Week in Review

H.128, Certificate of Need/Hospital Governance/Health Care Budget

The big news late Friday afternoon was the preliminary release of Rep. Anne Donahue's omnibus 65-page bill titled "An Act Relating to Hospital and Health Care System Accountability, Capital Spending and Annual Budgets." The members of the House Health and Welfare Committee were given an advanced copy of the bill to read over the weekend. We also obtained a copy of the bill. Please refer to an email we sent earlier today for a summary of the bill.

In addition to Representative Anne Donahue, R-Northfield, other sponsors include House Health and Welfare Committee Chair Tom Koch, R-Barre, John Tracy, D-Burlington, Lynn Bohi, D-Hartford, Kinny Connell, D-Warren (vice-chair of the House Health and Welfare Committee), Maxine Grad, D-Moretown, Bob Kiss, P-Burlington, Clint Martin, D-Springfield, Norman McAllister, R-Highgate and David Zuckerman, P-Burlington.

Read the text of H.128.

The Committee will start taking testimony regarding H.128 on Tuesday, February 4th.

H.1, Department of Substance Abuse and Recovery

On Thursday, January 30th, the House Health and Welfare Committee voted to advance H.1, a bill that proposes to establish a new department of substance abuse and recovery within the Agency of Human Services, by a 9-1-1 vote. The new department is responsible for all programs related to tobacco, alcohol and drug abuse. One key goal of the bill is to integrate mental health and substance abuse treatment so that individuals affected by these "co-occurring conditions" will be treated holistically. The new department will not be established until July 1, 2004, to give the Douglas Administration a little over a year to reorganize the Agency of Human Services more comprehensively to address these same issues. This one-year delay in establishing the department was one of the key concessions made by Chair Tom Koch, R-Barre, to get approval for the bill in the committee.

The bill also proposes to create a Substance Abuse Program Review Board, consisting of 20 members, including various department heads and community members. The Board is authorized to submit a proposed budget to the General Assembly, hold public hearings, and propose strategies for the department to coordinate its work with other state agencies and community groups, among other things. The review board is created effective July 1, 2003.

The bill also requires that the "family development plan" for Reach-Up participants (Vermont's welfare-to-work program for family members applying for or receiving ANFC benefits) contain a substance abuse evaluation, and, if appropriate, a referral to treatment services. This is a toned-down version of H.6, a controversial bill that would have required drug testing of Reach-Up participants. Finally, the bill also contains some changes to the scope of practice and other licensing requirements for alcohol and drug abuse counselors.

The bill has an appropriation so it will likely be referred to the House Appropriations Committee. We will post a copy of the bill as voted by the House Health and Welfare Committee as soon as it is on-line.

S.17, Abuse of Vulnerable Adults

The Senate Judiciary Committee continued to take testimony on this bill that proposes to increase the criminal penalties for abuse of vulnerable adults in nursing homes and hospitals. The Attorney General's Office continues to push hard for the bill. Lots of groups such as the Defender General's Office, the Vermont Health Care Association and the Vermont Council of Developmental and Mental Health Services all testified that they are concerned that the bill is overbroad, unnecessary and vague. The Committee plans to mark up and vote on the bill on Thursday, Feb. 6th and Friday, February 7th.

H.96, Report regarding Managed Behavioral Health Organizations

The House Health and Welfare Committee unanimously voted to advance this bill. This bill proposes to change the due date of the annual report to the house and senate committees on health and welfare by the task force created to develop performance quality measures and address oversight issues for managed behavioral health care organizations (such as Magellan which contracts with Blue Cross of VT) from December 1 to January 15. The extension of the due date is to give more time to get year-end data together. The bill is up for final approval in the House on Tuesday, February 4th. Read the text of the bill.

Medicaid Budget

We learned this week that Representative Patricia O'Donnell, R-Vernon, is working on a plan to replace the tiered deductibles proposed by Gov. Douglas in his FY 04 budget for the Vermont Health Access Plan (VHAP) program with premiums based on income. O'Donnell is trying to figure out if the agency of human services can plug into the tax department income tax return information to link income tax filings with eligibility for Medicaid. O'Donnell's goal is to find a way to save the same amount of money as the Governor's plan but without shifting the costs to hospitals and other providers. O'Donnell is a member of the House Appropriations Committee and is given the primary responsibility to oversee the Medicaid budget and Department of Aging and Disability budget.

In other news, the details relative to the inflation factor for nursing homes, or even the increase in the bed tax to fund it, are not in the Governor's proposed budget. When a representative of the Department of Aging and Disabilities appears before the House Appropriations Committee later in the session they will present the specifics on this item. Many of these details are still being worked out.

The increase in the nursing home bed tax will likely be in the miscellaneous tax bill that the House Ways and Means Committee will work on later in the session. The hospital provider tax, which is scheduled to sunset July 1, 2003, will also likely be in this bill.

We will continue to be in contact with the Agency of Human Services to find out specifically what they are proposing with regard to both the nursing home and hospital provider taxes and get that information to you as soon as possible.

Draft Professional Regulation Bill

Jessica Porter, of the Office of Professional Regulation, submitted a draft professional regulation bill to the House Government Operations Committee this week. The bill contains revisions to the systems for regulating chiropractors, optometrists, pharmacists, clinical mental health counselors, psychotherapists and naturopathic physicians, among others. The bill hasn't been formally introduced and we are in the process of reviewing it to ensure there isn't anything objectionable in it.

Emergency Service Rules Approved

This week the Legislative Committee on Administrative Rules (LCAR) gave its final approval to rules submitted by the Department of Health. The rules revise the scope of practice for intermediate EMTs, among other things. The department agreed to remove a controversial deadline for intermediate EMTs to achieve new training. Once that deadline was removed there was unanimous support for the proposed rules from all EMTs and district coordinators present.

Tort Reform Hearing

Senate and House Judiciary Committees will have a joint hearing regarding tort liability issues, including Medical Malpractice on Wednesday, Feb. 5, 2003, from 9 to noon at the State House. They will hear from the following witnesses: BISHCA Commissioner John Crowley; Paul Harrington of the Vermont Medical Society; Michael Sirotkin of the Vermont Trial Lawyers Association; John Hollar for the American Insurance Association; Bob Paolini of the Vermont Bar Association and Zina Cary, a Health Care Consumer Advocate from VPIRG.

Public Hearing on FY 2004 budget - Vermont Interactive Television - Tuesday, February 11, 2003, 4:00-6:00 p.m.

The House Appropriations Committee will hold a public hearing on Vermont Interactive Television (VIT) to give Vermonters throughout the state an opportunity to express their views about the State's budget for the fiscal year 2004. The following VIT sites will be available for the hearing: Bennington, Brattleboro, Castleton, Colchester, Johnson, Lyndon, Middlebury, Newport, Randolph, Rutland, Springfield, St. Albans, Waterbury and White River Junction. The Canaan site will be opened if a citizen makes a request to do so in advance. VIT's web site has an up-to-date location listing, including directions and telephone numbers.