Vermont Legislative Update 04-26-2019
An analysis from DRM's Government & Public Affairs Team
Vermont Legislative Update Quick Links
House committee hears testimony on medical monitoring bill
The House Committee on Judiciary heard vastly different views this week on a new version of S.37, legislation passed by the Senate last month that would have adopted a strict liability standard for harm caused by toxic chemical releases, as well as creating a new cause of action for medical monitoring damages. The new version, drafted by Judiciary member Martin LaLonde, D-S. Burlington, strips out the strict liability standard and makes modest changes to the medical monitoring provisions.
Trey Martin, representing DRM clients, along with fellow lobbyist Warren Coleman, presented the committee with a modified bill on Thursday that is generally supported by Vermont’s business community. That version is intended to align the legislation with decisions from state and federal courts that have recognized the cause of action for medical monitoring.
Emily Joselson, a plaintiffs’ attorney from Middlebury, gave strident testimony in response, urging the committee to reject the “industry fear-mongering.” Joselson avoided any mention about the specific provisions in the bill, instead portraying the issue as one pitting David against Goliath; innocent Vermonters against greedy and villainous manufacturers. She argued that “every single suggestion in Martin’s and Coleman’s proposal would create insurmountable barriers” for claimants.
The debate continued on Friday, with DRM attorney John Hollar squaring off against Vermont Natural Resources attorney Jon Groveman over the details in the bill.
Committee members are clearly struggling to understand the complex legal concepts embedded in the legislation. They are expected to hear additional testimony next week before beginning mark-up and deliberations.
Minimum wage passes House General with funding for Medicaid providers
The House General, Housing, and Military Affairs Committee passed S.23 on Friday after a day of tense debate. Rep. Matt Birong, D-Vergennes, joined the two Republicans on the committee in voting against the bill. Birong had offered an amendment to slow the rate of the wage increase, which was rejected by the committee.
Last week, the committee considered an amendment to the bill that would provide annual Medicaid rate increases to certain health care providers to fund minimum wage increases and wage compression. On Tuesday, the committee received numbers from the Joint Fiscal Office outlining the budgetary pressure the amendment would create. This testimony seemed to kill the bill’s momentum and Rep. Tom Stevens, D-Waterbury, delayed the planned vote. Over the course of several days, provider groups worked with the committee to refine the original estimate and the language. In the end, committee members reached a compromise.
The bill appropriates funds to home health agencies and long term care providers to fund the increase in the minimum wage and wage compression. It also requires that the Agency of Human Services to address any shortfall in the appropriation in the budget adjustment process. Finally, it calls for a study of the impact of increasing the minimum wage on home health agencies, long term care providers and all other Medicaid providers beginning in FY21.
Water bill moves to Ways and Means
The House Committee on Natural Resources, Fish and Wildlife concluded its work and approved S.96 this week on a vote of 10-1. The bill, and the elaborate governance mechanism it would create to oversee state investments in water pollution reduction projects, is now headed to the House Committee on Ways and Means where the debate on how to fund Vermont’s clean water needs is likely to heat up again.
House approves T-21 legislation
The House voted 124-14 on Tuesday on a bill that increases the minimum age of tobacco and related product purchases to 21. The bill, S.86, passed the Senate earlier this year by voice vote.
The House rejected by a 33-109 vote an amendment that would have exempted members of the military from the bill.
The large margins of support show how far public opinion has shifted on the issue in just two years. The same bill passed the House in 2016 by a relatively small margin and failed in the Senate the next year by a 12-16 vote.
Gov. Phil Scott has said that he will sign the legislation.
Health committee advances medication-assisted treatment bill
The House Health Committee gave its approval this week to S.43, a bill that limits prior authorization requirements for medication-assisted treatment. The bill requires insurers to remove prior authorizations and cost-sharing for medication-assisted treatment for patients as long as the treatment is within the U.S. Food and Drug Administration dosing recommendations. It also ensures that at least one MAT medication from each drug class is available on the lowest cost-sharing tier. The health care committee amended the bill to remove prior authorizations for all counseling services associated with MAT.
The bill does not apply to Vermont Medicaid. As of October 2018, the Department of Vermont Health Access does not require prior authorization for MAT sublingual film for Medicaid beneficiaries. The bill does require DVHA to report to the legislature on the use of prior authorization for all MAT services in Vermont’s Medicaid program.
Senate panel advances rural health care bill
The Senate Health and Welfare on Friday voted to approve H.528, a bill that creates a Rural Health Services Task Force. The Task Force will look at financial, administrative, and workforce barriers in Vermont’s rural health care system. The bill requires the Department of Mental Health to determine the mental health bed needs for residential programs across the State by geographic area and provider type. The evaluation will include a review of needs in rural locations, current and historic occupancy rates, an analysis of admission and referral data, and an assessment of barriers to access for individuals who require residential services.
The bill also calls for the Department of Mental Health to collaborate with the Vermont Housing and Conservation Board, the Vermont State Housing Authority, and other community service organizations to increase affordable housing opportunities for individuals with mental health needs and those experiencing homelessness by identifying potential funding sources to support housing.
House panel approves ambulatory surgical center licensing requirements
The House Health Care Committee on Wednesday advanced S.73, a bill that would require ambulatory surgical centers to obtain operating licenses from the Vermont Department of Health. Licensees would be required to meet specific minimum operating standards and allow VDH to conduct inspections and investigations as it deems necessary to ensure compliance.
The bill also requires the Green Mountain Care Board to collect and review data from ambulatory surgical centers on scope of services, volume, utilization, payer mix, quality, coordination with other parts of the health care system, and financial conditions. The GMCB will also consider ways in which surgical centers can be integrated into payment and delivery system reform initiatives.
The bill is headed now to the House Committee on Ways and Means for review of the proposed $600 licensing fee intended to pay for administrative costs at the Department of Health. The Joint Fiscal Office noted that with only two ambulatory surgical centers currently in Vermont, the licensing fee will raise only raise $1200 annually.
The House Ways and Means Committee is expected to vote on the bill early next week.
Brattleboro Retreat provides update on bed expansion
Brattleboro Retreat President and CEO Dr. Louis Josephson appeared before the House Corrections and Institutions Committee on Thursday to provide the committee with an update on the expansion of inpatient mental health beds and treatment for the most acutely mentally ill. Josephson told the committee that clinical leadership and the design team determined it would be prudent to invest the state’s $5.5 million in a single location – the Linden Lodge – rather than two separate buildings as was originally planned. He said focusing on Linden Lodge will allow them to build a modern, 12-bed inpatient unit that will provide a high quality care environment that meets today’s standards of care while also meeting the future needs of the state.
Josephson said the Retreat is optimistic that the 12 beds will be online in the first half of 2020. The project will include an outdoor courtyard, a dedicated admissions area, and other safety enhancements. The Agency of Human Services, the Department of Mental Health, and the Department of Building and General Services support the change.
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