be about. Dyslexia. There are multiple different things that schools can provide. The challenge for them is that it’s very costly and schools pay for all of the services. Now once they pay for them, they can apply to get federal Medicaid money to offset but they can only get that for IEP services not for the services they provide for everybody that doesn't have an IEP. Ok. I'm going to get to your questions in a minute. They provide a lot of other services they can never bill for. All that cost, in a way, becomes an obstacle to kids getting what they need because there's just so little money. We can change the state plan for Medicaid and allows schools to bill and be reimbursed the federal portion of Medicaid, which is 50% of the cost, for other services that they're providing outside of IEPs. That’s going to help us start expanding school-based services and get the funding to localities need so kids get the quality program that they need so they can succeed at learning. I’m also going to be looking at telemedicine for schools. This is a way to kind of really break open how we get services for kids in schools. If I am providing telemedicine and It is going to another location where there's somebody there to assist, me maybe a nurse maybe another doctor, there are certain ways that you can build for that site fee which helps to offset the cost of providing telemedicine services on the side where the patient is. There is certain technology you have to have. Schools don't have a way to bill for that. They don't have a way to provide those resources and if they can bill for the site fee for telemedicine, we can start getting him some real support for our kids that is mediated by the school nurse. There's legislation from other legislators that I just supported in the past that every school have a school nurse. That’ll be one step in this direction. We’re going to make sure we can get telemedicine into the schools. As you can see, I’m very focused on our kids this year. I'm very focused on education. I'm very focused on the composite child. We need to meet their needs for nutrition. We need to make sure that they have support for learning challenges that they have. We need to make sure that they have support for emotional or social challenges that they have. We need to support our children, so they have the opportunity to thrive and that is a real focus for what I'm working on in this legislative session and probably is going to take a few years. I talked about the vaccination response.

Dual enrollment. I've been working for years to standardize the core curriculum classes your children need for higher education so that they only have to take them once. Where we are after 4 years, 5 years of work is that we have a core curriculum that is offered both at the 4-year colleges and at the community colleges. These are passport credit that means that the passport you can use anywhere you go, and it's received. Once it's stamped with that course, once you have that core curriculum course you never have to take it again. So, that means you're not paying twice. So many of us have paid twice for classes because you get your English 101, and you end up at UVA of Virginia Tech and they're like so sorry that doesn't count because it doesn’t meet our quality criteria. Well, we have now standardized core curriculum. It’s 30 credits. It is available at every community college across Virginia and every four-year institution also recognizes it. If your kids are going to go into technical education or if they're going to go on to an Associate's Degree or Baccalaureate Degree that is standard across that the whole spectrum. I think it's time that we make the standard make sure that we are offering them in dual enrollment. Now we're going to extend that continuum. We're going to say if your kid gets a passport credit in high school you know that that is going to count when they go on to higher ed. So, it’s just kind of the next step in my passport credit legislation.

Grandparent mediation. We have lots of instances where grandparents, particularly a personal issue for a constituent of mine, is that their son died, and they have now been excluded from a relationship with their grandchild. We respect that parents have the final decision power in the state of Virginia, but we also think that there are opportunities for the courts to allow for mediation where grandparents can make an argument about the value that they provide in that child's life. If there are risks, then that can be accessed by the courts as well and mediation. So, we're going to be working to see if we can make sure that grandparents get the opportunity to at least mediate and be considered as having an opportunity to see their grandchildren when their child has died. We worked on that last year. It failed in the House. We’ve refitted it in a way that is more lined with some of the strong opinions of lawyers in the state of Virginia. We think this will work.

We want to get some additional funding to the poor elderly. There's something in Virginia called auxiliary grants which is where Virginia pays for an assisted living for an elderly person without means. They're still vastly underpaid. That is a real challenge especially COVID and we know our elderly have been at such extraordinary risk with COVID. We're going to look at it and see if we can improve reimbursement for that. I have something that came, again, from constituents where they just need to be able to have HOA meetings be virtual. There are a lot of snags during COVID and making sure things could get worked out in the neighborhoods that still have to have a full quorum, that still have to meet all of the criteria. We’re going to see if we can't change code to make that happen. We've had advocates working in that space building consensus so it looks like that should be pretty well supported.

Some real estate appraisal issues that a constituent has and finally a piece of legislation to protect… In California there was an attempt, especially with Uber and Lyft, to force corporations to have contract employees be considered full-time employees. Even if they wanted to be contract employees. A lot of people like to have more than one job and be a contract employee and that would have meant full benefits for everybody that was a full-time employee. Well, that went as a referendum to the California voters and even in California they voted to not allow that to happen. So, based on that experience and as a proactive move in Virginia, we would work to make sure that nobody can step up and try and compel contract workers to be forced into a single option when they might want the flexibility of being able to do lots of different things. It allows for a vibrant economy, you know. We need to make sure that the government doesn't have to tell us how to do everything. Two people can contract together and come up with something, there is so much contract law already, that is fair and representative of their desires but allow them to thrive in this economy. So, I would support that, and I will be carrying that.

So, that is kind of my 12 bills. I'd be happy to answer questions on any of them. They’ll be up on LIS very shortly with bill numbers. We’ll post them when we have them. We would love your input. More importantly, we would love for you to come speak to those bills if they're important to you and if you have other members. I mean, certainly in-person school, I know, is important to a lot of you and the diagnostic tool for your kids. I persuade other legislators to agree with my legislation when they hear true stories from people coming forward and expressing how valuable this will be to them. Most of these don't cost anything or very little money. They're for kids. So, I will need your advocacy and I will hope for that. On that note, as you probably know already, many of you are very plugged in with everything, the Pocahontas Building and your ability to access your legislator is significantly thwarted by COVID. They have made a decision on the recommendation of the Virginia Department of Health to close the Pocahontas Building. So, people will not be able to come and have regular meetings with legislators. I believe there's a tent situation that's maybe being worked out that you might be able to come to but it's only going to be ten people at a time. Whatever we work out, it is not going to be an easy access that has always been the case with the legislature before where we have hundreds of people in the building every day looking to their legislators on regular appointments. To that end, we are going to have virtual meetings set up. You will be able to sign up to meet with my team and me. As often as I can be there, I will be there, but I will also be in my committee meetings. So, you will get one of us. Whatever you tell my team I hear. We sign out everyday. So, we will get you all that information. I want you to feel like you have free and easy access to us. Obviously, those will be limited but you can put as many people on zoom as you want. Just reach out to my office for that information or it will be posted on Facebook. We're also trying to cobble together something. We hope we're going to be able to do something really regular Facebook live like this or something else where you can get to me and ask questions and answer them and I can let you know what's going on down to the general assembly. I just think that two-way communication is so important. So, with that in mind, I'm now going to turn to the text that Katelyn sent me, and I missed. Let me go back I know I have one other question that came in ahead of time. It is about data I believe. Let me just get to it. I’m sorry I have to scroll down on this document.

Who has oversight to the Virginia Department of Health?

The Governor. The Governor has oversight and in order for us to direct what the Virginia Department of Health does, we have to actually legislate it. Somehow this vaccination legislation won't intersect with the Virginia Department of Health and we need to clear the way for as many people in giving the vaccine as possible. So, the Virginia Department of Health is directly reportable to the governor of Virginia. Only when we pass legislation can we direct what they do. As you know, I carried legislation during special to talk about data. That is up on the website. It is hard to find and it’s not nearly as helpful as I was hoping it would be. I have been able to go back and discern looking at that 80% of the cases we have seen in Virginia over these last several weeks have been in people 50 and under. So, I think that's why you're seeing so many cases with an increase in hospitalization, but not a commiserate increase in hospitalization, as we saw in the past. Fewer people are hospitalized because younger people are getting it. So, that is that question. I'm sorry let me know I'll go to the other question so that I can make sure and do that with you.

Do you know if there is a plan to help make testing more readily available?

I don’t. I will have to look into that. I know this much: we're doing fewer tests than we used to do. Fewer tests mean that the percent positive can go up more easily because the more volume you have, with most of the testing negative, those that are positive… most people go in for symptomatic testing and not just exposure testing. They're going for symptomatic testing. So, no I don't know about testing. I know that we were supposed to have more rapid tests available and that we were purchasing those. We’ve done an interstate compact to purchase more of those. I will see if I can find out and shoot an email to whoever asked that question.

Folks are wondering about what the plan is to elect a new Senator in the 38th District. What's the plan to have a special election?

I too had to do some research on that because this is a new experience to me. I can get you more details on that and send you an email. The bottom line is, when we are in session and a special election has to be called, it’s called by the Senate or the House respectively. So, I believe it is the President Pro-Temp. that calls for the special election from the Senate. Our President Pro-Temp. is Louise Lucas and I believe that there will be a call probably with a window for nomination and then a window for election. So that will be the Dems that are deciding that. It's to their advantage for us to not have a senator in that seat because it's one less vote and whoever is elected is most likely going to be a Republican. So, I don’t know how quickly that timetable will turnaround, but I will be asking the same question and see if I can find out.

School nurses to help vaccinate teachers?

Yeah, I don't see why not. That's a brilliant idea. I think we have a robust workforce, but we have obstacles to allowing that workforce be a part of the vaccination team. I think we have a lot of retired nurses that still have their RN but then what you run into is a health system doesn't necessarily want to bring in somebody that they don't employ that they haven’t vetted and done a bunch of checks on. So I don't know how we do this yet. We have medical students. We have nursing students. We have people that are employed in offices all over the state of Virginia. We have volunteers. We have free clinics. We have…why not drive through? This is what I'm thinking. What about that workforce that has been doing drive through testing? I know some states are doing drive through vaccination. Somehow, we need to remove the obstacles that make it easy for somebody to say oh no I'm sorry I can't help. There seem to be some sort of obstacles that are in that way and I'm trying to tease that out now. Let’s just unleash this right. Let's just get everybody vaccinated for heaven sakes.

That will be my plan. That looks like all of the questions. We’re right at 30 minutes. I’m going to say goodbye. I will let you know what we work out with it. There are probably going to be weekends that we talk about what's happening in Session because the days are so crazy. I do have a few hours here and there during the week that I spend with my patients. I need to do that. That's an obligation I have to them and a promise I've made. I'm a citizen legislator. Whenever I'm not in Session I'm at the medical practice. It’s a tough week. I love it but I will need to talk to you on the weekend in order to make that a reliable time. So, signing off everybody. Keep me in your prayers. Let's go get this done and I'll let you know as soon as I do. You know, that is one last thing I'll say. There is a terrible lack of information. A lack of communication. We don't really know whether this is going to be a 30 or 45 day Session. By the Constitution it's 30 days. We usually wave that and let it go to 45. There’s a lot of people who think it should be done in 30 days because they're kind of fed up with how long everything has taken. There's disarray between the house and the Senate and I think the Senate is really trying to be reasonable and work things out but it’s just having a hard time. To that end, there are not even that many bills for me to tell you about I'm about to launch all my bills, but I wanted to make sure they were developed but the house hasn't released any of their bills. So, we just don't know a lot of what to tell you to predict. So, we will be in touch as quickly as we can and until then take care and be safe. Bye.



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Dr. Siobhan Dunnavant
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804-698-7512
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Henrico, VA 23255

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