Vermont Legislative Update Quick Links
Governor vetoes Paid Family Leave bill
Commerce nears approval of bill to limit non-compete agreements
Testimony continues on bill to ban flavored tobacco
Agreement finally reached on employee misclassification bill
Senate finance panel considers eliminating primary care cost sharing
Senate advances Budget Adjustment Act
Scott administration proposes Woodside as secure residential site
Workforce a priority for health care committee
Act 250 district commissions safe for now
Bi-state Primary Care Association holds legislative day
Workforce Development Report presented
Pupil weighting recommendations may affect property taxes
Physician Assistants seek licensing changes
Changes pondered to corporate income tax
Department of Mental Health presents 10-year plan
Governor vetoes Paid Family Leave bill
As expected, Gov. Phil Scott has vetoed a paid family leave bill that was passed by the legislature. In a veto statement that he issued on Friday afternoon, he reiterated that he would not support a mandatory paid family leave program that includes a payroll tax. While dismissing the efforts of the legislature, he is moving forward on a voluntary plan that begins with the implementation of a program for Vermont’s state employees.
The House and Senate will attempt to override the Governor’s veto. Needing two-thirds of those present in both the House and Senate will be a challenge. The Senate appears to have the votes for that effort but the House numbers are much closer. There were a number of liberal-leaning Democrats and Progressives who voted against the bill because they didn’t believe it was generous enough. Democrats and Progressives may feel pressure to override the veto in an effort to give Lt. Governor David Zuckerman an election issue in his upcoming challenge to Gov. Scott.
Commerce nears approval of bill to limit non-compete agreements
After hearing from more than 25 witnesses since last May, the House Commerce and Economic Development Committee is close to passing a bill that would restrict the use of non-compete agreements.
The bill as drafted would allow employers to enter into non-compete agreements with key employees who earn more than $75,000 per year. Employers would be required to pay for up to two hours of attorney consultation for the employee. Agreements would have to be supported by “substantial consideration,” and agreements entered into as part of a promotion would have to be supported by additional compensation.
The committee heard testimony from several industries with continued concerns about the bill. Financial advisors urged the committee to exempt nonqualified deferred compensation agreements, which could be prohibited by the bill. The Vermont Association of Broadcasters argued that the wage threshold is too high and doesn’t reflect the salary levels of broadcast journalists.
The committee is expected to vote on the bill early next week.
Testimony continues on bill to ban flavored tobacco
The Senate Health and Welfare Committee heard more testimony this week on a bill, S.288, that would ban the sale of flavored tobacco products, including menthol cigarettes. The committee heard from a health expert from the University of Vermont and a UVM Medical Center researcher who presented compelling evidence that menthol cigarettes and flavored products are resulting in high levels of addition by young people.
The committee is expected to vote on the bill next week.
Agreement finally reached on employee misclassification bill
The 2019 legislative session ended without a compromise between the Senate and House conference committee members on S.108, a bill to increase penalties on employers for misclassifying employees. The major sticking point was the Senate’s desire to require cases of misclassification complaints to be heard by the Attorney General in addition to the Department of Labor. Current law requires DOL to consider these complaints. The House wasn’t supportive of this second bite at the apple, feeling that the system didn’t need a big change.
After a seven-month break, the committee reconvened this week and quickly reached agreement. The compromise now states that complaints will be considered by DOL and may be referred to the AG at DOL’s discretion. However, DOL will be required to refer a case to the AG if it has been determined that the employer engaged in employee misclassification on two separate occasions within five years or is alleged to have misclassified five or more employers.
This bill will be up for action in the House and Senate next week and is expected to pass. The language can be found on page 154 of this House Calendar.
Senate finance panel considers eliminating primary care cost sharing
The Senate Finance Committee took testimony Tuesday on S.245, a bill that proposes to eliminate cost-sharing requirements for primary care. Blue Cross Blue Shield of Vermont Director of Government Affairs Sara Teachout told the committee that there is already no cost share for preventative care, and this proposal would only affect 25 percent of Vermont’s population. Teachout testified that although “spending money on primary care is the right thing to do … , it doesn’t produce cost savings, as people will live longer and require longer and eventually require more expensive care.” Sen. Chris Pearson, P/D-Burlington, sponsor of the bill, pushed back, saying, “Everyone has said that if we can treat people up front, we can save money. It is the basis of our health reform efforts.”
Both Teachout and Susan Gretkowski of MVP said that the requirements of the federal Affordable Care Act would make it difficult to meet the proposal’s requirements. Each plan must fall within a range of cost share percentage between insurer and insured. Locking in the amount for the copay for primary care (of zero) will put pressure on other line items. Both said that this proposal would increase premium costs.
Chief Health Care Advocate Michael Fisher is supportive of the idea, but he told the committee that the proposal may need to be revised to reach the right balance so as not to increase insurance costs.
The committee will return to the bill in the next few weeks.
Senate advances Budget Adjustment Act
On a vote of 28-1, the Senate advanced the FY 2020 Budget Adjustment Act on Thursday. Sen. Corey Parent, R-Franklin, was the lone dissenting vote. Senate Appropriations Committee Chair Jane Kitchel, D-Caledonia, said the BAA is supported with an additional $18 million in revenue from July’s revenue upgrade. The most recent upgrade in January will be part of the FY2021 state appropriations bill.
Parent rose in opposition to the bill due to cuts to the OneCare Vemont RiseVT program. He said RiseVT started at his local hospital and has expanded to many rural communities in the state. The program helps children and families embrace healthier lifestyles and he opposes the budget reduction of $550,000. Kitchel responded that the Department of Vermont Health Access has made a commitment to OneCare and will honor that. She said the committee wanted to have a rigorous process between the Agency of Human Services and OneCare for the allocation of delivery system reform dollars to prevent duplication of state programs.
The BAA:
- Transfers funds to address deficits in the Workers’ Compensation and State Liability Insurance funds;
- Provides funding to the Department of Corrections for out-of-state beds, medication assisted treatment, and Hepatitis C treatment;
- Addresses the gap in the Vermont Technical College National Guard tuition program;
- Provides for a rate increase at the Brattleboro Retreat;
- Funds increased costs in Judiciary; and
- Provides funds to the Department of Aging and Independent Living for increased costs of serving higher acute needs patients at nursing homes.
Scott administration proposes Woodside as secure residential site
The commissioners of the departments of Mental Health and Building and General Services have recommended the closure of the Middlesex Therapeutic Community Residence, and the construction of a new facility at the site of the Woodside Juvenile Detention center. On Friday, BGS Commissioner Chris Cole told the House Health Care Committee that the Scott administration is proposing that the Woodside facility be demolished and replaced with a 16-bed, state-run, physically secure residential program with increased clinical capacity. Cole said funds to support the planning and development of a larger, permanent facility are included in the proposed FY 2020 Capital Bill. Cole told the committee that it is not possible to retrofit the existing space into a therapeutic environment.
DMH Commissioner Sarah Squirrell said six of seven beds at MTCR are filled and potential referrals are being reviewed for the seventh bed. At any given time, there are 10-15 people who could be referred to a secure residential program that has the capacity to perform occasional Emergency Involuntary Procedures. EIPs include restraint, seclusion or emergency involuntary medication. Squirrell said this cohort of individuals occupy significant inpatient hospital bed days and cannot be appropriately served at the Middlesex secure residential program due to current regulations for Therapeutic Community Residences, the facility’s design, and the staffing pattern. She said the new facility will continue to serve individuals who no longer require acute inpatient care, but who remain in need of treatment within a secure setting for an extended period.
The committee plans to take additional testimony on the proposal.
Workforce a priority for health care committee
The House Health Care Committee has identified workforce as a priority. This week, it heard from Rural Health Task Force member Laura Pelosi that Vermont’s health care workforce is aging, there is a decline in licensed professionals, and there are workforce vacancies in every sector. She said Vermont’s health care workforce crisis is driven by factors including student debt, education and credentialing challenges, licensing challenges, and provider burnout. Pelosi said the task force recommendations include occupational licensing reforms, higher education reforms, financial incentives, and maximizing of the workforce by removing telehealth barriers and reducing administrative burdens. The report can be found here.
The committee also heard from VNAs of Vermont Executive Director and task force member Jill Olson on care coordination. Olson thanked the committee for its support of the delivery system reform dollars to OneCare Vermont, which has allowed health care sectors to work as a system to provide care in the most appropriate setting. She described the UVM Health Network Home Health and Hospice Longitudinal Care Program, which is being expanded to other communities thanks to delivery sytsem reform funding. It allows patients to receive nursing, community health worker visits and telemonitoring services at home beyond the point where Medicare requires discharge. In Chittenden County, the program has successfully reduced hospital admissions and emergency department visits, reducing costs and improving patient experience.
Act 250 district commissions safe for now
The House Committee on Natural Resources, Fish, and Wildlife continued its deliberations this week on reforms to Act 250, Vermont’s landmark land use law.
A mutually agreed-upon joint proposal from the Scott administration and environmental groups to limit the functions of the state’s nine district commissions in favor of a professional three-person board appears to have little support among legislators. Swayed by the testimony of witnesses to keep district commissions in their current form, the committee is considering an amendment detailing a process for on the record proceedings at the district commission level to be used on appeal.
The new board proposal has been a key component of the alliance between the administration and environmental groups. The effect on their willingness to work together is unclear if the proposal is rejected by the committee.
The committee also agreed to incorporate exemptions for the state designation programs of Downtowns and Neighborhood Development Areas as outlined in the joint proposal. These designations are compact, previously developed areas with limited natural resource value, and are governed by robust local zoning bylaws that largely satisfy Act 250 criteria. The administration has long sought to remove jurisdiction for these areas, arguing the added layer of Act 250 review is a costly and unnecessary redundancy. In the joint proposal, the Vermont Natural Resources Council agreed, but with a caveat – during testimony Kate McCarthy, Sustainable Communities Program Director for VNRC, reminded the committee that consideration for designation exemptions was in exchange for greater protections in the state’s more critical resource areas.
The committee expects to review a new draft early next week, with a vote coming perhaps by the end of the week. The bill will then be taken up by other House committees.
Bi-state Primary Care Association holds legislative day
Members of the Bi-State Primary Care Association presented to the health care committees as part of its Legislative Day on Tuesday. BSPCA is a member organization made up of federally qualified health centers, rural health clinics, clinics for the uninsured, the area health education center network, and Planned Parenthood of Northern New England clinics. BSPCA Director of Vermont Policy Helen Labun said the health centers are committed to improving the health status of Vermonters and ensuring that all individuals have access to affordable and high-quality medical, mental health, substance abuse, and oral health care, regardless of insurance status or ability to pay.
Kim Anderson, Director of Development and Communications for Community Health Centers of Burlington, said CHCB addresses the needs of its community by providing an array of health services regardless of financial status or life circumstance – providing medical, dental, counseling and psychiatry services. Anderson said CHCB has played a critical role in combatting the opioid crisis with its robust medication assisted treatment program. She said its array of integrated services and collaborations with community partners isn’t limited to substance use. CHCB is the only federally granted Homeless Healthcare Program in the state and serves approximately 1,500 individuals experiencing homelessness each year.
Gifford Health Care Chief Medical Officer Dr. Josh White described strategies to address workforce issues. The hospital is hiring international nurses and is utilizing telemedicine with external agencies and internally between its clinics. This has been especially useful in psychiatry. He said the recent news about financial struggles at the Brattleboro Retreat is extremely frightening for all hospitals given the number of mental health patients that need treatment.
Workforce Development Report presented
At his weekly press conference on Thursday, Gov. Phil Scott put a spotlight on a report prepared by the state’s Regional Development Corporations. The Vermont Department of Labor and the State Workforce Development Board contracted with the RDC’s to create and promote a series of Regional Workforce Summits around the state last October. A detailed report of the Summits’ results was submitted by the RDCs to the Department of Labor. It includes actionable strategies, specific to each region, that will be implemented locally by the workforce partnerships that have evolved in each region. Fred Kenney of the Addison County Economic Development Corp. presented a summary of common themes and strategies within the report that are meant to inform state-level discussions.
Pupil weighting recommendations may affect property taxes
Agency of Education Secretary Dan French presented his recommendations to the legislature this week on cost factors based on a Pupil Weighting Factors Report related to education funding formulas. The agency contracted with the University of Vermont to conduct the weighting report, which was mandated by Act 173 of 2018.
The report makes various recommendations for changes to the census grant funding model, and changes or additions to the per pupil weighting factors used to allocate special education funding under the census grant model. Researchers found that the current weighting system is antiquated and out of step, and they could not explain its origins or on what basis it was established. The report says current weights for economically-disadvantaged students, English language learners,, and secondary-level students should be modified significantly.
French testified that the report points to a fundamental lack of equity in the education funding system, recommends that the state should move away from the small schools grant, and strongly suggests the need for immediate legislative action. When asked by a legislator what they should do given that certain supervisory unions would see drastic increases in property taxes if they enacted his recommended changes to weighting, French said, “That is a political question. It is going to be tough. But if you stay grounded in the empirical piece – and this is a good study – the choice is clear.”
Physician Assistants seek licensing changes
The Senate Health and Welfare Committee continued on Wednesday to take testimony on a proposal to modernize state law regarding the licensure of physician assistants. S.128 would simplify documentation and administrative requirements in the current PA and physician relationship.
Last week, Vermont Medical Society Executive Director Jessa Barnard told the committee that the changes in the statute governing PA practice was necessary to reduce barriers to licensure and healthcare workforce employment in Vermont. The proposed changes would bring the law into alignment with current practice, and would not change the scope of practice of PAs. The need for delegation agreements with primary and secondary supervisory physicians would be removed, as would physician liability for PA practice solely based on being a participating physician who completes a practice agreement.
The bill would mandate a practice agreement between a physician assistant and a physician. A practice agreement would not be submitted to the Board of Medical Practice for approval or filing, but would maintained by the physician assistant and provided to the board upon request. The Physician Assistant Academy of Vermont supports this language and testified that the board has rejected delegation agreements for minor reasons such as word choice, although the board is tasked with only accepting the agreements, not reviewing them. Other states in the region do not require the agreements to be filed with a regulatory board.
David Herlihy, the Executive Director for the Vermont Board of Medical Practice, urged the committee to consider requiring the filing of agreements with the board, saying that they are part of the authoritative public record on licensing, and with the shift in liability from physicians to physicians assistants, it would be beneficial to have them on file with the board. It would be difficult for the public to access the agreements if they were filed at hospitals.
Committee Chair Ginny Lyons, D-Chittenden, said that her committee will review an updated proposal next week.
Changes pondered to corporate income tax
The House Ways and Means Committee is considering additional changes to the taxation of corporations and banks. Graham Campbell, Fiscal Analyst, gave a presentation on Corporate Income Taxes and Abby Shephard, Legislative Counsel presented a bill draft for discussion purposes. The proposed legislation does three things: 1) changes the apportionment of a taxable corporation by tripling the sales factor; 2) repeals the financial institutions franchise tax; and 3) perhaps most significantly, moves away from the “80/20” taxation rule, thus capturing more of the foreign sourced income of U.S. corporations.
Bruce Fort, an advisor with the Multi-State Tax Commission told the committee that half of states have the “80/20” rule and that it has proven to be a tax shelter. He said based on the experience of other states that have eliminated it, Vermont could expect to see a revenue increase from the change. However, that gain would be partially offset by the bill’s proposed change to the sales factor. Committee Chair Janet Ancel, D-Calais, said that any changes made to the structure of corporate income taxation come with the goal of not losing state revenue and advantaging Vermont in-state businesses.
Department of Mental Health presents 10-year plan
The Department of Mental Health appeared before the House Health Care Committee on Wednesday to present its report on the 10-Year Plan for an Integrated and Holistic System of Care. DMH Commissioner Sarah Squirrell said the plan is informed by input from community members and stakeholders to include individuals with lived experience.
Squirrell said the plan promotes a population health approach to build a holistic and integrated system that includes all aspects of health. She said the goal is a model to present a whole-person approach in all aspects of wellness promotion, prevention and treatment of illness, health equity, social justice, and person-led care, with stigma elimination as a priority.
Squirrell said community members and stakeholders reviewed data describing the current state of the system as well as demographic trends to inform strategies and steps for implementation. Data show overall high rates of health and access when compared nationally, while other trends reviewed include high rates of suicide deaths, and an aging population.
Squirrell said the plan is organized into eight action areas supported by short-, mid- and long-term strategies for implementation. These include:
- Promoting health and wellness to improve the health of populations;
- Influencing social contributors to health to ensure individuals meet their most basic needs;
- Eliminating stigma and discrimination;
- Improving client experience by expanding access to community-based care;
- Enhancing intervention and discharge planning services for Vermonters in crisis;
- Embedding peer services in all levels of care;
- Ensuring service delivery is person-led; and
- Committing to workforce development and payment parity.
DMH also recommends creating a council or board with the authority to oversee and guide strategies in the plan.
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