Week in Review

Adjournment could occur by the end of May as Legislators have agreed to a tentative redistricting plan. Towns must now draw the new boundaries of certain House districts. Once this process is completed, legislators can finish their work on Medicaid reform, the state budget, and other issues.

The full House spent a considerable amount of time this week debating the Transportation Appropriations bill. In addition, the House Committee on Appropriations advanced the Capital Construction bill and the Executive Branch Fee bill.

In the Senate, the Committee on Finance spent the majority of the week on tax legislation, which included adjustments to the state income, estate tax, corporate income tax and tobacco tax. In other committee action, the Committee on Appropriations continued to mark-up the FY 2003 state appropriations bill, but has yet to address the Human Services section of the budget.

In summary, the stage has been set for adjournment. With a plan for reapportionment in hand, House and Senate leaders can now focus on managing the flow of debate on the other major issues of the session, move them to Committees of Conference and adjourn for the year.

Hearing on the Nursing Shortage

The Senate Health and Welfare Committee and the Senate Education Committee heard testimony on the nursing shortage from a wide array of nursing leaders including Bea Grause, RN, JD, President of VAHHS. The Chair of the Senator Health and Welfare Committee, Sen. Nancy Chard (D-Windham), called this hearing to gather information on the nursing shortage. She believes this information could serve as a starting point for the development of a plan to continue addressing the nursing shortage. Witnesses testified on numerous issues, ranging from the aging workforce to vacancy rates. Senator Chard invited attendees who have ideas for addressing the nursing shortage to write to her with the recommendations for consideration by the next Legislature.

Cigarette Tax and Medicaid Reform

The Senate Finance Committee agreed Friday to add a 67 cent cigarette tax increase onto H.753, the income tax bill that has been approved by the House. The House recently passed H.765, Medicaid reform legislation that included a 36 cent increase in the tobacco tax to fund various Medicaid programs. The proposal under consideration in the Committee on Finance would fund health care expenditures as well.

The remaining portions of H.765 include financial management tools for the Medicaid plan, the budget and reforms. The Senate has decided to take the budget pieces out of the H.765 and include them in the overall FY03 Appropriations bill being marked up in the Senate Appropriations Committee. The Senate Health and Welfare Committee met Friday afternoon to discuss the reform portions of the House’s Medicaid reform bill. As this committee finalizes its work it’s unlikely that the reform provisions of H.765 will rise to a priority level.

H.755 - Standard of Care for Physicians

H.755 continues to wend its way through the tortuous legislative process. A primary provision of this bill would move the Board of Medical Practice under the Department of Health. The Senate Government Operations Committee, Senate Health and Welfare Committee, and the Senate Judiciary Committee are currently considering H.755, primarily centering on the standard of care for physicians. The Senate Government Operations Committee has asked the Senate Judiciary Committee to review the gross vs. simple negligence issue. Last Thursday the Senate Health and Welfare Committee lent its support to language that would be a compromise on the standard of care issue, and has communicated this position in a memo to the members of the Senate Government Operations Committee. This language has come to be known as the “Campbell amendment” because Sen. John Campbell (D-Windsor), a member of the both the Judiciary and the Health and Welfare Committees, is offering it for consideration. The Campbell amendment proposes to insert the words “professional incompetence or” before “gross failure to use and exercise on a particular occasion.” The amendment would also add, “A licensee shall be considered incompetent in the practice if the licensee has on one or more occasions:

(A) Engaged in conduct that evidence a lack of ability or fitness to discharge the duty owed by the licensee to a client or patient of the general public; or

(B) Engaged in conduct that evidences a lack of knowledge or inability to apply principles or skills to carry out the practice for which the licensee is licensed.

The Standard of Care portion of H755 is also being reviewed by the Senate Judiciary Committee. In Committee discussions last week, the Chair, Sen. Dick Sears (D-Bennington), mentioned that this bill could be a vehicle for bills such as body piercing. He also added that since that bill was a priority of the House Government Operations it may get caught up in end- game negotiations. Nevertheless, he has scheduled testimony for Tuesday morning.

If the Judiciary Committee recommends the Campbell amendment to the Government Operations Committee, a Senate compromise is very possible. The question remains: Will this compromise pass muster with the House Government Operations Committee in conference?

Nursing Home Issues

As the Senate Appropriations Committee begins deliberations this week on the Human Services section of the FY03 Appropriations bill, an attempt by nursing homes will be made to increase the ACCS rate for residential care providers, currently set at $23.00 per day. An increase to $30.00 per day is the goal. The Vermont Health Care Association and VAHHS support this effort.

Also, H.767, the Fee Bill, contains the nursing home provider tax increase to $3,166.29 per bed. It also raises nursing home administrator licenses from $150 for an initial license to $325 and renewals will increase from $325 to $400. Registered and licensed practical nurse renewal licenses will increase from $60 to $85 and LNA renewal licenses will increase from $20 to $25. H.767 will now move to the Senate Finance Committee for their consideration.

No Action On…

· H.416 Medical Record Confidentiality
· S.258 Open Meeting Law
· S.254 VHAP Buy-in
· S.286 CON Regulation
· Medicaid Reimbursement Levels

On the Agenda This Week

Senate Floor - The cigarette tax will be debated as part of H.753.

Senate Appropriations Committee – The focus this week will be on the Human Services section of the FY03 budget.