H.B. 390 Veterans PTSD Clinical Research Amendments: transcript

Oh, thank you, Madam Chair. Mr. Vice Chair. Um, I am really, really excited for the opportunity to present House Bill three 90. Um, I have a couple of co-presenters, if I may. I'd like to invite up, um, Matthew Butler. And then online we've got Ben Lewiston. Then I've got one more after that, and I will, we'll get to that as we work through my co-presenters. So HB three 90 is, I think, the next logical and positive iteration of a process that was started a couple years ago in recognizing by the Utah legislature, um, that there is a potential for medical benefit, um, in psychedelics. And there is, um, there is the start of some good research, um, NA nationally and most recently, some really great research that is being supported at the state level, um, to suit a more localized need. And as you'll learn, um, through our presentation today, Utah's need, especially for our military veterans, is more acute than most states in the nation. And so with that, um, I am very, very pleased to be joined by Matthew. Um, he's going to tell his story, then we'll go to Ben Lewiston. Then we actually have Michael Warden here as well. And, uh, with, uh, after those presenters, um, we will conclude and open it up for questions.

Good afternoon esteem members of the committee. Um, as uh, said, uh, my name is retired Lieutenant Colonel, US Army Special Forces, Matthew Butler. Uh, last Friday I sat in my parents' home and celebrated my father's 84th birthday. That in and of itself is not tremendously significant, but what is significant is that that celebration took place in the home where I was arrested. I grew up in rural Summit County. I was a Boy Scout, served diminish mission and joined the Army to extend my service. That decision would lead me to six deployments, all with special operations and 40 months of combat before retiring and returning to Utah in 2018. Before retiring, I'd been diagnosed with alcohol, u alcoholism, uh, drug addiction, treatment resistant depression, PTSD and suicidal ideation By Father's Day of that year, I was going through my third divorce and was estranged from my children. And my life was full of rage. A disagreement ensued that quickly escalated into violence. My father made the hardest decision of his life that day, and he had me arrested. I was charged with destruction of property during a domestic disturbance and taken to the Summit County Jail. Perhaps the biggest takeaway from my time in jail was that I had to end that cycle of insanity, you know, doing the same thing over and over and over again, expecting a different result. I was, see, I was doing everything that the expert said and that the VA told me to do. I took a handful of pills, including an antidepressants. I was in counseling. I attended, um, group therapy and anger management class. But despite all of those efforts, nothing made a difference. And my life continued to spiral out of control. I had a total of 12 restraining orders on me, and I was well known by Loa local law enforcement, realizing that I had to do something different. I started research alternatives and discovered a psychedelic called ayahuasca. A tea that was made from plants found in the Amazon. I can say without absolute certainty that I own my life, my happiness and my sobriety, and most, most of all, the mended relationships with my family to that ayahuasca ceremony weekend. And the careful and occasional use of other psychedelics, my dear sweet mother who stood in her garage crying uncontrollably and watching through tear filled eyes as I was led away in handcuffs that day in 2018, had this to say. And I quote Why I don't understand how psychedelics work. I know that they do. We got our son back, the one that was sent off to the Army. I strongly urge you to support House Bill three 90. So Utah can lead the nation in creating safe, legal and medically supervised research options for veterans here in the state. Thank you. I'm happy to answer any questions.

And for staff Ben Lewis should be online.

All right, go ahead. Hi, can folks hear me okay? Yes. Okay, great. Well, uh, thank you members of the committee and thank you, representative Daley, Provo, and Matthew. My name is Ben Lewis. Um, I apologize. I can't be there in person today. I'm in clinic this afternoon. I'm an associate professor at the Huntsman Mental Health Institute. Uh, my clinical work is focused on adults with severe and often treatment resistant mental illness. And my research is focused on psychedelic assisted therapies, in particular for treatment resistant conditions. My research has involved a range of clinical trials that have been approved by the FDA, the DEA and our University of Utah Institutional Review Board. I have broad connections within our university environment as well as with the Salt Lake City va. I served on the mental illness psychotherapy drug task force several years ago, uh, for the state of Utah, crafting guidelines on the clinical use and applications of psychedelic compounds. And I currently serve on the National Network of Depression Center's work group for psychedelics and related compounds. I'm also the principal investigator of the University of Utah Psychedelic Science Initiative. My position on psychedelic treatments is that cautious, rigorous evaluation and staged evidence development are essential prior to any clinical rollouts. HB three 90 D represents a thoughtful and science forward approach. Rather than authorized in clinical programs, it authorizes a tightly scoped time-limited research trial under explicit legislative guardrails, alongside oversight by the FDA, the DEA and our institutional IRB to generate Utah specific safety and outcomes data. This distinction is central to how the bill should be understood. This is a not, this is not about public access, legalization, clinical rollout, or commercialization. Other states have pursued psychedelics through state governed research and drug development trials with FDA level oversight. And this has included Texas, Mississippi, more recently, West Virginia. Why focus on US military veterans with post-traumatic Stress Disorder or PTSD? Well, Utah is one of the largest veteran catchment areas in the nation. Post-traumatic stress disorder is a chronic and often debilitating condition that's estimated to affect 12 to 15% of combat veterans. PTSD is associated with significant medical, economic and social costs, as well as multiple comorbidities in veterans. PTSD is also associated with an increased risk of suicidal ideation and suicide completion. Together. PTSD and suicidality represent a crisis for veterans and for the VA system, placing huge burdens on patients' families and the VA healthcare system. There are existing treatments for PTSD, but they are significantly limited by high refusal rates, high dropout rates. Even after participating in one of these therapies, 60 to 72% of veterans continue to meet criteria for PTSD. There are two current FDA approved medications for this condition. However, up to 60% of patients do not respond. A VA PTSD psycho-pharmacology working group described the limitations of current treatment as a quote crisis in the pharmacotherapy of PTSD. As an inpatient psychiatrist, I frequent frequently work directly with the US military veterans with PTSD that are hospitalized at our institution. And I can speak firsthand as to the unmet needs for better treatments. This time limited trial would be conducted at the Huntsman Mental Health Institute with oversight by the FDA, the DEA, our University of Utah Institutional Review Board. It would combine a drug administration with a psychotherapeutic protocol in line with current safety and efficacy recommendations for psychedelic interventions. The proposed $2 million budget stands on its own and does not rely on matching funds to proceed. It describes the cost breakdown to run a trial with a requisite regulatory oversight, safety protocols and scientific rigor. That said, the Huntsman Mental Health Institute and its affiliated foundation have committed to supporting this work alongside the state. The foundation has pledged a hundred thousand dollars and is actively working with donors with the expectation of additional philanthropic support. In addition, my colleague Dr. Menan and I are prepared to contribute up to $250,000 of our own research funds to support the project reflecting our commitment to responsible execution. We believe it's appropriate for those closest to the work to share responsibility for its success alongside the state. These funds are contingent on state funding, however, state support is the state of Utah positioning itself as a leader in this space, committed to tackling veteran mental health with Utah, being home to one of the largest veteran catchments in the nation. The collaboration with the University of Utah demonstrates priority on scientific integrity and safeguards. Thank you very much.

Thank you. And then we just have, um, one more, one more co-presenter. Michael Warden.

Thanks. Thank you for the opportunity to speak. My name's Michael Warden. Um, I'm here in a personal capacity, but my professional background is of interest. I'm currently the chair at LDS hospital and I'm the medical director, um, of three behavioral health units there. And I also hold a position that was created by Intermountain in response to the bill two years ago, 2 66. I'm the consulting medical director for the psychedelic and ketamine initiatives. And as many of you know, after the Bill 2 66, which made an effort to provide access to psychedelic therapies, there, there was no access provided because the bill was limited in scope and it limited in ability to provide the necessary safeguards that we would need to provide these services. And so it's been a real rough year and a half or two years in this position because I know that there's great work to be done. And we've been hamstrung. Last year. There was another bill that was introduced SB 2 48, and some of you may have actually met me 'cause I came in opposition to that bill, which would've expanded psychedelic therapies, uh, to psychiatrists. Broadly, I am here to fully support this bill for being what those bills weren't. First of all, it is responsible. It is limited, and it is actionable. That is, this is something that can actually happen and will and will be done well. Um, I work for Intermountain Healthcare and none of this work will be done at Intermountain. So my reason for this is purely my professional belief that this is an important bill. It will be run by University of Utah. So there's no interest in me being here, outside of the strong belief that this represents a profound emerging opportunity to treat some of the most difficult conditions we treat as a chair of psychiatry ld. I see these patients every day, and this is what got me interested in psychedelic therapies in the first place. There is a significant contingent of patients in this state who are deeply suffering, and we are out of great ideas. I believe that psychedelic therapies represent the best great idea that we have right now, um, for these difficult to treat conditions. And we desperately need to further them through high quality responsible research like that, which will be done at the University of Utah. So I'm a strong supporter of this bill. I'm grateful for the opportunity to be here. Thank you.

Thank you. Um, I'll just make a couple of final comments. Um, later this week on your desk, I will deliver a packet that looks like this. We tried to have 'em ready for a committee today. Um, but one thing I just wanna point out, um, Utah's veteran suicide crisis is especially acute national average right now of, uh, veteran of suicides per 100,000 is 34.7. The Utah average for suicide, just population wise is 21 per 100,000. But our average veteran suicide rate in the state of Utah per 100,000 is 71.6 compared to the national veteran average of 34.7. Now, I understand as a scientist, and I've had a lot of opportunity this session to talk about science. Um, conducting clinical trials on a vulnerable population is a very, very sensitive, difficult topic to, to discuss. Um, there's a, it's a, it's really a catch 22. 'cause on the one hand, we need to be very, very careful about the clinical trials and the studies that we, um, that we undertake. But it's also very, very true that by not providing clinical trials on new treatments for very, very challenging health conditions, also does a disservice to those populations. And so that was what I was, what I really liked about, um, about this idea as we brought stakeholders together, was that this creates such a careful deliberate pathway that is very cognizant of all of those risks. Scientific research really is about relative risk. Um, and that is, is the failure to do something more damaging than the risk that might be posed in participating in a clinical trial. I believe that the relative risk on this provides a population of people who are desperate for relief, who are literally dying for relief. Um, I think that this is careful. It is. Um, it is, we are modeling this off of other states most recently, specifically the state of Texas. Um, I think that they're, they've done a, a great job in addressing gaps in research and gaps in available treatment, meaningful available treatment that is suitable to the state of Texas. This is Utah's version and we know that we like to do things a little bit better every opportunity that we can. We have a world class institution in the Huntsman Mental Health Institute. You have, um, received a letter or will, who have we? Yep. My intern's gonna pass out a letter, um, from the, uh, the CEO of the Huntsman Mental Health Foundation, um, expressing support for the opportunity. But the reality is we have struggled as a society to make really meaningful leaps in treating mental health crisis, especially something as challenging as treatment resistant PTSD. We just haven't made, um, we haven't done well enough in this area for a long time. And I really believe that careful exploration of this, and this is a treatment that is already approved, um, for, for pursuing by the FDA and the DEA. And as Dr. Lewis mentioned, this would be, um, controlled under the University of Utah Institutional Review Board, so that that indicates, um, world-class care in study standards. And so I think that this gives us an opportunity to finally get some meaningful answers and finally get at this horrific, uh, average that we've got, um, that Utah has to do something about. With that. Madam Chair, open up questions.

Uh, yes, I'd like to make a motion

Thank, thank you, Madam Chair. So there's a lot of different research that goes on in the United States. I guess many of those grants, uh, come from federal monies that are set aside for the grants. Um, what is it about this sit situation? And maybe you spoke to it, but maybe, maybe help me remember if you did. What is it about this situation that makes it, that, that normal way that studies are funded, I guess that is the most common way not work in this instance. If this, I mean, amongst all the other studies that could be funded, why is this, should the state pick this one out of all the others to put its money towards? Well,

I think that there are a couple of answers to that. Number one, federal, um, funding right now is really hard to come by. And also when you, when you accept federal funding for research, it comes with all the strings attached. And, um, we think that this is just a better methodology. And, um, you know, we've, we presented in higher education appropriations committee this morning to ask the state to be a partner in funding this. And that may be the case that, um, that the appropriation is funded, but it might not. But the way we've set it up is that it's not wholly dependent on that funding. It is an absolute truth that almost all medical studies are funded in part by government support and by private support. That's what large pharmaceuticals are. That's what fall small pharmaceuticals are. I think that this funding through the, um, HMHI Foundation and through, um, the Hunt Huntsman Mental Health Institute itself and the University of Utah offers, um, even more opportunity for transparency and clarity and most critically oversight by this body. This legislature has the opportunity to stay informed and, and be a partner in, in this innovative Utah specific project, which will be developed to meet the needs of Utahans, which is not typical in clinical trials that are, say, funded by the federal government.

One additional, if I may, Madam chair. So you had mentioned also that I think that a, a similar study may, you mentioned that there was some kind of study that had been funded in Texas. Yes. So is this kind of the same, the exact same study, but in our population here? Or is it by deliberate choice going to not be the same as what was done there? I mean, most medical studies of basic medical things are generalizable past the state boundary. So if you get a good study from Texas, does that solve our problem? What's different about this than that?

Um, well, I think that number one, it's more responsive to Utah population. And like I said before, I think that, um, I, I actually can't speak to exactly what's in the Texas study. I just know that I liked the framework and I thought that it was something that we could do meaningfully here with our resources and our oversight. Um, I just, I, like I said, I I think we can do it better. Okay.

Thank you. Thank you.

But I have one quick question. Just out of curiosity, what does one of these clinical trial, what would the procedure be for this? Is this done one time and then you're done? Is it like every month? Is it every week? Is it every day?

So the bill outlines, um, a couple of different, so we're also, I just wanna also clarify we're, I'm speaking to the first substitute, which actually paired back, um, the list of, um, of psychedelic medications that, that could be researched. And I am not a, a, a clinical scientist. Um, I don't, I don't do medical tri clinical trials, and so I, and I certainly don't research psychedelics. Um, so I would have to invite somebody who actually delivers this medication to answer that question. But, um, I do know that they're all different. So there would be different mechanisms as far as how many dosing and, and the pre-screening process. And I'm, I, I'd be happy to phone a friend if Dr. Lewis is still on or anybody else in the

Okay. Yeah. Happy, happy to chime in on that. And that's a great question. And, and, um, she's here, yes, as representative Daley Provo was, was mentioning, there are some variabilities depending on the specific compound that would be studied in the context of this trial. That being said, all of these treatments are really, um, aligned in that they are a, a limited number of treatments. So sometimes even a single dosing session, and that's a real contrast to standard psychopharmacology, right? Where somebody might be taking a medicine every day for, you know, some long duration of time. These treatments are time limited, often just a single session. And so a study like this would be looking at perhaps one treatment, perhaps a couple, right? But a but a very small number of sessions that are combined with a psychotherapeutic protocol. And that's really, that is another kind of key element to this sort of treatment. It's not simply giving a pill or giving a medicine. This is really a combination of a, a pharmacologic Parents to start again, start doing, I don't know if you can still hear me. Yes. Sorry, go ahead. Sorry. A combination of a drug and, and a psychotherapy protocol. Um, but it, but it's a very small number of treatments. And, and, and to also address a, a prior question as well that, you know, there, there have been other efforts in other states, Texas was brought up and that was looking specifically at, at ibogaine, a different, a different compound. Um, and it is true, like we can gain knowledge from other trials that, that have been done. And we, we will hopefully gain knowledge from what's being done in Texas, but that, that doesn't exhaust the kinds of questions that really face Utah veterans. And that that's not really a reason for not continuing to build an evidence base that we can then use very specifically in our state to address the crisis that, that our veterans face. And, um, anyway, well maybe I'll, maybe I'll stop there.

If it's okay, Madam Chair, um, Rona, Anya, Ron Hil fight is here. She couldn't answer the Texas question if that's of interest that Representative Ward had. Um, Representative Ward, do you wanna The question about the, what they're doing in Texas compared to what we're doing here?

Yeah. Anya's here.

Hello, my name is Anya swe, and, um, I was born and raised here in Salt Lake City, and I run an independent psychedelic research center called Pneumo Science and have been a long time collaborator with the University of Utah and Ben Lewiston. I'm completing my PhD in clinical psychiatry at the University of Cambridge in England, where I recently helped launched, uh, their psychedelic research center. And so just in the context of, um, comparing what we're proposing here in Texas, here in Utah with some of the other work that's been done in other states, including Texas, uh, and for additional context, uh, Texas has really been at the forefront of passing, uh, legislation that has really expanded access to psychedelic assisted therapy, specifically for veterans with PTSD and, and, and through primarily clinical research. And so, while we're taking some of the framework that was done in Texas, uh, with the bill that, um, Lynette Avril, uh, really helped spearhead, and I know she's on the call here who could take some questions for any, uh, one who has additional questions. Um, but there that bill, uh, house bill 1802, uh, was specifically to fund, um, a clinical study on psilocybin assisted, uh, therapy for veterans with PTSD. And so while that may be one of the psychedelics that could be investigated, uh, with the bill that we're proposing, we've put in, uh, particular elements that distinguishes it from the bill in Texas. Uh, and one of those elements is it requires trauma-informed, uh, preparatory and integrative psychotherapy to be used as a safeguard, um, when delivering the psychedelic, um, of choice. And so that's one of the, the additional safeguards we've, uh, implemented with it. And, um, it also allows us to look at other alternative psychedelics beyond psilocybin, if that's, um, what the research team decides to do. Thank You. Thank you.

Hello, my name is Kyle Bingham. I'm a combat veteran, and I received a treatment grant from veterans Exploring Treatment Solutions are known as vets. I'm here today in strong support of Utah, advancing this bill. Um, since 2001, more than 125,000 veterans have died by suicide. Um, estimates show between 17 and 44 veterans die by suicide every single day. We've heard some of these results earlier, some of these statistics. Um, traditional treatments often fail, many of us years of talk therapy, me, medications that don't work, or treatments that leave us emotionally numb. I was one of those veterans who looked down the barrel of his own gun and seriously questioned whether to keep living. I thank God I did not pull that trigger. I did not yet know how much better life could become. I joined the Army in 2002, served as a combat engineer in the 82nd Airborne Division, 19 years old. I experienced combat in Iraq during one mission. Multiple roadside bombs detonated on the vehicle I was driving while under fire. We survived, but that day changed me. Like many soldiers, I learned rules for survival, rules that were internalized, forgotten, and carried home for me. PTSD is what happens when rules made to survive combat are brought into civilian life where they no longer belong. Those rules shaped my reactions, my relationships, and my sense of safety. Long after the war ended, combat began to feel more familiar than peace. I later became a Green Beret and deployed multiple times before being medically retired In 2016. In 2023, after years of personal work, I reached a wall. I came to understand that much of my trauma lived as implicit knowledge, deeply embedded patterns that talk therapy alone could not access. It felt like trying to extinguish and inferno with a bucket. Through Evets Grant, I received psychedelic assisted therapy outside the United States. I cannot fully put into words that what that experience gave me. What I can say is this. It allowed me to reconcile with the weight I had been carrying for decades. It gave me lasting relief clarity in the ability to move forward. This treatment did not erase my past. It gave me my life back. I urge this committee to support this bill and give veterans access to safe regulated evidence-based treatment options here at home. Thank you.

Ward. Kyle, thank you so much for being here with us at this point. With what you have experienced so far with the treatment you received. Do you feel like you are now, I guess, cured, if we would say? Or do you feel like that you need, would need additional psychedelic treatments to, to continue to, um, get the benefit you need?

This is a very good question. I very much appreciate it because this is, this is, um, this is a good question. One that I've debated much, uh, for myself for. So all those things that weight in which I felt down there, um, I Uintah Mexico and did IGA and five M-E-O-D-M-T. Um, the, the things that I experienced in the things which I reconciled down there, they've been reconciled and they've been put in their place. Now, the thing, um, that hasn't changed is going to be, okay, well, it has changed, but what is different is how I'm going to react to life going on forward. And, and so that's something, um, that's always to be looked at because it's, it's part of these programs, um, part of these ways in which I've reacted to stress and internalized it, um, over all these past decades. And so, yeah, it might be, um, but as far as, uh, uh, re reconciling something that's been reconciled, I don't see the, the need in that. But as far as like, there might be more stuff in the works that needs to be worked through that no amount of talk therapy could ever get to the bottom of. So, uh, it very much could be needed to be repeated.

Thank you for the floor. My name is Corey Lynn Cheatum Bartley and I support, strongly support this bill. I'm, I'm gonna speak to you as a survivor of Complex PTSD, as well as a licensed trauma specialty psychotherapist that has training in psychedelic psychotherapy. My credentials include that I'm a licensed clinical mental health counselor, and I'm a nationally certified counselor. My training consists of evidence-based trauma methodologies, including EMDR, which is well known in the field. Um, I was fortunate in the year 2022 to be invited by MAPS multidisciplinary Association for Psychedelic Studies to participate in their training. And I trained under the principal investigator for phase two and phase three of MDMA clinical trials. During that time, I didn't have a lot of time, did I? Alright,

I'm Dr. Nesa Holmes. You have an email for me last night? Um, first of all, I wanna correct the record saying that Johns Hopkins has been studying this since 1970. I've conducted seven research projects myself around the world. I have presented at the un I have done work for Obama in Africa. I worked on the Mandela Washington project. I know about research. There are many problems with this research that will hurt a very vulnerable group of people. How do I know this? Because I'm married to a five tour Green Beret who I've written a book about. I've worked in Israel with IDF, the IDF, I know how PTS works. Our system is failing for multiple reasons, not just because of psychedelics not being offered or pharmaceutical. It's a much bigger problem. We've got to look at the amendments that have to be done on this. I I'm all about research. I love it. I think it gives us a lot of answers, but we need to also look at Johns Hopkins because they have a center they opened in 2019 and they've been working on it since 1970. So we might wanna look at some of that thing.

Am I a clinical scientist? I am a PhD psychiatrist. No, I'm not. I have a PhD in psychology.

I'm not opposing it. I'm opposing some of the things written in this, in this study. Okay. Thank you. That's all I'm saying. Thank you. Yeah,

Hi, my name is Michael Jones and I'm supportive. Uh, house Bill three 90. I am also a combat veteran. I serve from 2010 to 2015. And I did whatever other combat veteran does, they go to the VA for help. And I was just pushed with medication after medication and it does not work. It has not worked. And what I found in was the healing through psychedelic medicine. I traveled to Costa Rica where I was, uh, where I did the ayahuasca. And it has been one of the most helpful things for me. And I've, it's given my life back and my family could attest to that. And I really, really hope that if there is any doubt on this, to please just look at the science and the research behind this because it does help us veterans, especially as combat veterans. Thank you.

Ahead. Thank you. My name is Neil Schultz and I'm speaking for myself. Last year I had the opportunity of traveling to Costa Rica to witness ayahuasca ceremonies in the world's only medically licensed facility. And so I can say that having watched several veterans turn their lives around in one week, I can, I strongly support this bill when it's done appropriately and properly. And I, and I've seen personal results of that and, and so I, I'm very strongly support the bill. Thank you. Thank

My name is Whitney Dini and I'm a military wife here in Utah, a former Navy Seal. I'm intimately connected with the military, communicate, uh, community across Utah. I'm also a nurse and a lawyer and a mom. My three kids are named after friends of ours who died in combat and very connected to this cause. Um, when these men come home, it is not just scars of memories or physical injuries. Their brains are different. And countless of our friends have tried every possible way to get better, including standard therapy and medication and electric shock therapy. And they just find no respite and they flounder their marriages, flounder their families flounder, their kits flounder. And it's devastating. And I've seen the people in who have found this treatment, and I'm not a specialist, but it's a miracle, the before and after. And I fully support looking into this as a nurse. The trials, the, the, the boundaries, the professionalism is amazing. As a lawyer, I see the cusp benefit that you guys must have to look at. Is this worth it for Utah? And I'm telling you that it is. And as a military wife, this would help dozens and dozens of families, and I'm speaking for them today.

Good afternoon. My name's Brandy Bellows. Thank you for the opportunity to speak today. I am representing myself as well as several veterans that couldn't attend. Um, our veterans are not asking for shortcuts. They're asking to survive many return home, having given everything, body, mind, years of their lives in service to this country. And what they carry back with them is often unseen, trauma held in their nervous systems, in the body, and in their minds, these are not failures of character. They're the cost of service. And veterans do what we ask. They seek help, they comply with, they comply with treatment, they take prescription medications. And for too many, those approaches still bring no relief. Um, at, sorry, I'm just skipping ahead to the important parts. But basically this is not escapism, it's courage at its finest. Those who protect us should not have to risk themselves again in order just to heal. Lawmakers are not meant to be gatekeepers to survival. We are meant to be protectors of those who already gave everything. And I thank you for any consideration given.

Ahead. Thank you. Chair Hall, members of the committee. My name is Logan Davidson. I'm here on behalf of Veterans exploring treatment Solutions to support HB three 90. And I thank you for the opportunity to speak today. Vets is a 5 0 1 C3 nonprofit organization with a mission to end the disproportionate incidents of suicide among American veterans. Since 2019, we have provided financial and organizational support to more than a thousand special operations veterans and their spouses to leave the United States and access this Corinne countries where it is legal. Kyle, who you heard from earlier, is one of those thousand. We have supported legislation like this in states across the country, including in Texas and Georgia, and currently Oklahoma and North Carolina, and more than a dozen other states this year. While other states have taken important steps, many of them small, some large, Utah has the opportunity to take the next giant leap in psychedelic leadership and research. The passage of HP three 90 would place Utah at the forefront of veteran mental health leader innovation, building upon successful initiatives in other states. We would just respectfully request your support on this bill, and thank you for your time.

Hi, my name's Justin Ola. I am a, um, a US Navy veteran. I was born and raised here in Utah, and I will keep this short and sweet. Um, we have a higher than average military population in the state of Utah. We have double the rate of suicide and national average. When we come back. We're given a combat cocktail of medicine that does not work. And we're asking for the state of Utah to lead in this area to do the studies that would allow us to have access to something that would help us. Thank you.

Hello, I'm Eric Tolman. I'm a, uh, represent myself. I'm a civilian, but I'm, uh, friends with a lot of these guys here. And, uh, strongly, uh, recommend that you consider, um, passing this bill so that they have, um, access to help, because I've seen the transformation in my friends and, uh, what the opportunity has, um, you know, done for them. And let's bring it here so that they don't have to go out of the country or get it somewhere else illegally where it's handled professionally. And, uh, supervise. Thank you.

You. Thank you so much for the time. I'm really grateful that I have the opportunity to speak. I am Lynette Avril. I am a clinical psychologist, a trauma researcher, um, the daughter of a US Marine who died by suicide after years of struggling with ineffective treatments. And today I speak on behalf of myself as well as on behalf of Reason for Hope and the Veteran Mental Health Leadership Coalition, um, in strong supportive House Bill three 90. The, the Leadership Coalition is actually a group of over 60 veteran service organizations, um, really focused on mental health and suicide prevention. I will note that I am not a Utah native, but did my, um, undergrad at Westminster and my graduate school at the University of Utah. Um, and have had the opportunity to work at the Georgie Wallin VA all throughout my graduate training. Um, all of my work has been with veterans. I have worked at Premier institutions, and I have had the opportunity to publish many, many papers of veterans who have left the country. I know that these treatments work. I know they work well, they work rapidly, they work robustly, and that we need more research. Um, I would comment just a couple of quick things to the gentleman who, uh, Mr. Ward,

Uh, yes. I'd like to make a motion that we pass. Uh, the bill is substituted out with a favorable recommendation. The motion is in order. Would you like to speak to It? Yes, I would. So if you look at, uh, healthcare in our nation over the past several decades, you've seen that we've driven down, uh, rates of mortality for heart disease, cancer aids, and so many other conditions, even found a cure for many people with, um, cystic fibrosis, the hu the American Life's average lifespan a few years ago, finally started going down after a hundred years because of deaths of despair, which includes suicide. The amount of research that has been poured into those areas is very small compared to those other areas. So I think this is very timely. Um, this just one statistic is demonstrative of why we need to do this. In, during the Vietnam War, we lost approximately 47,000 soldiers in combat. After the war, we lost 23,000 to suicide from about half the, the number of combat deaths to suicide. In Lincoln's second inaugural address, he said that we need to care for him who shall have born the battle and for his widow and his orphan. And, um, our veterans in this country have not been given the the level of respect and care that I think that they ultimately deserve. I believe that these types of drugs have the potential to change neural pathways and rewire the brain in ways that, um, traditional medications have not been able to do. Um, so I'd like to pass out, uh, this with a Fable recommendation. The last thing I wanna say before, um, go back to the sponsor is I wasn't planning to do this today, but this is an area near and dear to my heart, though I've never worn the uniform. Um, actually wrote a song about veteran suicide entitled Keep Fighting Soldier. I just wanna read one quick line from that. Faith and Friends helped see you through, helped you conquer the enemy of the red, white, and blue. With your duty done to your Uncle Sam, you headed back to the Promised Land. Uh, but those unseen scars, they caused you pain like a bullet inside. It was an awful strain. Some friends gave up, but you have a choice. Keep waging a flight, a fight, please. Just don't ever give up. So I think this is a, a small, um, measure, very important that we can do to, um, help, uh, our many veterans in this room. Thank you for your service and for so many others that are here. And, uh, hopefully we'll be here in the future if we can, uh, find some better treatments. Thank you, Madam Chair.

Thank you, Madam Chair. And, um, thank you for the motion. Um, I just wanna take the opportunity to express what an honor it is to be able to work on a policy like this. This is why we choose to serve our communities. I really think that we can make a difference in people's lives for the better. And I think we have an obligation to help as many people in as many ways as we can. But this, especially as the representative said, where we have as a society, we have failed our veterans. And I just wanna thank everybody for being here and sharing your stories. I know that just talking about it is, is itself its own additional trauma, but it helps us all understand a little bit better, um, mechanisms that we can, steps we can take finally, to help so many people turn a corner. I do really, really believe in the science, and I'm so, so grateful, um, to the clinicians who are passionate about this, who have worked on this for years, who are ready to step up with all the resources that we have to bear. Um, and I'd be really, really grateful, um, for a to sup for everybody to support the motion.

Thank you Mr. Chair. Thank you. Committee. Um, I gotta hand it to you for running an incredibly efficient meeting. That's the way we roll here in this committee. We're all good. Definitely Do. I really appreciate that. Um, so I have two co-presenters and if it's okay with the chair, we have a couple of handouts. Of course. Thank you. Um, so I'll briefly just introduce my guests. Matthew Butler is here to speak to the bill, um, uh, followed by Dr. Ben Lewis, um, to present, um, the why behind the bill, um, titled Veterans PTSD Clinical Research Amendments, which we will believe creates a, a really transformative and meaningful pathway toward getting some, um, moving the needle on mental healthcare treatment for treatment resistant PTSD among our veteran population. And I'll let them present, and then I will just follow up with some brief comments and then, um, uh, turn it back to the committee for questions. Thank you.

Thank you Esteem Members of the committee. My name is retired Lieutenant Colonel, US Army Special Forces Matthew Butler. On February 6th, I sat in my parents' home celebrating my father's 84th birthday. That in and of itself is not significant. What is significant is, is that celebration took place in the home of my father and family that had me arrested. I grew up in rural Summit County. I was a Boy Scout, I was a return missionary, and I joined the Army in an effort to continue to a life of service. That decision would lead me to six deployments, all with special operations and 40 months of combat before retiring and returning in 2018. Before retiring, I had been diagnosed with alcoholism, drug addiction, treatment resistant depression, PTSD and suicidal ideation. By Father's Day of 2018, I was going through my third divorce was estranged from my children, and my life was full of rage. A disagreement ensued that quickly escalated into violence. My father made the hardest decision of his life that day, and he had me arrested. I was charged with destruction of property during a domestic disturbance and taken to the Summit County Jail. Perhaps one of the biggest takeaways of my time in jail was that I'd had to end the, I had to end the cycle of insanity, you know, doing the same thing over and over and over again, expecting different results. You see, I was doing what the expert said, and I was doing what the VA said. I was on antidepressants. I was in counseling, I was in anger management, and I was in group therapy. Despite all those efforts, my life continued to spiral outta control. At that time, I had 12 restraining orders against me, and I was well known to local law enforcement, realizing that I had to do something different. I started to research for alternative solutions and discovered a psychedelic called ayahuasca. It's a tea made from plants found in the Amazon, I can say with absolute certainty that I owe my life, my happiness, my sobriety, my happy marriage, and most of all the MedEd relationships with my parents, my sister and my daughters, all to that ayahuasca ceremony weekend. And the careful and occasional use of other psychedelics. My dear sweet mother Who stood in her garage crying uncontrollably and watching through teared filled eyes as I was led away in handcuffs that day in 2018, had this to say. And I quote, I don't understand how psychedelics work, but I know that they do. We got our son back, the one we sent off to the army. While my story is uniquely mine, sadly, it's the norm. Hundreds of thousands of veterans who desperately seek relief from PTSD depression and addiction and suicidal thoughts are turning to underground overseas options because of safe, regulated care does not exist here at home. Organizations that help coordinate these efforts receive tens of thousands inquiries and applications every year. I'm personally involved in one and more well-known nonprofits and know from firsthand experience that the wait lines are 18 months or more. The demand is real. The suffering is real. The urgent the need is urgent. I strongly encourage you to support HB three 90. Thank you. I'm happy to answer any questions.

Thank you. And we'll invite up next, Dr. Ben Lewis. Thank You Matthew.

Thank you committee members and thank you Matthew. My name is Benjamin Lewis. I'm an associate professor of psychiatry at the Huntsman Mental Health Institute. My clinical work is focused on adults with severe and often treatment resistant mental illness. And my research is focused on psychedelic assisted therapies for treatment resistant conditions. I served on the mental illness psychotherapy drug task force for the state of Utah several years ago to craft guidelines on the clinical use of psychedelic compounds. And I currently serve on the National Network of Depression Centers work group on psychedelics and related compounds. I'm also the principal investigator of the University of Utah Psychedelic Science Initiative. My position on psychedelic treatments has been that cautious, rigorous evaluation and staged evidence development are essential prior to any clinical rollouts. HB three 90 represents a fundamentally different approach from prior Utah legislation. In this space, rather than authorizing clinical programs, it authorizes a tightly scoped time limited research trial under explicit legislative guardrails, alongside oversight by the F-D-A-D-E-A and our institutional review board to generate Utah specific safety and outcomes data. And this distinction is central to how this bill should be understood. This is not about public access legalization, clinical rollout or commercialization. This level of regulatory oversight is the highest level possible for a clinical trial. There are existing effective therapies for post-traumatic stress disorder, but they're significantly limited by refusal and high dropout rates. Even with established therapies and existing FDA approved medications, a significant majority of veterans continue to meet criteria for PTSD in veterans. PTSD is associated with an increased risk of suicidality. And together PTSD and suicide represent a crisis for veterans, their families in the VA healthcare system. This crisis disproportionately affects Utah military veterans. As an inpatient psychiatrist, I frequently work directly with US military veterans with PTSD that are hospitalized at our institution. And I can speak firsthand as to the unmet needs for better treatments. This time limited trial would be conducted at the Huntsman Mental Health Institute with regulatory oversight. It would involve strict inclusion and exclusion criteria. Safety monitoring defines stopping rules in the context of serious adverse events with regular reporting to the state on study process milestones and outcomes. State support is the state positioning itself as a leader in this space, committed to tackling veteran mental health with Utah, being home to one of the largest veteran catchments in the nation. The collaboration with the University of Utah demonstrates priority on scientific integrity and safeguards. Thank you very much.

Thank you Dr. Lewis. So, just a couple of points that I wanted to make. Um, there's this information is in the packets that you received. Um, but a a lot of, uh, issues inform, uh, the decision on trying to move forward on this, in this area, in this way. As Dr. Lewis mentioned, excuse me. Uh, the legislature a couple years did pass legislation a couple of years ago to allow for some carefully controlled, um, studies on psychedelics for mental health treatment. Um, if it was discovered by the entities that had been granted that authority, that it was actually limited in ways that made it not functional. And so it's kind of been in a holding pattern. Um, one of the reasons that we wanted to make sure that we focused on focus, this particular study on our veteran population is, um, is there are several reasons. Number one, Utah is a, as was mentioned, is a very high catchment area of, of veterans. We have a higher number of veterans population relative to most of the country. In addition to that, our veteran suicide rate in Utah is more than double the national average. And so we know that people are, are really, really struggling. Um, veterans are dying, their families are being shattered, or communities are broken. And increasingly, um, people struggling with treatment resistant PTSD are learning about these psychedelic treatments. But right now, because of the legal, um, restrictions on them, which are, I I will say they're appropriate, these are schedule one medications and need to be considered very, very carefully in an, in an extremely tightly controlled setting. But the reality is they know that they can leave the country and access these medications. There are mechanisms for them to do that. It's not in a clinically controlled environment. It's not in conjunction with the therapy that is required under this study, which we think is, um, really, um, key to making sure that the long-term outcomes are positive for the the patients. And really, because Utah has one of the best research environments in the, in the country. And I think that this is an opportunity to really get at some of the answers. This is not a study that we're saying, we're gonna figure out the gold standard and we'll all be figured out case closed. We're just saying this is a good opportunity, excuse me, to finally start to get some meaningful data so that we can give answers and opportunities to people who are, whose lives very lives are at risk. Um, and so, you know, I just want to, to wrap up by saying I don't have the three organizations off the top of my head. They're in your binder. There are a number of studies like this that are being supported, um, through policy and funding in several states across the nation. There are, this is the only one that is being proposed that is supported by the three primary veterans advocacy groups in this, in the nation. All three of them agree that this is, um, the best mechanism that we found to move forward for this. And so I'm hoping that we can, we can get this done. We can get some meaningful data, um, move forward for this, uh, incredibly at risk population, but also become the gold standard and model for other states to follow and hopefully, um, move careful, uh, move carefully forward, but forward. Indeed. And with that, Mr. Chair, we're open to questions.

Yeah, so treatment resistant post-traumatic stress disorder is probably best understood as veterans that have been through an evidence-based psychotherapy or evidence-based treatment and failed that treatment. Meaning that they still have, um, they have not met remission for PTSD despite going through, uh, evidence-based treatment.

Well, This in the future Potentially, although that would be down the road.

That's right. This is looking at individuals who have failed those existing treatments that are unfortunately limited. Right. And, and a significant majority of patients don't actually achieve remission with those Treatments. Yeah. And some of my

Thank you chair, appreciate the, the legislation, the, the, the intentional carefulness here compliment. Thank you for your service and, and your example and fighting the dragons and so drawn. But, uh, could you just review the fiscal note and how that interacts?

Yeah, yeah. Thank you for the question. So it does have a fiscal note, but passage of the bill is not, um, dependent on funding the fiscal note. So it sets up a funding mechanism asking the state to be a stakeholder in the, um, in the, the, the study and the cost of the study. Um, it also allows for other funding mechanisms. There's a donation already, several donations already secured by the Huntsman Mental Health Institute. Um, and several donors, many of them veterans themselves have come forward and offered, um, potential funding as well. And I, you know, I just wanna point out that virtually every medication that's approved, um, in, you know, even in big Pharma has often has a combination of private and public funding. And so this kind of copies that mechanism, but does it in a more thoughtful, um, accountable mechanism through the transparent process. And I am working with EAC to, to try to get some state funding, but recognizing we're in a tight budget year. So we'll see how it goes. Um, it does have a Sunset date. If the funding isn't raised, um, then any, any donated or or offer or promised money would have to be returned, um, before this study went was underway.

Follow up real quick is the, is the cost of study $4 million? Is that what it is? And then there's 2 million that is kicked in and matched. Is

That, so the, the nice thing about a study like this is it is scalable. They'll take in as many patients into treatment as they have, um, funding to support. Okay. Thank you. Yeah. Okay. Thank you.

Okay. We will. There you are. Okay. Go Ahead. Okay. Can you guys hear me? Gotcha. Great. Thanks for the, uh, opportunity to speak. My name's Justin Ola. I'm a veteran who works in the, uh, alternative medicine space. Um, I'm one of the cannabis license holders, and prior to that work, a lot of my work centered on, um, helping veterans who had run the gamut of treatment around PTSD to explore other treatment methods. Um, I just wanted to say this bill is a very important first step. Um, we do need guardrails in place. Um, I think the bill has those guardrails, um, firmly in place and will allow us to, um, further understand what this medicine can do for veterans. Um, we know that it's been very helpful to help people get out of those, you know, brain loops that keep us reacting in a traumatic way. And I would just encourage the committee to, to please consider passing this bill out to the Senate floor so that we can, um, further understand the mechanisms behind it and really get, um, maybe even lead the nation in a, in a way to move forward that would allow our veterans and potentially other people who experience, um, PTSD to have a treatment mechanism that, that, um, is, is very beneficial.

Okay. Thank you. Thank you, Mr. Chair. Appreciate the opportunity to speak. My name is Neil Schultz and I'm from Davis County. Um, I'm a board certified traditional naturopath, and I've seen a lot of veterans in this situation, so I work with some of them in regards to that. But we had a special experience, my wife and I last year as we traveled to Costa Rica to experience plant medicine in the only world's licensed, uh, resort, medically licensed resort. And as we watched the veterans go through that four day week long program, it was an amazing experience. We watched particularly two veterans who both expressed that they wouldn't be there if this program hadn't worked for them or didn't work for them. They would no longer be around for much longer. And they were pretty serious, um, with that expression. And so at the end of the week, we watched the countenance change. We watched their whole demeanor change, and, and they had been brought there by a friend who had been there the year prior. So they had started a community and, and this was a, such a beneficial experience to them. So I, I'm, I'm grateful for the good representative, the work that she's done for the state of Utah to tackle something like this, which is critical to our veterans and their support. So I highly support this bill. Thank you.

Okay. Hello Chair and members of the committee. Thank you, uh, for the opportunity to speak today. My name is Anya Swe, and I was born and raised in Salt Lake City. And I'm the CEO of Pneumo Science, which is a Utah based psychedelic research center. For more than a decade, I've been, I've worked in clinical research focused on people with the most complex treatment resistant conditions, particularly PTSD and veterans first responders and healthcare workers. I also worked very closely with clinicians, researchers, and legislatures in the state of Texas to help pass, um, house bill 1802, which authorized a state funded, uh, clinical study on psilocybin assisted therapy for veterans with PTSD. And, um, part of why I'm really passionate about this is that not only does Utah have a particular veteran mental health and suicide epidemic with up to 44 veterans, um, committing suicide, um, every day. Um, and there are not a lot of treatment options for those who have not responded to conventional evidence-based treatments for PTSD, primarily psychotherapy and medication. And so this, um, bill would allow, uh, psychedelic therapy to be, um, investigated within a clinical research context. And there are more than 25 veteran advocacy organizations supporting this bill across the United States, um, along with several local stakeholders and clinicians. And so I strongly urge you to support House Bill, uh, three 90 for these reasons. And thank you so much for your time.

Uh, thank you, Mr. Chair. Um, make a motion that we favorably recommend first substitute HB three 90, and if I can speak to that, Go ahead. Um, and I, you know, this is, uh, a labor of many years and I applaud the Senate. Uh, the representative, uh, actually I was the first one to introduce legislation trying to address specifically, uh, PTSD for our veterans. And I think where this bill is, is, is a ride, um, balance, uh, between being very careful of something that, you know, it still needs more research. And we are not as familiar in the United States as other places in the world are, and things in other places are working great and doing great things is, if you think about who can actually have access to those are very limited. And you have to be very, very privileged to be able to, um, afford those type of, um, access. So I, I think we are a state that applauds innovation. We just had a bill via one, the majority, the whip in our Senate related to trials and being, you know, really on the edge of trying to bring solutions for everyone because it's not gonna look the same. And this is not gonna be the solution for all of our veterans, but it's certainly gonna change the life of many and their loved ones. And it's, it is a serious concern that has not been addressed systemically. And this will just bring one professionals that are within a really, uh, respected institution such as the Huntsman Cancer Institute, and, uh, I'm sorry, the Huntsman Mental Health Institute, and, and making sure that we, that we are helping, um, the ones that have served us and continue to serve us. So I, I think it's the right approach. It is careful, it, it will require a lot of probably legislation moving forward, which you're the good representative knows how to do this as we've been in the cannabis legislation for many years. But I, I feel confident the state of Utah, if any state can do this, is the state of Utah. So I'm, I'm excited to see it moving forward. And with that, we'll ask for your support to our, our members in, in the committee. Thank you.

I could not have said it better and really appreciate the motion. Thank you.

To Adjourn. Motion adjourn.

consideration. Mad reading clerk For substitute house bill three 90 Veterans, PTSD, clinical Research amendments by Representative Daley Provo. This bill for Health and Human Services with the vote, 10 0 4 Representative Daley Provo.

Thank you, Mr. Speaker. I'm really excited today to present house Bill three 90 veterans PTSD treatment amendments. This is a piece of legislation that is crafted off of some legislation in other states, but is enhanced, um, by the expertise and creativity of, uh, the way we do things here in Utah. So HB three 90 creates a clinical study on the safety and feasibility of psychedelic treatments for, um, treatment resistant trauma. Uh, PTSD in our veteran population. It is a very tightly controlled study that will be conducted at Huntsman Mental Health Institute, um, adhering to very strict protocols that already exist as per the FDA, the DEA and the University of Utah Institutional Review Boards colleagues. The reason for this bill are why we're here today to discuss this. Utah is a, has an extremely high catchment of veterans in the state of Utah, and we are very proud of our veterans. We know the, however that we're failing them, veteran suicide in the state of Utah is over double the national rate. We know that over 44 veterans die every day from suicide in our nation, which is far higher than the number of, um, individuals we lose even in combat. So the questions that I want to answer for you today, why Utah? We have a very large, highly engaged veteran population. As I said, we have disproportionately high suicide rates among our veteran population. We have world class academic infrastructure here in the state of Utah, particularly with the, the benefit of having the Huntsman Mental Health Institute here in the state of Utah. We have demonstrated capacity for ethical, responsible, and accountable research. Why now? The reality for mental health crises in our nation and in our world is that we are experiencing as a population an increased mental health crisis. And of course, our veteran population in our veteran population that is particularly acute. Unfortunately, we haven't seen the medical advancements in this area that real, that we really need. And this bill provides an opportunity to answer some of those questions as to why. We also know that this is a treatment that people can seek if they leave the country, which is unfortunate because we don't want our veterans to have to leave the country as a last resort to save their own lives, keep their own families intact, to rejoin society in meaningful, fulfilling ways. And so if we can be responsible about how we implement this, which is the goal in this bill, we can bring that care here in a tightly controlled, careful setting. But the benefit of it over any other option is that it is layered and includes very careful therapy that happens concurrently with the administration of the medication in a tightly controlled, careful clinical setting. The science right now on psychedelic research is at an inflection point, and good work is being done in other states, but we think that we can do it better here in the state of Utah, which is why we're looking at funding and creating this program right here at the Huntsman Mental Health Institute. This does build on past legislation that has been done, um, that has been passed by this body that seeks to explore psychedelics as a treatment option. But unfortunately, past legislation left some gaps, and so we haven't been able to progress with that. This bill addresses those. So with that Mr. Speaker, I'll finish by just explaining that I think that this institutional partnership between the state and our, and our amazing Huntsman mental health months amazing mental, Huntsman Mental Health Institute, HMHI, um, provides us with an opportunity to really bend the curve for a population that deserves our care. Nobody in the world wants to leave our veterans behind, but the unfortunate reality is that they, we've got individuals who are hurting, who are suffering. They gave everything for our country. Many of them desperately, desperately want to be better. They've done everything that has been asked of them. They served our country. They came home carrying deep, deep trauma. They've done their therapy, they've taken their medications, they've done everything we've asked. And the treatments for some of these folks simply is not working. This gives those individuals a possibility, a ray of hope and hopefully a better tomorrow if we can get behind them and support this bill. And I'd ask for. And with that Mr. Speaker, I'm open to questions.

Thank you, Mr. Speaker. Uh, I have concerns about this bill because while I love to honor veterans in any way possible, and whenever I feel like 2 million, maybe 4 million with matching and four psychedelic drug treatments, um, is a really big thing to ask. I think we can care about our veterans without investing 2 million state dollars into psychedelics. And so I would just caution my members of the body to vote against this bill. Thank you, Representative Peck.

Thank you, Mr. Speaker. Will the sponsor yield to a question? Representative Daley Provo, will you yield to a question?

Yes. Thank you Mr. Speaker.

Does the, um, is, is the Huntsman Mental Health Institute the only institution in Utah that does that, that can do this, Uh, that has the capacity to do this?

No, but it is the partnership that we have chosen as the most meaningful that has the most current expertise in this.

All right, thank you.

Thanks, Mr. Speaker. I'm probably the last person that you would think would stand up and say that I support this bill. Uh, but I do, and, and the reason that I do is I've, I've had a lot of my soldiers in the past many years who let's say, have had 10 deployments in, in, uh, a 20 year period and are so, so troubled by the PTSD symptoms that nothing in the traditional program of, uh, treatment offered, uh, either through the military or the va, has been effective. And many of them have had to go down to Mexico and, and use these substances illegally. And, and we've seen really positive results from them. So for, for the fact that it would be handled in a clinical setting, um, I'm supportive of this for those really difficult cases who aren't getting relief in any other way. So I'd appreciate your support for this bill. Thank you.

Thank you, Mr. Speaker. I really appreciate. Um, any, any supportive thoughts and comments? I know that I've had a lot of conversations with, um, many colleagues and I can't stress enough how important it is to recognize that this psychedelics are an option for people experiencing treatment resistant PTSD for people who are at the end of their rope, that they feel like it's this or suicide. And we just wanna make sure that we give these people an option that isn't leaving the country, that isn't expending that, um, that expense, that unnecessary expense that are receiving these medications outside of a clinical setting, um, with or without, oftentimes without the underlying therapy that actually has potential for making the treatment more effective and more sustainable, sustainable long term. Um, I just, I wanna reiterate, veterans who are suffering, who are on the edge of taking their own lives, have absolutely nothing left. And they are begging for any opportunity to get some answers about what we can do better. And this is one thing that I believe that we can do better, but if we don't try, we're never going to know. And we're leaving people, um, to the whims of other opportunities or at worst, um, I'm sorry, other opportunities outside of the country, which is, is not a good mechanism for attaining healthcare. And so I think that, I know that we can do better by these veterans who are desperate, who are clinging to life. I've spoken with dozens of them. I hope that you've heard from some of them. We have a good opportunity to, to move the needle in mental healthcare. And particularly with this population who is crying for help, I would urge the body's support. Thank you.

Thank you colleagues. You, you'll have, uh, some material on your desk in, in regards to this bill, but, uh, what this bill addresses is Utah's home to a substantial veteran community, including many individuals with service related trauma who rely on state and regional healthcare systems for care. Unfortunately, Utah reports higher suicide rates than the national average, including among veterans underscoring the urgency of developing more effective interventions. Utah's research institutions, including the Huntsman Mental Health Institute, are nationally recognized and and have expertise in in psychiatric, uh, clinical trials, trauma-informed care, and federal regulatory compliance. Uh, Utah institutions routinely conduct FDA regulated investigative in investigational drug trials involving complex and vulnerable populations. So Utah, through this bill is not attempting to circumvent federal systems, is prepared to operate fully within them. Uh, as mentioned, we are unique in an unfortunate STA statistic in having an, uh, unusually high proportion of individuals with, uh, particularly veterans PTSD, that do not experience meaning meaningful or durable improvement with existing FDA approved therapies. So this bill proposes a study. No other state is currently conducting a clinical trial using the therapeutic model proposed in this legislation. No state enabled clinical trial is currently evaluating five M-E-O-D-M-T in a regulated therapeutic research setting, the protocol integrates psychotherapy with investigational compounds reflecting current scientific, uh, understanding on how these interventions exert their efforts. And the focus is research not commercialization. Veterans here are engaged as partners and not subjects, and I've met with, with several of these veterans that, uh, have, have gone through, uh, PTSD and are treatment resistant to PTSD and, and have found success through some of these clinical trials. So with that, Utah is not acting alone, but is leveraging a lot of its strongest institutions, which are listed on the handout you have in the service of its veterans. This legislation addresses the needs of our veteran population, contributes high quality data to the national evidence base, maintains the strongest regulatory and ethical safeguards, demonstrates col collaborative and accountable state leadership. And we have the opportunity here to lead with care urgency and integrity. So with that, I'm open to any questions,

Uh, I will waive summation. My motion is that we read first substitute house bill three 90 for a third time.

Point of personal privilege, Please. Granted,

And Utah is uniquely positioned and I would suggest uniquely obligated to lead responsibly in advancing clinical research for veterans with post-traumatic stress disorder. Uh, we have a large and highly engaged veteran population. We statistically are disproportionately high in suicide rates generally, but also for, uh, veterans in Utah. We have world class academic infrastructure here and we have just demonstrated a capacity for ethical research in this type of stuff. And so, um, This bill, no, no other state is currently conducting clinical trial using the therapeutic models. Proposed. Proposed. In this legislation, the protocol integrates psychotherapy with investigated investigational compounds reflecting current scientific understanding of how these intervi interventions, uh, exert their effects. And so the focus is research and not commercialization. We're looking to be safe. We're looking for feasibility and outcomes that are prioritized over speed or scale and veterans are engaged as partners in this, in this and not subjects. So the Huntsman Mental Health Institute has expressed strong institutional support for this. Uh, they're prepared to contribute institutional resources and financial support. The partnership en ensures that the study is well resourced, carefully monitored, and fully integrated. So through this legislation, you Utah can address the needs of veteran population at an elevated risk, contribute high quality data to the national evidence base, maintain strong regulatory and ethical safeguards to demonstrate collaborative accountable state leadership, and help offset the declining federal investment in mental health research. And with that I'm open to any questions.

I'll move that we pass. First substitute house bill three 90 And the question is under suspension of the rule.

Okay, listen up colleagues. I'm gonna upload another list and just, just to ruin the suspense. Senator Sandall, you're gonna be on standby with Senator Cullimore on the first two. So just pay attention on this new list. So, Mr. President pro tem, I move that the following bills be placed after house Bill 1 46 on the second second reading calendar in the following order. House bill four 10 substitute one house bill 5 0 7 substitute two house bill five 30 house bill 5 72 substitute four house bill 76 substitute three house bill 2 23 substitute one house bill 2 41 substitute three house bill 2 73 substitute two house bill 4 0 2 substitute one house bill 4 38 substitute one house bill 4 71 substitute one. That is my first motion.

Okay. And Fallon's given you a pause, let's make sure I didn't do something wrong. Will, will you read the last two bills on that list again?

Do we need to motion on that? Okay. All in favor of placing the uh, red end bills right underneath. First substitute house bill 4 86 and the order,

Motion. I'm gonna, I'm gonna do another motion but again, Senator Sandall. Senator Comore. You guys are both on standby on the first two bills. So the next motion I move that the following bills be lifted from the Senate tabled on third reading calendar and placed after first substitute house bill 4 71 on the Senate second reading calendar in the following order. House bill 73 and house bill three 18. That is my motion. Okay, I'll infl favor placing those two bills on the Senate. Uh, second reading calendar after house.

Thank you Mr. President Pro Tem. I'd like to mo make a motion to recall house bill three oh eight. We pass it last evening. It's, it's back to the house. Um, I'd like to recall it and uh, amend it. We had another homeless bill that failed in the house yesterday and I'd like to take some of the non-controversial provisions from that bill and stick it into this bill.

Thank you Mr. President Prote. I'm happy, I mean I'm okay with the motion. Just asking if there will be a minute to circle that bill so we can review that. Of

Course. Yeah. Okay. I haven't subbed it yet, I just need To recall. Oh perfect. Thank You. I'm only moving to recall it right now.

Judge A recall. Perfect. Thank you Mr. President Prote.

motion to um, move amendment number one, this amendment to adjust the fiscal note to what is currently funded in the budget.