Political Overview

On Tuesday, April 8th, the organized nursing community brought dozens of nurses to the State House to lobby for whistleblower legislation, a ban on mandatory overtime and a bill setting minimum staffing ratios for nurses. The House Judiciary Committee and the House and Senate Health and Welfare Committees held hearings on these subjects so that they could hear from the nurses. It does not appear at this time that any of these bills is a priority for any of these committees. The Senate Economic Development and General Affairs Committee has a hearing scheduled on the whistleblower bill on April 16th, with several nurses scheduled to testify. It is not yet clear whether or not this committee has a serious interest in the bill. In support of these bills, representatives of the nurses are arguing that the current nursing shortage is caused, in part by nurses leaving the profession due to adverse working conditions. This State House activity by nurse organizers is part of a broader effort over time to create favorable conditions for creation of labor unions for nurses.

In the broader political context, permit reform and modifications to Act 60 dominated State House activity during the week. Bickering in the press between Governor Jim Douglas and Senate President Pro Tem Peter Welch, D-Windsor, about the progress of the Governor's permit reform proposal was just the public backdrop for private discussions between the Administration and the Senate on this subject. With adjournment not likely until mid to late May, plenty of time remains for resolution of this issue. The same is true for Act 60 reform. Late in the week the Administration and House leadership announced the framework for a compromise on this issue. The press accounts were more optimistic than the reality, since several major issues, such as how to contain escalating education costs, are yet to be resolved. Nonetheless, there is momentum now for a proposal that would allow all of the political factions in Montpelier to hold hands and claim victory on this contentious issue.

Issues of interest to VAHHS the General Assembly addressed this week include:

Hospital Regulation, Certificate of Need (H.128)

The Senate Health and Welfare Committee took testimony on H.128, the certificate of need reform bill. The Committee heard from the lead House sponsor of the bill, Rep. Anne Donahue, R-Northfield, BISHCA Commissioner John Crowley and his staff, Bea Grause on behalf of VAHHS, Peter Cobb on behalf of the Visiting Nurses Association, and state health care ombudsperson Donna Sutton-Fay. These witnesses were giving the committee an overview of the bill and highlighting the issues of particular interest to their organizations. It is not yet clear what direction or pace the committee will choose for this bill. The committee will be taking the bill up again on Thursday, April 17th, when they will be hearing from Tom Huebner, CEO of Rutland Regional Medical Center, among others.

Whistleblower Protections for Health Care Workers (H.470)

On Tuesday, April 8th, the House Judiciary Committee heard from Rep. Anne Donahue, R-Northfield, and a number of nurses regarding H.470, the bill that establishes whistleblower protections for health care workers. Rep. Donahue's comments focused primarily on FAHC's plans to relocate its psychiatric unit and the calls she received from FAHC employees at the time. Donahue said that health care workers are still contacting her with patient safety issues because they feel the internal mechanism in hospitals won't work. "Perception is a problem," according to Donahue. Nurses gave examples where they claim a whistleblowing statute would provide them with protection if they were to speak out. For example, if someone with a communicable disease is admitted to a shared hospital room or placing a licensed nurse assistant in charge of six babies. Committee members questions ranged from asking whether the bill should apply to all workers, to whether the situations the nurses were discussing were "judgment calls" where a blanket protection of health care workers might not be appropriate, or to whether having whistleblower protections would affect peer review or confidentiality. Committee Chair Rep. Peg Flory, R-Pittsford, said that the committee would not likely get back to H.470 for some time since they already have a heavy load of bills they are working on, including mandatory reporting of child sexual abuse for clergy. Text of H.470.

Agency of Human Services Reorganization (H.450)

This week the House passed H.450, a bill that authorizes the Secretary of the Agency of Human Services to restructure the agency. The bill was referred to the Senate Health and Welfare Committee. The Senate Government Operations Committee is also taking testimony on the bill next week. Two public hearings on this issue have been scheduled: April 15th, 5:15-6:45 p.m. on Vermont Interactive Television (before the Senate Health and Welfare Committee and the Senate Government Operations Committee) and April 22nd, 2:00-5:00 p.m. at Contois Auditorium, City Hall, Burlington (before the Senate Health and Welfare Committee). The bill as it passed the House.

FY04 Medicaid Budget

The Senate Appropriations Committee is working hard on the FY 04 budget bill that it just received from the House. Douglas Administration officials told the committee that the House-passed plan to replace co-pays with premiums for certain Medicaid recipients cannot be implemented by July 1, 2003 as the House envisioned. It will take at last until January 2004 to implement, according to administration officials. As a result, a lot of the savings the House booked on account of its premium proposal will not materialize. This means the Senate Appropriations Committee will have to find even more money to fund Medicaid even if it makes few changes to the House-passed bill.

Anesthesiologist Assistants (S.144)

The Senate passed S.144, a bill that proposes to establish a system for certifying Anesthesiologist Assistants (AAs) in Vermont. When the bill came over to the House, the bill was unexpectedly referred to the House Health and Welfare Committee rather than the House Government Operations Committee. However, the chairs of both committees agreed that the House Government Operations Committee would take a full morning of testimony on Wednesday, April 16th. Some members of the House Health and Welfare Committee may attend to listen to the testimony. VAHHS's witnesses include Donna Madigan, Director of the OR, and Dr. Michael Tarazi, both from Southwestern Medical Center and Dr. Howard Shapiro and Terance Lynch, AA from Fletcher Allen Health Care. Text of the bill as it passed the Senate.