Updates
March 15, 2019

Vermont Legislative Update 03-15-19

An analysis from DRM's Government & Public Affairs Team

Vermont Legislative Update Quick Links

Strict liability and medical monitoring bill clears Senate

Child care bill passes unanimously out of House Human Services

House Commerce approves workforce development bill

Committee advances hospital transparency bill

Panel passes social services integration bill

Panel advances primary care spending legislation

Committee passes rural health services bill

Individual health insurance mandate penalty received skeptically

Strict liability and medical monitoring bill clears Senate

The Senate this week passed a bill imposing strict liability and medical monitoring obligations on commercial users of toxic substances on a 21-8 vote. Given the recent and intense focus on toxic releases of chemicals such as PFOA, the passage of S.37 was expected. But the bill moves Vermont far beyond jurisprudential norms.

The legislation holds any company with ten or more employees liable for any personal injury or property damage caused by a chemical used in its operations, even if that use is fully compliant with every applicable federal, state, and local regulation. Companies would be liable even if the harm were caused by the undiscoverable and intentional wrongdoing of an upstream supplier, or the reckless misuse of a product by a downstream consumer. Even proponents of the bill acknowledge that no other jurisdiction has adopted such a liability standard.

Less controversially (though not without room for argument), the bill also creates a statutory cause of action for recovery of medical monitoring damages when a plaintiff has been exposed to a harmful substance beyond background levels. A handful of state courts already recognize such claims in the case of operator negligence or recklessness, and the bill could be amended to codify those decisions and provide bright lines for parties on all sides of the issue in Vermont.

Advocates and business representatives now look to the House, which rejected the strict liability and approved the medical provisions last year.

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Child care bill passes unanimously out of House Human Services

The House Committee on Human Services finished an impressive week of collaborative work on Friday afternoon, voting unanimously to approve a committee child care and early learning bill. The committee worked closely all week with child care advocates and representatives from the Scott administration to consolidate several previously introduced bills into a final product that committee members and advocates applauded following the vote tally.

The bill would:

  • Appropriate nearly $7 million to the Childcare Financial Assistance Program to adjust the sliding fee scale to support more families in need;
  • Appropriate $100,000 to the Department of Children and Families to modernize the Bright Futures Information System;
  • Require that at least $1 million of the appropriation for CCFAP be used to provide student loan repayment and scholarship assistance to individuals working in regulated childcare centers; and
  • Appropriate $300,000 to the Department of Children and Families Integrated Services to increase reimbursement rates to providers.

The bill will go to the House Ways and Means and Appropriations committees before heading to the House floor, but it is clear that House leadership has already blessed the expenditures in the bill, so a pathway for final approval seems straightforward.

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House Commerce approves workforce development bill

Several weeks and nineteen drafts later, the House Commerce and Economic Development Committee has passed its workforce development bill. The committee spent weeks hearing testimony on the workforce issues facing Vermont before starting work on a bill just before Town Meeting week. On Friday afternoon, the committee voted the bill out 11-0.

The bill includes an assortment of provisions meant to address the many workforce issues that were raised by the Administration and witnesses. It funds weatherization job training, directs the Vermont Training Program’s money to apprenticeships or programs that result in a credential of value, and supports the governor’s proposed worker relocation program. The bill also recognizes the Vermont Talent Pipeline Management Program, an initiative of the Vermont Business Roundtable that links employers and education providers to promote skills development in high-need fields.

Other provisions include the creation of an Adult Career and Technical Education Study Committee, the commissioning of a study from the Office of Professional Regulation on the barriers to entry for nursing educators, and the creation of a registry of employers by the Department of Labor.

The final version of the bill is consistent with early drafts’ focus on adult and technical education, nursing shortages, and worker recruitment. One notable deletion, however, is a proposed tax credit for child care businesses or employers that provide child care.

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Committee advances hospital transparency bill

On Friday, the Senate Health and Welfare Committee advanced S.31, a bill that aims to provide consumers with information it believes is necessary to make informed health care decisions. The bill requires the Green Mountain Care Board to examine health care price transparency initiatives in other states to identify possible options for Vermont and how to make that information available to health care consumers.

S.31 also requires the GMCB to recommend ways for hospitals and insurers to give patients a single, comprehensive bill that reflects his or her entire financial obligation.

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Panel passes social services integration bill

After weeks of testimony, the Senate Health and Welfare Committee advanced S.7, a bill that evaluates the extent to which social services are integrated into Vermont’s health care system and OneCare Vermont, the state’s only accountable care organization.

The bill requires:

  • The Agency of Human Services to submit a plan to coordinate the financing and delivery of Medicaid behavioral health services and Medicaid home and community-based services with the all payer model, an alternative payment model that incentivizes value and quality.
  • The Green Mountain Care Board to evaluate the degree to which parent-child centers, designated mental health and specialized service agencies, and home health and hospice agencies are integrated into OCV.
  • The director of trauma prevention and resilience development and the director of maternal and child health to assess the effectiveness of embedding social service providers within primary care practices, as well as an evidence-based nurse home visiting model used in the Children’s Integrated Services Division.

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Panel advances primary care spending legislation

On Friday, the Senate Health and Welfare Committee approved S.53, a bill that requires the Green Mountain Care Board to determine the proportion of health care spending that is now allocated to primary care in order to target any appropriate increases. To accomplish this work, the GMCB and the Department of Vermont Health Access will identify the categories of health care professionals who should be considered primary care providers and which procedures are considered primary care services.

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Committee passes rural health services bill

The House Health Care Committee unanimously passed a committee bill today that creates a Rural Health Services Task Force. The task force would evaluate the rural health care in Vermont and explore ways to ensure that it provides access to affordable, high quality health care services. Members said the recent situation at Springfield Hospital and the latest report that many of Vermont hospitals posted operating losses in 2018 has elevated the need to ensure the system is on sound footing.

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Individual health insurance mandate penalty received skeptically

The House Committee on Ways and Means expressed serious concerns this week about the proposed penalty structure in a bill that would affect the individual health insurance mandate.

As proposed, H.524 would impose a three-tiered financial penalty for failure to maintain minimum essential health insurance coverage that is modeled on the federal penalty structure. The bill includes exemptions for low-income individuals, as well as those who have short gaps in coverage or gaps based on religious reasons or hardships. The state penalty would be suspended if the federal penalty is reinstated.

Doug Farnham of the Department of Taxes told the committee that the administration doesn’t support any penalty and said that the structure is so complex that the Internal Revenue Service failed to implement it properly. He said it was hard to imagine Vermont’s Tax Department doing a better job, and estimated that it would cost the department at least $1 million to implement.

Given the wide range of member concerns, Chair Janet Ancel, D-Calais, said that the committee would spend some of its limited committee time on the issue next week.

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