For the week ending Friday, April 13, 2001
Once again, the House of Representatives continued to be the focus of attention in the State House this week, as the Committee on Ways and Means finalized its plan for changes to Act 60, and supporters of the plan worked hard to garner enough votes for its passage. The House also began consideration of the final "money" bill of this session, the annual Transportation Appropriations bill, which the full House gave it final approval on Friday. The House also approved the report of the Committee of Conference on the Budget Adjustment Act, legislation that makes mid-year adjustments to the FY 2001 state budget.
In the Senate, the Committee on General Affairs and Housing voted S.161, the Paid Parental Leave bill, out of Committee. The bill will now move to the Committee on Appropriations prior to its consideration by the full Senate. The Committee on Natural Resources and Energy is continuing its work on H.475, the Act 250 Reform bill, and the Committee on Appropriations is working on H.485, the FY 2002 Appropriations bill. Committee work on the Appropriations bill should be completed within the next two weeks, at which time it will be forward to the full Senate for its consideration.
At this point, the linchpin for adjournment is the Act 60 reform proposal that has been put together by the Committee on Ways and Means. Should that bill be forwarded to and passed by the full House, the Senate may feel compelled to act on it this year. However, Senate leaders this week told the House leadership that they must receive this bill soon if they are to act on it this session. If the Senate does not receive the bill in a timely manner, the Senate leadership has indicated that they want to begin to prepare for adjournment.
Public Oversight Commission
Joe Blanchette and Shawn Bryan testified before the Senate Committee on Health and Welfare last week to discuss the Public Oversight Commission (POC). The desire of the Committee was to get feedback on the process from Mr. Blanchette and Mr. Bryan, in addition to any and all improvements to the system they would recommend. It is apparent that the Committee would like to get a handle on the ever-increasing costs of health care, and the POC process is one avenue, which they believe, warrants further investigation.The comments of the two POC members included the following:
- Although health care costs have skyrocketed in recent years, it has done so for a number of reasons, including rising energy prices and the recent nursing shortage. The costs have not risen because of indiscriminate spending at the hospitals.
- The role of the POC is that of advisor. It is not the job of the POC to slash and burn hospital budgets. Rather, the POC examines the hospital budgets very carefully, determines whether or not the numbers make sense, and gives the hospitals advice based on these examinations.
- The POC currently is doing exactly what was intended when it was created. If the Committee believes there should be more to the process and more expected, than rigid regulations would be in order.
Although the Committee would have liked to hear more concrete ideas on how the POC process can assist in keeping health care costs down, it was evident that Mr. Blanchette and Mr. Bryan were not in a position to make such recommendations. However, Mr. Blanchette was quick to tell the Committee that he is convinced that rigid regulations are the wrong way to go at this point in time.
Open Meeting Law for Hospitals - H.158
On Wednesday, Norm Wright, VAHHS President, and Jessica Comai of Fletcher Allen Health Care appeared before the House Committee on General, Housing and Military Affairs testifying in opposition to H.158, a proposal to require that meetings of boards of directors of non-profit hospitals be subject to the open meeting laws. Both witnesses used the VAHHS talking points on this issue stating that this type of regulation is unnecessary since most of the conversations at a hospital board meeting are items that are exempt from open meetings and can be conducted in executive session. Additionally, hospitals have enhanced relations with their communities in many ways plus their trustees are members of the local community. Ms. Comai cited examples of FAHC’s outreach to the community as they have proposed and began the current expansion. The a few exceptions, the majority of the committee did not seem convinced that H.158 should be a priority of the committee.
Nursing Homes
The Senate Committee on Appropriations heard testimony from Mary Shriver of the Vermont Health Care Association (VHCA) last week. After an overview and explanation of the current situation facing nursing homes, Ms. Shriver explained that unlike hospitals, nursing service rates are adjusted every three years and indirect costs are adjusted every four years. An inflation factor is used to compensate for yearly increases. VHCA worked with the Administration for months to address these rates but to no avail. The Administration recommended increasing and maxing out the provider tax to fund the inflation factor, which always previously had been funded from the General Fund. VHCA opposes using the provider tax for this purpose since at its maximum no funds will be available to cover emergency situations or wage increases. To strengthen VHCA position, the House added language that is the equivalent to the Federal Boren amendment, which states that nursing homes should be paid costs that are adequate and reasonable. Since this has been tested in court and was favorable to the nursing home industry, VHCA supports the including this amendment in the budget. However, the Administration adamantly opposes this language.
Coming UpHouse Committee on Appropriations – All week this committee will focus on H.31, the pharmaceutical bill.
House Committee on Health and Welfare – The committee will continue their discussions regarding H.416, medical record privacy. They will also be discussing the Fletcher Allen CON.
Senate Committee on Appropriations – The committee will hear testimony from The Medical Society this week along with several other groups prior to their discussions and mark-up of H.485, the Appropriations bill.