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House Calendar
Wednesday, April 30, 2014
114th DAY OF THE ADJOURNED SESSION
House Convenes at 9:30 A.M.
TABLE OF CONTENTS
Page No.
ACTION CALENDAR
Action Postponed Until April 30, 2014
Favorable with Amendment
S. 252
An act relating to financing for Green Mountain Care .................... 2672
Rep. Fisher for Health Care
Rep. Ancel for Ways and Means ................................................................. 2691
Rep. Fisher Amendment .............................................................................. 2695
S. 295
An act relating to pretrial services, risk assessments, and criminal
justice programs ........................................................................................... 2701
Rep. Haas for Human Services
Rep. Lippert for Judiciary ............................................................................ 2714
Rep. O’Brien for Appropriations ................................................................. 2726
Senate Proposal of Amendment
H. 890
Approval of amendments to the charter of the City of Burlington
regarding the redistricting of City election areas ........................................ 2726
NEW BUSINESS
Third Reading
H. 883
Expanded prekindergarten–grade 12 school districts ...................... 2726
Rep. Buxton Amendment ............................................................................ 2726
Rep. Donovan Amendment ......................................................................... 2735
Rep. Cross et al Amendment ....................................................................... 2736
J.R.H. 23
Relating to the cleanup of Lake Champlain ............................... 2737
S. 208
An act relating to solid waste management ...................................... 2737
S. 220
An act relating to furthering economic development ....................... 2738
Rep. Pugh Amendment ................................................................................ 2738
Rep. Johnson Amendment ........................................................................... 2738
S. 239
An act relating to the regulation of toxic substances ....................... 2740
Rep. Komline et al Amendment .................................................................. 2740
Rep. Deen Amendment ............................................................................... 2741
Rep. Marcotte Amendment ......................................................................... 2741
S. 241
An act relating to binding arbitration for State employees .............. 2742
S. 291
An act relating to the establishment of transition units at State
correctional facilities ................................................................................... 2742
S. 293
An act relating to reporting on population-level outcomes and indicators
and on program-level performance measures .............................................. 2742
Rep. Donahue et al Amendment .................................................................. 2742
Favorable with Amendment
S. 184
An act relating to eyewitness identification policy .......................... 2742
Rep. Grad for Judiciary
S. 287
An act relating to involuntary treatment and medication ................. 2747
Rep. Koch for Judiciary
Rep. Donahue et al Amendment .................................................................. 2767
Action Postponed Until May 1, 2014
Senate Proposal of Amendment
H. 758
Notice of potential layoffs ............................................................... 2770
NOTICE CALENDAR
Favorable with Amendment
S. 281
An act relating to vision riders and a choice of providers for vision and
eye care services .......................................................................................... 2776
Rep. Dakin for Health Care
Favorable
J.R.S. 27
Joint resolution relating to an application of the General Assembly
for Congress to call a convention for proposing amendments to the U.S.
Constitution ................................................................................................. 2778
Rep. Townsend for Government Operations
Senate Proposal of Amendment
H. 297
Duties and functions of the Department of Public Service ............. 2778
H. 325
A bill of rights for children of arrested and incarcerated parents .... 2797
H. 350
The posting of medical unprofessional conduct decisions and to
investigators of alleged unprofessional conduct .......................................... 2800
H. 581
Guardianship of minors ................................................................... 2801
H. 690
The definition of serious functional impairment ............................. 2814
H. 699
Temporary housing .......................................................................... 2814
H. 795
Victim’s compensation and restitution procedures ......................... 2815
H. 809
Designation of new town centers and growth centers ..................... 2822
Ordered to Lie
S. 91
An act relating to privatization of public schools .............................. 2825
- 2672 -
ORDERS OF THE DAY
ACTION CALENDAR
Action Postponed Until April 30, 2014
Favorable with Amendment
S. 252
An act relating to financing for Green Mountain Care
Rep. Fisher of Lincoln,
for the Committee on
Health Care,
recommends
that the House propose to the Senate that the bill be amended by striking all
after the enacting clause and inserting in lieu thereof the following:
* * * Intent and Principles * * *
Sec. 1.
LEGISLATIVE INTENT; FINDINGS; PURPOSE
(a)(1)
It is the intent of the General Assembly to continue moving forward
toward implementation of Green Mountain Care, a publicly financed program
of universal and unified health care.
(2)
It is the intent of the General Assembly not to change in any way the
benefits provided to Vermont residents by Medicare, the Federal Employees
Health Benefit Program, TRICARE, a retiree health program, or any other
health benefit program beyond the regulatory authority of the State of
Vermont.
(b)
The General Assembly finds that:
(1)
It has been three years since the passage of 2011 Acts and Resolves
No. 48
(Act 48),
which
established
the
Green
Mountain
Care
Board,
authorized payment reform initiatives, and created the framework for the
Vermont Health Benefit Exchange and Green Mountain Care.
(2)
The Green Mountain Care Board currently regulates health insurance
rates, hospital budgets, and certificates of need.
In 2013, the Green Mountain
Care Board’s hospital budget review limited hospital growth to 2.7 percent, the
lowest annual growth rate in Vermont for at least the last 15 years.
The Green
Mountain Care Board issued four certificates of need and one conceptual
development phase certificate of need.
It also issued 31 health insurance rate
decisions and reduced by approximately five percent the rates proposed by
insurers in the Vermont Health Benefit Exchange.
(3)
In 2013, Vermont was awarded a three-year State Innovation Model
(SIM) grant of $45 million to improve health and health care and to lower
costs for Vermont residents.
The grant funds the creation of a sustainable
- 2673 -
model of multi-payer payment and delivery reform, encouraging providers to
change the way they do business in order to deliver the right care at the right
time in the right setting.
The State has created a 300-person public-private
stakeholder group to work collaboratively on creating appropriate payment and
delivery system models.
Through this structure, care management models are
being coordinated across State agencies and health care providers, including
the Blueprint for Health, the Vermont Chronic Care Initiative, and accountable
care organizations.
(4)
From the SIM grant funds, the State recently awarded $2.6 million in
grants to health care providers for innovative pilot programs improving care
delivery or for creating the capacity and infrastructure for care delivery
reforms.
(5)
Three accountable care organizations (ACOs) have formed in
Vermont:
one led by hospitals, one led by federally qualified health centers,
and one led by independent physicians.
The Green Mountain Care Board has
approved payment and quality measures for ACOs, which create substantial
uniformity across payers and will provide consistent measurements for health
care providers.
(6)
The Vermont Health Benefit Exchange has completed its first open
enrollment period.
Vermont has more people enrolled through its Exchange
per capita than are enrolled in any other state-based Exchange, but many
Vermonters experienced difficulties during the enrollment period and not all
aspects of Vermont’s Exchange are fully functional.
(7)
According to the 2013 Blueprint for Health Annual Report, Vermont
residents receiving care from a patient-centered medical home and community
health team had favorable outcomes over comparison groups in reducing
expenditures and reducing inpatient hospitalizations. As of December 31,
2013, 121 primary care practices were participating in the Blueprint for Health,
serving approximately 514,385 Vermonters.
(8)
The Agency of Human Services has adopted the modified adjusted
gross income standard under the Patient Protection and Affordable Care Act,
further streamlining the Medicaid application process.
(9)
Vermonters currently spend over $2.5 billion per year on private
funding of health care through health insurance premiums and out-of-pocket
expenses.
Act 48 charts a course toward replacing that spending with a
publicly financed system.
(10)
There is no legislatively determined time line in Act 48 for the
implementation of Green Mountain Care.
A set of triggers focusing on
decisions about financing, covered services, benefit design, and the impacts of
- 2674 -
Green Mountain Care must be satisfied, and a federal waiver received, before
launching Green Mountain Care.
In addition, the Green Mountain Care Board
must be satisfied that reimbursement rates for providers will be sufficient to
recruit and retain a strong health care workforce to meet the needs of all
Vermonters.
(11)
Act 48 required the Secretary of Administration to provide a
financing plan for Green Mountain Care by January 15, 2013.
The financing
plan delivered on January 24, 2013 did not ―recommend the amounts and
necessary mechanisms to finance Green Mountain Care and any systems
improvements
needed
to
achieve
a
public-private
universal
health
care
system,‖ or recommend solutions to cross-border issues, as required by Sec. 9
of Act 48.
The longer it takes the Secretary to produce a complete financing
plan, the longer it will be until Green Mountain Care can be implemented.
(c)
In order to implement the next steps envisioned by Act 48 successfully,
it is appropriate to update the assumptions and cost estimates that formed the
basis for that act, evaluate the success of existing health care reform efforts,
and obtain information relating to key outstanding policy decisions.
It is the
intent of the General Assembly to obtain a greater understanding of the impact
of health care reform efforts currently under way and to take steps toward
implementation of the universal and unified health system envisioned by
Act 48.
(d)
Before making final decisions about the financing for Green Mountain
Care, the General Assembly must have accurate data on how Vermonters
currently pay for health care and how the new system will impact individual
decisions about accessing care.
(e)
The General Assembly also must consider the benefits and risks of a
new health care system on Vermont’s businesses when there are new public
financing mechanisms in place, when businesses no longer carry the burden of
providing health coverage, when employees no longer fear losing coverage
when they change jobs, and when business start-ups no longer have to consider
health coverage.
(f)
The General Assembly must ensure that Green Mountain Care does not
go forward if doing so is not cost-effective for the residents of Vermont and for
the State.
(g)
The General Assembly must be satisfied that an appropriate plan of
action is in place in order to accomplish the financial and health care
operational
transitions
needed
for
successful
implementation
of
Green
Mountain Care.
Sec. 2.
PRINCIPLES FOR HEALTH CARE FINANCING
- 2675 -
The
General
Assembly
adopts
the
following
principles
to
guide
the
financing of health care in Vermont:
(1)
All Vermont residents have the right to high-quality health care.
(2)
All Vermont residents shall contribute to the financing for Green
Mountain Care.
(3)
Vermont residents shall finance Green Mountain Care through taxes
that are levied equitably, taking into account an individual’s ability to pay and
the value of the health benefits provided so that access to health care will not
be limited by cost barriers.
The financing system shall maximize opportunities
to pay for health care using pre-tax funds.
(4)
As provided in 33 V.S.A. § 1827, Green Mountain Care shall be the
payer of last resort for Vermont residents who continue to receive health care
through plans provided by an employer, by a federal health benefit plan, by
Medicare, by a foreign government, or as a retirement benefit.
(5)
Vermont’s system for financing health care shall raise revenue
sufficient to provide medically necessary health care services to all Vermont
residents, including:
(A)
ambulatory patient services;
(B)
emergency services;
(C)
hospitalization;
(D)
maternity and newborn care;
(E)
mental health and substance use disorder services, including
behavioral health treatment;
(F)
prescription drugs;
(G)
rehabilitative and habilitative services and devices;
(H)
laboratory services;
(I)
preventive
and
wellness
services
and
chronic
care
management; and
(J)
pediatric services, including oral and vision care.
(6)
The financing system for Green Mountain Care shall include an
indexing mechanism that adjusts the level of individuals’ and businesses’
financial contributions to meet the health care needs of Vermont residents and
that ensures the sufficiency of funding in accordance with the principle
expressed in 18 V.S.A. § 9371(11).
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* * * Vermont Health Benefit Exchange * * *
Sec. 3.
33 V.S.A. § 1803 is amended to read:
§ 1803.
VERMONT HEALTH BENEFIT EXCHANGE
* * *
(b)(1)(A)
The Vermont Health Benefit Exchange shall provide qualified
individuals and qualified employers with qualified health benefit plans,
including the multistate plans required by the Affordable Care Act, with
effective dates beginning on or before January 1, 2014.
The Vermont Health
Benefit
Exchange
may
contract
with
qualified
entities
or
enter
into
intergovernmental agreements to facilitate the functions provided by the
Vermont Health Benefit Exchange.
* * *
(4)
To the extent permitted by the U.S. Department of Health and
Human Services, the Vermont Health Benefit Exchange shall permit qualified
employers to purchase qualified health benefit plans through the Exchange
website, through navigators, by telephone, or directly from a health insurer
under contract with the Vermont Health Benefit Exchange.
* * *
Sec. 4.
33 V.S.A. § 1811(b) is amended to read:
(b)(1)
No person may provide a health benefit plan to an individual or
small employer unless the plan is offered through the Vermont Health Benefit
Exchange and complies with the provisions of this subchapter.
(2)
To the extent permitted by the U.S. Department of Health and
Human Services, a small employer or an employee of a small employer may
purchase
a
health
benefit
plan
through
the
Exchange
website,
through
navigators, by telephone, or directly from a health insurer under contract with
the Vermont Health Benefit Exchange.
(3)
No person may provide a health benefit plan to an individual or
small employer unless the plan complies with the provisions of this subchapter.
Sec. 5.
PURCHASE OF SMALL GROUP PLANS DIRECTLY FROM
CARRIERS
To the extent permitted by the U.S. Department of Health and Human
Services and notwithstanding any provision of State law to the contrary, the
Department of Vermont Health Access shall permit employers purchasing
qualified health benefit plans on the Vermont Health Benefit Exchange to
purchase the plans through the Exchange website, through navigators, by
- 2677 -
telephone, or directly from a health insurer under contract with the Vermont
Health Benefit Exchange.
Sec. 6.
OPTIONAL EXCHANGE COVERAGE FOR EMPLOYERS WITH
UP TO 100 EMPLOYEES
(a)(1)
If permitted under federal law and notwithstanding any provision of
Vermont law to the contrary, prior to January 1, 2016, health insurers may
offer health insurance plans through or outside the Vermont Health Benefit
Exchange to employers that employed an average of at least 51 but not more
than 100 employees on working days during the preceding calendar year.
Calculation of the number of employees shall not include a part-time employee
who works fewer than 30 hours per week or a seasonal worker as defined in 26
U.S.C. § 4980H(c)(2)(B).
(2)
Health insurers may make Exchange plans available to an employer
described in subdivision (1) of this subsection if the employer:
(A)
has its principal place of business in this State and elects to
provide coverage for its eligible employees through the Vermont Health
Benefit Exchange, regardless of where an employee resides; or
(B)
elects to provide coverage through the Vermont Health Benefit
Exchange for all of its eligible employees who are principally employed in this
State.
(3)
Beginning on January 1, 2016, health insurers may only offer health
insurance plans to the employers described in this subsection through the
Vermont Health Benefit Exchange in accordance with 33 V.S.A. chapter 18,
subchapter 1.
(b)(1)
As soon as permitted under federal law and notwithstanding any
provision of Vermont law to the contrary, prior to January 1, 2016, employers
may purchase health insurance plans through or outside the Vermont Health
Benefit Exchange if they employed an average of at least 51 but not more than
100 employees on working days during the calendar year.
Calculation of the
number of employees shall not include a part-time employee who works fewer
than 30 hours per week or a seasonal worker as defined in 26 U.S.C.
§ 4980H(c)(2)(B).
(2)
An employer of the size described in subdivision (1) of this
subsection may purchase coverage for its employees through the Vermont
Health Benefit Exchange if the employer:
(A)
has its principal place of business in this State and elects to
provide coverage for its eligible employees through the Vermont Health
Benefit Exchange, regardless of where an employee resides; or
- 2678 -
(B)
elects to provide coverage through the Vermont Health Benefit
Exchange for all of its eligible employees who are principally employed in this
State.
* * * Green Mountain Care * * *
Sec. 7.
UPDATES ON TRANSITION TO GREEN MOUNTAIN CARE
(a)
The Secretary of Administration or designee shall provide updates at
least quarterly to the House Committees on Health Care and on Ways and
Means and the Senate Committees on Health and Welfare and on Finance
regarding the Agency’s progress to date on:
(1)
determining the elements of Green Mountain Care, such as claims
administration and provider relations, for which the Agency plans to solicit
bids for administration pursuant to 33 V.S.A. § 1827(a), and preparing a
description of the job or jobs to be performed, the bid qualifications, and the
criteria by which bids will be evaluated; and
(2)
developing a proposal to transition to and fully implement Green
Mountain Care as required by Sec. 26 of this act.
(b)
The Green Mountain Care Board shall provide updates at least quarterly
to the House Committees on Health Care and on Ways and Means and the
Senate Committees on Health and Welfare and on Finance regarding the
Board’s progress to date on:
(1)
defining the Green Mountain Care benefit package;
(2)
deciding whether to include dental, vision, hearing, and long-term
care benefits in Green Mountain Care;
(3)
determining whether and to what extent to impose cost-sharing
requirements in Green Mountain Care; and
(4)
making the determinations required for Green Mountain Care
implementation pursuant to 33 V.S.A. § 1822(a)(5).
Sec. 8.
33 V.S.A. § 1825 is amended to read:
§ 1825.
HEALTH BENEFITS
(a)(1)
Green Mountain Care shall include primary care, preventive care,
chronic care, acute episodic care, and hospital services and shall include at
least the same covered services as those included in the benefit package in
effect for the lowest cost Catamount Health plan offered on January 1, 2011
are available in the benchmark plan for the Vermont Health Benefit Exchange.
(2)
It is the intent of the General Assembly that Green Mountain Care
provide a level of coverage that includes benefits that are actuarially equivalent
- 2679 -
to at least 87 percent of the full actuarial value of the covered health services.
(3)
The Green Mountain Care Board shall consider whether to impose
cost-sharing requirements; if so, whether how to make the cost-sharing
requirements
income-sensitized;
and
the
impact
of
any
cost-sharing
requirements on an individual’s ability to access care.
The Board shall
consider waiving any cost-sharing requirement for evidence-based primary and
preventive care; for palliative care; and for chronic care for individuals
participating in chronic care management and, where circumstances warrant,
for individuals with chronic conditions who are not participating in a chronic
care management program.
(4)(A)
The Green Mountain Care Board established in 18 V.S.A.
chapter 220 shall consider whether to include dental, vision, and hearing
benefits in the Green Mountain Care benefit package.
(B)
The Green Mountain Care Board shall consider whether to
include long-term care benefits in the Green Mountain Care benefit package.
(5)
Green Mountain Care shall not limit coverage of preexisting
conditions.
(6)
The Green Mountain Care board Board shall approve the benefit
package and present it to the General Assembly as part of its recommendations
for the Green Mountain Care budget.
(b)(1)(A)
For individuals eligible for Medicaid or CHIP, the benefit
package shall include the benefits required by federal law, as well as any
additional benefits provided as part of the Green Mountain Care benefit
package.
(B)
Upon implementation of Green Mountain Care, the benefit
package for individuals eligible for Medicaid or CHIP shall also include any
optional Medicaid benefits pursuant to 42 U.S.C. § 1396d or services covered
under the State plan for CHIP as provided in 42 U.S.C. § 1397cc for which
these individuals are eligible on January 1, 2014.
Beginning with the second
year of Green Mountain Care and going forward, the Green Mountain Care
Board may, consistent with federal law, modify these optional benefits, as long
as at all times the benefit package for these individuals contains at least the
benefits described in subdivision (A) of this subdivision (b)(1).
(2)
For children eligible for benefits paid for with Medicaid funds, the
benefit package shall include early and periodic screening, diagnosis, and
treatment services as defined under federal law.
(3)
For individuals eligible for Medicare, the benefit package shall
include the benefits provided to these individuals under federal law, as well as
- 2680 -
any additional benefits provided as part of the Green Mountain Care benefit
package.
Sec. 9.
33 V.S.A. § 1827 is amended to read:
§ 1827.
ADMINISTRATION; ENROLLMENT
(a)(1)
The Agency shall, under an open bidding process, solicit bids from
and award contracts to public or private entities for administration of certain
elements of Green Mountain Care, such as claims administration and provider
relations.
(2)
The Agency shall ensure that entities awarded contracts pursuant to
this subsection do not have a financial incentive to restrict individuals’ access
to health services.
The Agency may establish performance measures that
provide incentives for contractors to provide timely, accurate, transparent, and
courteous services to individuals enrolled in Green Mountain Care and to
health care professionals.
(3)
When considering contract bids pursuant to this subsection, the
Agency shall consider the interests of the State relating to the economy, the
location of the entity, and the need to maintain and create jobs in Vermont.
The agency Agency may utilize an econometric model to evaluate the net costs
of each contract bid.
* * *
(e)
[Repealed.]
(f)
Green Mountain Care shall be the secondary payer of last resort with
respect to any health service that may be covered in whole or in part by any
other health benefit plan, including Medicare, private health insurance, retiree
health benefits, or federal health benefit plans offered by the Veterans’
Administration, by the military, or to federal employees.
* * *
Sec. 10.
CONCEPTUAL WAIVER APPLICATION
On or before November 15, 2014, the Secretary of Administration or
designee shall submit to the federal Center for Consumer Information and
Insurance Oversight a conceptual waiver application expressing the intent of
the State of Vermont to pursue a Waiver for State Innovation pursuant to Sec.
1332 of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148,
as amended by the Health Care and Education Reconciliation Act of 2010,
Pub. L. No. 111-152, and the State’s interest in commencing the application
process.
* * * Employer Assessment * * *
- 2681 -
Sec. 11.
21 V.S.A. § 2003(b) is amended to read:
(b)
For any quarter in fiscal years 2007 and 2008 calendar year 2014, the
amount of the Health Care Fund contribution shall be $ 91.25 $119.12 for each
full-time equivalent employee in excess of eight four.
For each fiscal calendar
year after fiscal year 2008, the number of excluded full-time equivalent
employees shall be adjusted in accordance with subsection (a) of this section,
and calendar year 2014, the amount of the Health Care Fund contribution shall
be adjusted by a percentage equal to any percentage change in premiums for
the second lowest cost silver-level plan in the Vermont Health Benefit
Exchange.
* * * Green Mountain Care Board * * *
Sec. 12.
18 V.S.A. § 9375(b) is amended to read:
(b)
The Board shall have the following duties:
* * *
(4)
Review the Health Resource Allocation Plan created in chapter 221
of this title, including conducting regular assessments of the range and depth of
health needs among the State’s population and developing a plan for allocating
resources over a reasonable period of time to meet those needs.
* * *
Sec. 13.
18 V.S.A. § 9375(d) is amended to read:
(d)
Annually on or before January 15, the Board shall submit a report of its
activities for the preceding calendar year to the House Committee on Health
Care and, the Senate Committee on Health and Welfare, and the Joint Fiscal
Committee.
* * *
Sec. 14.
2000 Acts and Resolves No. 152, Sec. 117b, as amended by 2013
Acts and Resolves No. 79, Sec, 42, is further amended to read:
Sec. 117b.
MEDICAID COST SHIFT REPORTING
* * *
(b)
Notwithstanding
2
V.S.A.
§ 20(d),
annually
on
or
before
December January 15, the chair Chair of the Green Mountain Care Board, the
Commissioner of Vermont Health Access, and each acute care hospital shall
file with the Joint Fiscal Committee, the House Committee on Health Care,
and the Senate Committee on Health and Welfare, in the manner required by
the Joint Fiscal Committee, such information as is necessary to carry out the
purposes of this section.
Such information shall pertain to the provider
- 2682 -
delivery system to the extent it is available.
The Green Mountain Care Board
may satisfy its obligations under this section by including the information
required by this section in the annual report required by 18 V.S.A. § 9375(d).
* * *
Sec. 15.
2013 Acts and Resolves No. 79, Sec. 5b is amended to read:
Sec. 5b.
STANDARDIZED HEALTH INSURANCE CLAIMS AND EDITS
(a)(1)
As part of moving away from fee-for-service and toward other models
of payment for health care services in Vermont, the Green Mountain Care Board,
in consultation with the Department of Vermont Health Access, health care
providers, health insurers, and other interested stakeholders, shall develop a
complete set of standardized edits and payment rules based on Medicare or on
another set of standardized edits and payment rules appropriate for use in
Vermont.
The Board and the Department shall adopt by rule the standards and
payment rules that health care providers, health insurers, Medicaid, and other
payers shall use beginning on January 1, 2015 and that Medicaid shall use
beginning on January 1, 2017.
* * *
* * * Pharmacy Benefit Managers * * *
Sec. 16.
18 V.S.A. § 9472 is amended to read:
§ 9472.
PHARMACY BENEFIT MANAGERS; REQUIRED PRACTICES
WITH RESPECT TO HEALTH INSURERS
* * *
(d)
At least annually, a pharmacy benefit manager that provides pharmacy
benefit management for a health plan shall disclose to the health insurer, the
Department of Financial Regulation, and the Green Mountain Care Board the
aggregate amount the pharmacy benefit manager retained on all claims charged
to the health insurer for prescriptions filled during the preceding calendar year
in excess of the amount the pharmacy benefit manager reimbursed pharmacies.
(e)
Compliance with the requirements of this section is required for
pharmacy benefit managers entering into contracts with a health insurer in this
state State for pharmacy benefit management in this state State.
Sec. 17.
18 V.S.A. § 9473 is redesignated to read:
§ 9473 9474.
ENFORCEMENT
Sec. 18.
18 V.S.A. § 9473 is added to read:
§ 9473.
PHARMACY BENEFIT MANAGERS; REQUIRED PRACTICES
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WITH RESPECT TO PHARMACIES
(a)
Within 14 calendar days following receipt of a pharmacy claim, a
pharmacy benefit manager or other entity paying pharmacy claims shall do one
of the following:
(1)
Pay or reimburse the claim.
(2)
Notify the pharmacy in writing that the claim is contested or denied.
The notice shall include specific reasons supporting the contest or denial and a
description of any additional information required for the pharmacy benefit
manager or other payer to determine liability for the claim.
(b)
A pharmacy benefit manager or other entity paying pharmacy claims
shall:
(1)
make
available,
in
a
format
that
is
readily
accessible
and
understandable by a pharmacist, a list of the drugs subject to maximum
allowable cost, the actual maximum allowable cost for each drug, and the
source used to determine the maximum allowable cost; and
(2)
update the maximum allowable cost list at least once every seven
calendar days.
(c)
A pharmacy benefit manager or other entity paying pharmacy claims
shall not:
(1)
impose a higher co-payment for a prescription drug than the
co-payment applicable to the type of drug purchased under the insured’s health
plan;
(2)
impose a higher co-payment for a prescription drug than the
maximum allowable cost for the drug; or
(3)
require a pharmacy to pass through any portion of the insured’s
co-payment to the pharmacy benefit manager or other payer.
Sec. 19.
9 V.S.A. § 2466a is amended to read:
§ 2466a.
CONSUMER PROTECTIONS; PRESCRIPTION DRUGS
(a)
A violation of 18 V.S.A. § 4631 shall be considered a prohibited
practice under section 2453 of this title.
(b)
As provided in 18 V.S.A. § 9473 9474, a violation of 18 V.S.A. § 9472
or 9473 shall be considered a prohibited practice under section 2453 of this
title.
* * *
* * * Adverse Childhood Experiences * * *
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Sec. 20.
FINDINGS AND PURPOSE
(a)
It is the belief of the General Assembly that controlling health care
costs
requires
consideration
of
population
health,
particularly
Adverse
Childhood Experiences (ACEs).
(b)
The ACE Questionnaire contains ten categories of questions for adults
pertaining to abuse, neglect, and family dysfunction during childhood.
It is
used to measure an adult’s exposure to traumatic stressors in childhood.
Based
on a respondent’s answers to the Questionnaire, an ACE Score is calculated,
which is the total number of ACE categories reported as experienced by a
respondent.
(c)
In a 1998 article entitled ―Relationship of Childhood Abuse and
Household Dysfunction to Many of the Leading Causes of Death in Adults‖
published in the American Journal of Preventive Medicine, evidence was cited
of a ―strong graded relationship between the breadth of exposure to abuse or
household dysfunction during childhood and multiple risk factors for several of
the leading causes of death in adults.‖
(d)
The greater the number of ACEs experienced by a respondent, the
greater the risk for the following health conditions and behaviors:
alcoholism
and alcohol abuse, chronic obstructive pulmonary disease, depression, obesity,
illicit drug use, ischemic heart disease, liver disease, intimate partner violence,
multiple sexual partners, sexually transmitted diseases, smoking, suicide
attempts, and unintended pregnancies.
(e)
ACEs are implicated in the ten leading causes of death in the United
States and with an ACE score of six or higher, an individual has a 20-year
reduction in life expectancy.
(f)
An individual with an ACE score of two is twice as likely to experience
rheumatic
disease.
An
individual
with
an
ACE
score
of
four
has
a
three-to-four-times higher risk of depression; is five times more likely to
become an alcoholic; is eight times more likely to experience sexual assault;
and is up to ten times more likely to attempt suicide.
An individual with an
ACE score of six or higher is 2.6 times more likely to experience chronic
obstructive pulmonary disease; is three times more likely to experience lung
cancer; and is 46 times more likely to abuse intravenous drugs.
An individual
with an ACE score of seven or higher is 31 times more likely to attempt
suicide.
(g)
Physical, psychological, and emotional trauma during childhood may
result in damage to multiple brain structures and functions.
(h)
ACEs are common in Vermont.
In 2011, the Vermont Department of
- 2685 -
Health reported that 58 percent of Vermont adults experienced at least one
adverse event during their childhood, and that 14 percent of Vermont adults
have
experienced
four
or
more
adverse
events
during
their
childhood.
Seventeen percent of Vermont women have four or more ACEs.
(i)
The impact of ACEs is felt across all socioeconomic boundaries.
(j)
The earlier in life an intervention occurs for an individual with ACEs,
the more likely that intervention is to be successful.
(k)
ACEs can be prevented where a multigenerational approach is
employed to interrupt the cycle of ACEs within a family, including both
prevention and treatment throughout an individual’s lifespan.
(l)
It is the belief of the General Assembly that people who have
experienced adverse childhood experiences can be resilient and can succeed in
leading happy, healthy lives.
Sec. 21.
VERMONT FAMILY BASED APPROACH PILOT
(a)
The Agency of Human Services, through the Integrated Family Services
initiative, within available Agency resources and in partnership with the
Vermont Center for Children, Youth, and Families at the University of
Vermont, shall implement the Vermont Family Based Approach in one pilot
region.
Through the Vermont Family Based Approach, wellness services,
prevention, intervention, and, where indicated, treatment services shall be
provided to families throughout the pilot region in partnership with other
human service and health care programs.
The pilot shall be fully implemented
by January 1, 2015 to the extent resources are available to support the
implementation.
(b)(1)
In the pilot region, the Agency of Human Services, community
partner organizations, schools, and the Vermont Center for Children, Youth,
and Families shall identify individuals interested in being trained as Family
Wellness Coaches and Family Focused Coaches.
(2)
Each Family Wellness Coach and Family Focused Coach shall:
(A)
complete the training program provided by the Vermont Family
Based Approach;
(B)
conduct outreach activities for the pilot region; and
(C)
serve as a resource for family physicians within the pilot region.
Sec. 22.
REPORT; BLUEPRINT FOR HEALTH
On or before December 15, 2014, the Director of the Blueprint for Health
shall submit a report to the House Committee on Health Care and to the Senate
Committee on Health and Welfare containing recommendations as to how
- 2686 -
screening for adverse childhood experiences and trauma-informed care may be
incorporated into Blueprint for Health medical practices and community health
teams, including any proposed evaluation measures and approaches, funding
constraints, and opportunities.
Sec.
23.
RECOMMENDATION;
UNIVERSITY
OF
VERMONT’S
COLLEGE
OF
MEDICINE
AND
SCHOOL
OF
NURSING
CURRICULUM
The General Assembly recommends to the University of Vermont’s College
of Medicine and School of Nursing that they consider adding or expanding
information to their curricula about the Adverse Childhood Experience Study
and the impact of adverse childhood experiences on lifelong health.
Sec. 24.
TRAUMA-INFORMED EDUCATIONAL MATERIALS
(a)
On or before January 1, 2015, the Vermont Board of Medical Practice,
in collaboration with the Vermont Medical Society Education and Research
Foundation, shall develop educational materials pertaining to the Adverse
Childhood
Experience Study,
including
available
resources
and
evidence-based
interventions
for
physicians,
physician
assistants,
and
advanced practice registered nurses.
(b)
On or before July 1, 2016, the Vermont Board of Medical Practice and
the Office of Professional Regulation shall disseminate the materials prepared
pursuant to subsection (a) of this section to all physicians licensed pursuant to
26 V.S.A. chapters 23 and 33, naturopathic physicians licensed pursuant to
26 V.S.A. chapter 81, physician assistants licensed pursuant to 26 V.S.A.
chapter 31, and advanced practice registered nurses licensed pursuant to
26 V.S.A. chapter 28, subchapter 3.
Sec. 25.
REPORT; DEPARTMENT OF HEALTH; GREEN MOUNTAIN
CARE BOARD
(a)
On or before November 1, 2014, the Department of Health, in
consultation with the Department of Mental Health, shall submit a written
report to the Green Mountain Care Board containing:
(1)
recommendations
for
incorporating
education,
treatment,
and prevention of adverse childhood
experiences into Vermont’s medical
practices and the Department of Health’s programs;
(2)
recommendations on the availability of appropriate screening tools
and
evidence-based interventions
for
individuals
throughout
their
lives,
including expectant parents; and
(3)
recommendations on additional security protections that may be used
for information related to a patient’s adverse childhood experiences.
- 2687 -
(b)
The Green Mountain Care Board shall review the report submitted
pursuant to subsection (a) of this section and attach comments to the report
regarding the report’s implications on population health and health care costs.
On or before January 1, 2015, the Board shall submit the report with its
comments to the Senate Committees on Education and on Health and Welfare
and to the House Committees on Education, on Health Care, and on Human
Services.
* * * Reports * * *
Sec. 26.
GREEN MOUNTAIN CARE FINANCING AND COVERAGE;
REPORT
(a)
Notwithstanding the January 15, 2013 date specified in 2011 Acts and
Resolves No. 48, Sec. 9, on or before February 3, 2015, the Secretary of
Administration shall submit to the House Committees on Health Care and on
Ways and Means and the Senate Committees on Health and Welfare and on
Finance a proposal to transition to and fully implement Green Mountain Care.
The report shall include the following elements, as well as any other topics the
Secretary deems appropriate:
(1)
a detailed analysis of how much individuals and businesses currently
spend on health care, including the average percentage of income spent on
health care premiums for plans in the Vermont Health Benefit Exchange by
Vermont residents purchasing Exchange plans as individuals and by Vermont
residents whose employers provide health coverage as an employment benefit,
as well as data necessary to compare the proposal to the various ways health
care is currently paid for, including as a percentage of employers’ payroll;
(2)
recommendations for the amounts and necessary mechanisms to
finance Green Mountain Care, including:
(A)
proposing the amounts to be contributed by individuals and
businesses;
(B)
recommending financing options for wraparound coverage for
individuals with other primary coverage, including evaluating the potential for
using financing tiers based on the level of benefits provided by Green
Mountain Care; and
(C)
addressing cross-border financing issues;
(3)
wraparound benefits for individuals for whom Green Mountain Care
will be the payer of last resort pursuant to 33 V.S.A. § 1827(f), including
individuals covered by the Federal Employees Health Benefit Program,
TRICARE, Medicare, retiree health benefits, or an employer health plan;
(4)
a thorough economic analysis of the impact of changing from a
- 2688 -
health care system financed through premiums to the system recommended in
the financing proposal, taking into account the effect on wages and job growth
and the impact on various wage levels;
(5)
recommendations for addressing cross-border health care delivery
issues;
(6)
establishing provider reimbursement rates in Green Mountain Care;
(7)
developing estimates of administrative savings to health care
providers and payers from Green Mountain Care; and
(8)
information regarding Vermont’s efforts to obtain a Waiver for State
Innovation pursuant to Section 1332 of the Patient Protection and Affordable
Care Act, Pub. L. No. 111-148, as amended by the Health Care and Education
Reconciliation Act of 2010, Pub. L. No. 111-152, including submission of a
conceptual waiver application as required by Sec. 10 of this act.
(b)
If the Secretary of Administration does not submit the Green Mountain
Care financing and coverage proposal required by this section to the General
Assembly by February 3, 2015, no portion of the unencumbered funds
remaining as of that date in the fiscal year 2015 appropriation to the Agency of
Administration for the planning and the implementation of Green Mountain
Care shall be expended until the Secretary submits to the General Assembly a
plan recommending the specific amounts and necessary mechanisms to finance
Green Mountain Care.
Sec. 27.
CHRONIC CARE MANAGEMENT; BLUEPRINT; REPORT
On or before October 1, 2014, the Secretary of Administration or designee
shall provide to the House Committees on Health Care and on Human Services
and the Senate Committees on Health and Welfare and on Finance a proposal
for modifications of the payment structure to health care providers and
community health teams for their participation in the Blueprint for Health; a
recommendation on whether to expand the Blueprint to include additional
services or chronic conditions such as obesity, mental conditions, and oral
health; and recommendations on ways to strengthen and sustain advanced
practice primary care.
Sec. 28.
HEALTH INSURER SURPLUS; LEGAL CONSIDERATIONS;
REPORT
The Department of Financial Regulation, in consultation with the Office of
the Attorney General, shall identify the legal and financial considerations
involved in the event that a private health insurer offering major medical
insurance plans, whether for-profit or nonprofit, ceases doing business in this
State, including appropriate disposition of the insurer’s surplus funds.
On or
- 2689 -
before July 15, 2014, the Department shall report its findings to the House
Committees on Health Care, on Commerce, and on Ways and Means and the
Senate Committees on Health and Welfare and on Finance.
Sec. 29.
TRANSITION PLAN FOR UNION EMPLOYEES
The Commissioners of Labor and of Human Resources, in consultation with
the
Vermont
League
of
Cities
and
Towns,
Vermont
School
Boards
Association, a coalition of labor organizations active in Vermont, and other
interested stakeholders, shall develop a plan for transitioning
all union
employees with collectively bargained health benefits from their existing
health insurance plans to Green Mountain Care, with the goal that all union
employees shall be enrolled in Green Mountain Care upon implementation,
which is currently targeted for 2017.
The Commissioners shall address the role
of collective bargaining on the transition process and shall propose methods to
mitigate the impact of the transition on employees’ health care coverage and
on their total compensation.
Sec.
30.
FINANCIAL
IMPACT
OF
HEALTH
CARE
REFORM
INITIATIVES
(a)
The Secretary of Administration or designee shall consult with the Joint
Fiscal Office in collecting data and developing methodologies, assumptions,
analytic models, and other factors related to the following:
(1)
the distribution of current health care spending by individuals,
businesses,
and
municipalities,
including
comparing
the
distribution
of
spending by individuals by income class with the distribution of other taxes;
(2)
the
costs
of
and
savings
from
current
health
care reform
initiatives; and
(3)
updated cost estimates for Green Mountain Care, the universal and
unified health care system established in 33 V.S.A. chapter 18, subchapter 2.
(b)
The Secretary or designee and the Joint Fiscal Committee shall explore
ways to collaborate on the estimates required pursuant to subsection (a) of this
section and may contract jointly, to the extent feasible, in order to use the same
analytic models, data, or other resources.
(c)
On or before December 1, 2014, the Secretary of Administration shall
present his or her analysis to the General Assembly.
On or before January 15,
2015, the Joint Fiscal Office shall evaluate the analysis and indicate areas of
agreement and disagreement with the data, assumptions, and results.
Sec. 31.
[Deleted.]
Sec. 32.
INCREASING MEDICAID RATES; REPORT
- 2690 -
On or before January 15, 2015, the Secretary of Administration or designee,
in consultation with the Green Mountain Care Board, shall report to the House
Committees
on
Health
Care
and
on
Ways
and
Mean and
the
Senate
Committees on Health and Welfare and on Finance regarding the impact of
increasing Medicaid reimbursement rates to providers to match Medicare rates.
The issues to be addressed in the report shall include:
(1)
the amount of State funds needed to effect the increase;
(2)
the level of a payroll tax that would be necessary to generate the
revenue needed for the increase;
(3)
the
projected
impact
of
the
increase
on
health
insurance
premiums; and
(4)
to the extent that premium reductions would likely result in a
decrease in the aggregate amount of federal premium tax credits for which
Vermont residents would be eligible, whether there are specific timing
considerations for the increase as it relates to Vermont’s application for a
Waiver for State Innovation pursuant to Section 1332 of the Patient Protection
and Affordable Care Act.
Sec.
33.
HEALTH
CARE
EXPENSES
IN
OTHER
FORMS
OF
INSURANCE
The Secretary of Administration or designee, in consultation with the
Departments of Labor and of Financial Regulation, shall collect the most
recent available data regarding health care expenses paid for by workers’
compensation, automobile, property and casualty, and other forms of non-
medical insurance, including the amount of money spent on health care-related
goods and services and the percentage of the premium for each type of policy
that is attributable to health care expenses.
The Secretary of Administration or
designee shall consolidate the data and provide it to the General Assembly on
or before December 1, 2014.
* * * Health Care Workforce Symposium * * *
Sec. 34.
HEALTH CARE WORKFORCE SYMPOSIUM
On or before November 15, 2014, the Secretary of Administration or
designee, in collaboration with the Vermont Medical Society, the Vermont
Association of Hospitals and Health Systems, and the Vermont Assembly of
Home Health and Hospice Agencies, shall organize and conduct a symposium
to address the impacts of moving toward universal health care coverage on
Vermont’s health care workforce and on its projected workforce needs.
* * * Repeal * * *
- 2691 -
Sec. 35.
REPEAL
3 V.S.A. § 635a (legislators and session-only legislative employees eligible
to purchase State Employees Health Benefit Plan at full cost) is repealed.
* * * Effective Dates * * *
Sec. 36.
EFFECTIVE DATES
This act shall take effect on passage, except that:
(1)
Notwithstanding 1 V.S.A. § 214, Sec. 35 (repeal of legislator
eligibility to purchase State Employees Health Benefit Plan) shall take effect
on passage and shall apply retroactively to January 1, 2014, except that
members and session-only employees of the General Assembly who were
enrolled in the State Employees Health Benefit Plan on January 1, 2014 may
continue to receive coverage under the plan through the remainder of the 2014
plan year; and
(2)
Sec. 18 (18 V.S.A. § 9473; pharmacy benefit managers) shall take
effect on July 1, 2014 and shall apply to contracts entered into or renewed on
or after that date.
(Committee vote: 7-2-2 )
(For text see Senate Journal 3/27/2014 &3/28/2014 )
Rep.
Ancel
of
Calais,
for
the
Committee
on
Ways
and
Means,
recommends the bill ought to pass when amended as recommended by the
Committee on
Health Care
and when further amended as follows:
First:
In Sec. 1, legislative intent; findings; purpose, by striking out
subsection (d) in its entirety and inserting in lieu thereof a new subsection (d)
to read as follows:
(d)
Before making final decisions about the financing for Green Mountain
Care, the General Assembly must have accurate data on the direct and indirect
costs of the current health care system and how the new system will impact
individual decisions about accessing care.
Second:
In Sec. 1, legislative intent; findings; purpose, by striking out
subsections (f) and (g) in their entirety and inserting in lieu thereof new
subsections (f) and (g) to read as follows:
(f)
The General Assembly must ensure that Green Mountain Care does not
go forward if the financing is not sufficient, fair, predictable, transparent,
sustainable, and shared equitably.
(g)
The General Assembly must be satisfied that an appropriate plan of
action is in place in order to accomplish the transitions needed for successful
- 2692 -
implementation of Green Mountain Care.
Third:
By striking out Sec. 2, principles for health care financing, and
inserting in lieu thereof a new Sec. 2 to read as follows:
Sec. 2.
PRINCIPLES FOR HEALTH CARE FINANCING
The
General
Assembly
adopts
the
following
principles
to
guide
the
financing of health care in Vermont:
(1)
All Vermont residents have the right to high-quality health care.
(2)
All Vermont residents shall contribute to the financing for Green
Mountain Care through taxes that are levied equitably, taking into account an
individual’s ability to pay and the value of the health benefits provided so that
access to health care will not be limited by cost barriers.
(3)
The financing system shall maximize opportunities to take advantage
of federal tax credits and deductions.
(4)
As provided in 33 V.S.A. § 1827, Green Mountain Care shall be the
payer of last resort for Vermont residents who continue to receive health care
through plans provided by an employer, by a federal health benefit plan, by
Medicare, by a foreign government, or as a retirement benefit.
(5)
Vermont’s system for financing health care shall raise revenue
sufficient to provide medically necessary health care services to all Vermont
residents, including:
(A)
ambulatory patient services;
(B)
emergency services;
(C)
hospitalization;
(D)
maternity and newborn care;
(E)
mental health and substance use disorder services, including
behavioral health treatment;
(F)
prescription drugs;
(G)
rehabilitative and habilitative services and devices;
(H)
laboratory services;
(I)
preventive
and
wellness
services
and
chronic
care
management; and
(J)
pediatric services, including oral and vision care.
Fourth:
By striking out Sec. 11, 21 V.S.A. § 2003(b), in its entirety and
inserting in lieu thereof a new Sec. 11 to read as follows:
- 2693 -
Sec. 11.
21 V.S.A. § 2003(b) is amended to read:
(b)
For any each quarter in fiscal years 2007 and 2008 year 2015, the
amount of the Health Care Fund contribution shall be $ 91.25 $133.30 for each
full-time equivalent employee in excess of eight four.
For each fiscal year
after fiscal year 2008, the number of excluded full-time equivalent employees
shall be adjusted in accordance with subsection (a) of this section, and 2015,
the amount of the Health Care Fund contribution shall be adjusted by a
percentage equal to any percentage change in premiums for the second lowest
cost silver-level plan in the Vermont Health Benefit Exchange.
Fifth:
By striking out Sec. 26, Green Mountain Care financing and
coverage; report, in its entirety and inserting in lieu thereof a new Sec. 26 to
read as follows:
Sec. 26.
GREEN MOUNTAIN CARE FINANCING AND COVERAGE;
REPORT
(a)
Notwithstanding the January 15, 2013 date specified in 2011 Acts and
Resolves No. 48, Sec. 9, no later than January 15, 2015, the Secretary of
Administration shall submit to the House Committees on Health Care and on
Ways and Means and the Senate Committees on Health and Welfare and on
Finance a proposal to transition to and fully implement Green Mountain Care.
The report shall include the following elements, as well as any other topics the
Secretary deems appropriate:
(1)
a detailed analysis of the direct and indirect financial impacts of
moving from the current health care system to a publicly financed system,
including the impact by income class and family size for individuals and by
business size, economic sector, and total sales or revenue for businesses, as
well as the effect on various wage levels and job growth;
(2)
recommendations for the amounts and necessary mechanisms to
finance Green Mountain Care, including:
(A)
proposing the amounts to be contributed by individuals and
businesses;
(B)
recommending financing options for wraparound coverage for
individuals with other primary coverage, including evaluating the potential for
using financing tiers based on the level of benefits provided by Green
Mountain Care; and
(C)
addressing cross-border financing issues;
(3)
wraparound benefits for individuals for whom Green Mountain Care
will be the payer of last resort pursuant to 33 V.S.A. § 1827(f), including
individuals covered by the Federal Employees Health Benefit Program,
- 2694 -
TRICARE, Medicare, retiree health benefits, or an employer health plan;
(4)
recommendations for addressing cross-border health care delivery
issues;
(5)
establishing provider reimbursement rates in Green Mountain Care;
(6)
developing estimates of administrative savings to health care
providers and payers from Green Mountain Care; and
(7)
information regarding Vermont’s efforts to obtain a Waiver for State
Innovation pursuant to Section 1332 of the Patient Protection and Affordable
Care Act, Pub. L. No. 111-148, as amended by the Health Care and Education
Reconciliation Act of 2010, Pub. L. No. 111-152, including submission of a
conceptual waiver application as required by Sec. 10 of this act.
(b)
If the Secretary of Administration does not submit the Green Mountain
Care financing and coverage proposal required by this section to the General
Assembly by January 15, 2015, no portion of the unencumbered funds
remaining as of that date in the fiscal year 2015 appropriation to the Agency of
Administration for the planning and the implementation of Green Mountain
Care shall be expended until the Secretary submits the required proposal.
Sixth:
By striking out Sec. 29, transition plan for union employees, in its
entirety and inserting in lieu thereof a new Sec. 29 to read as follows:
Sec. 29.
TRANSITION PLAN FOR UNION EMPLOYEES
The Commissioners of Labor and of Human Resources; one representative
each from the Vermont League of Cities and Towns, the Vermont School
Boards Association, and the Vermont School Board Insurance Trust; and five
representatives from a coalition of labor organizations active in Vermont, in
consultation with other interested stakeholders, shall develop a plan for
transitioning employees with collectively bargained health benefits from their
existing health insurance plans to Green Mountain Care, with the goal that
union
employees
shall
be
enrolled
in
Green
Mountain
Care
upon
implementation, which is currently targeted for 2017.
The transition plan shall
be consistent with State and federal labor relations laws and public and private
sector collective bargaining agreements and shall ensure that total employee
compensation does not decrease significantly, nor financial costs to employers
increase significantly, as a result of the transition of employees to Green
Mountain Care.
Seventh:
By striking out Sec. 30, financial impact of health care reform
initiatives, in its entirety and inserting in lieu thereof a new Sec. 30 to read as
follows:
Sec.
30.
FINANCIAL
IMPACT
OF
HEALTH
CARE
REFORM
- 2695 -
INITIATIVES
The Joint Fiscal Committee shall:
(1)
determine the distribution of current health care spending by
individuals, businesses, and municipalities, including the direct and indirect
costs by
income class, family
size, and other demographic factors for
individuals and by business size, economic sector, and total sales or revenue
for businesses;
(2)
for each proposal for health care system reform, evaluate the direct
and indirect impacts on individuals, businesses, and municipalities, including
the
direct
and
indirect
costs
by
income
class,
family
size,
and
other
demographic factors for individuals and by business size, economic sector, and
total sales or revenue for businesses;
(3)
estimate the costs of and savings from current health care reform
initiatives; and
(4)
update the cost estimates for Green Mountain Care, the universal and
unified health care system established in 33 V.S.A. chapter 18, subchapter 2.
Eighth:
In Sec. 36, effective dates, by inserting a new subdivision (1) to
read as follows:
(1)
Sec. 11, 21 V.S.A. § 2003(b), shall take effect on passage and shall
apply beginning with the calculation of the Health Care Fund contributions
payable in the first quarter of fiscal year 2015, which shall be based on the
number of an employer’s uncovered employees in the fourth quarter of fiscal
year 2014.
and by renumbering the remaining subdivisions to be numerically correct.
( Committee Vote: 8-3-0)
Amendment
to
be
offered
by Rep.
Fisher
of
Lincoln to
the
recommendation of amendment of the Committee on Health Care to S.
252
First:
By adding a Sec. 6a to read as follows:
* * * Health Insurance Rate Review * * *
Sec. 6a.
8 V.S.A. § 4062(h) is amended to read:
(h)(1)
This The authority of the Board under this section shall apply only to
the rate review process for policies for major medical insurance coverage and
shall not apply to the policy forms for major medical insurance coverage or to
the rate and policy form review process for policies for specific disease,
accident, injury, hospital indemnity, dental care, vision care, disability income,
- 2696 -
long-term care, student health insurance coverage, or other limited benefit
coverage; to Medicare supplemental insurance;, or to benefit plans that are
paid directly to an individual insured or to his or her assigns and for which the
amount of the benefit is not based on potential medical costs or actual costs
incurred.
(2)
The policy forms for major medical insurance coverage, as well as
the policy forms, premium rates, and rules for the classification of risk for the
other lines of insurance described in subdivision (1) of this subsection shall be
reviewed and approved or disapproved by the Commissioner.
In making his or
her determination, the Commissioner shall consider whether a policy form,
premium rate, or rule is affordable and is not unjust, unfair, inequitable,
misleading, or contrary to the laws of this State.
The Commissioner shall
make his or her determination within 30 days after the date the insurer filed the
policy form, premium rate, or rule with the Department.
At the expiration of
the 30-day period, the form, premium rate, or rule shall be deemed approved
unless prior thereto it has been affirmatively approved or disapproved by the
Commissioner or found to be incomplete.
The Commissioner shall notify an
insurer in writing if the insurer files any form, premium rate, or rule containing
a provision that does not meet the standards expressed in this subsection.
In
such notice, the Commissioner shall state that a hearing will be granted within
20 days upon the insurer’s written request.
(3)
Medicare supplemental insurance policies shall be exempt only from
the requirement in subdivisions (a)(1) and (2) of this section for the Green
Mountain Care Board’s approval on rate requests and shall be subject to the
remaining provisions of this section.
Second:
By adding Secs. 15a–15c to read as follows:
* * * Certificates of Need * * *
Sec. 15a. 18 V.S.A. § 9432 is amended to read:
§ 9432.
DEFINITIONS
As used in this subchapter:
* * *
(8)
―Health care facility‖ means all persons or institutions, including
mobile facilities, whether public or private, proprietary or not for profit, which
offer diagnosis, treatment, inpatient, or ambulatory care to two or more
unrelated persons, and the buildings in which those services are offered.
The
term shall not apply to any institution operated by religious groups relying
solely on spiritual means through prayer for healing, but shall include but is
not limited to:
- 2697 -
(A)
hospitals, including general hospitals, mental hospitals, chronic
disease facilities, birthing centers, maternity hospitals, and psychiatric facilities
including any hospital conducted, maintained, or operated by the state State of
Vermont, or its subdivisions, or a duly authorized agency thereof; and
(B)
nursing homes, health maintenance organizations, home health
agencies, outpatient diagnostic or therapy programs, kidney disease treatment
centers, mental health agencies or centers, diagnostic imaging facilities,
independent
diagnostic
laboratories,
cardiac
catheterization
laboratories,
radiation therapy facilities, or and any inpatient or ambulatory surgical,
diagnostic, or treatment center, including non-emergency walk-in centers.
* * *
(15)
―Non-emergency
walk-in
center‖
means
an
outpatient
or
ambulatory diagnostic or treatment center at which a patient without making an
appointment
may
receive
medical
care
that
is
not
of
an
emergency,
life-threatening nature.
The term includes facilities that are self-described as
urgent care centers, retail health clinics, and convenient care clinics.
Sec. 15b.
18 V.S.A. § 9434 is amended to read:
§ 9434.
CERTIFICATE OF NEED; GENERAL RULES
(a)
A health care facility other than a hospital shall not develop, or have
developed on its behalf a new health care project without issuance of a
certificate of need by the board.
For purposes of As used in this subsection, a
―new health care project‖ includes the following:
* * *
(6)
The
construction,
development,
purchase,
lease,
or
other
establishment of an ambulatory surgical center or non-emergency walk-in
center.
* * *
Sec. 15c.
18 V.S.A. § 9435 is amended to read:
§ 9435.
EXCLUSIONS
(a)
Excluded from this subchapter are offices of physicians, dentists, or
other practitioners of the healing arts, meaning the physical places which are
occupied by such providers on a regular basis in which such providers perform
the range of diagnostic and treatment services usually performed by such
providers on an outpatient basis unless they are subject to review under
subdivision 9434(a)(4) of this title.
* * *
- 2698 -
(c)
The provisions of subsection (a) of this section shall not apply to offices
owned, operated, or leased by a hospital or its subsidiary, parent, or holding
company, outpatient diagnostic or therapy programs, kidney disease treatment
centers,
independent
diagnostic
laboratories,
cardiac
catheterization
laboratories,
radiation
therapy
facilities,
ambulatory
surgical
centers,
non-emergency walk-in centers, and diagnostic imaging facilities and similar
facilities owned or operated by a physician, dentist, or other practitioner of the
healing arts.
* * *
Third:
By striking out Sec. 16, 18 V.S.A. § 9472, in its entirety and
inserting in lieu thereof a new Sec. 16 to read as follows:
Sec. 16.
18 V.S.A. § 9472 is amended to read:
§ 9472.
PHARMACY BENEFIT MANAGERS; REQUIRED PRACTICES
WITH RESPECT TO HEALTH INSURERS
(c)
Unless the contract provides otherwise, a A pharmacy benefit manager
that provides pharmacy benefit management for a health plan shall:
(1)
Provide all financial and utilization information requested by a
health insurer relating to the provision of benefits to beneficiaries through that
health insurer’s health plan and all financial and utilization information
relating to services to that health insurer.
A pharmacy benefit manager
providing information under this subsection may designate that material as
confidential. Information designated as confidential by a pharmacy benefit
manager and provided to a health insurer under this subsection may not be
disclosed by the health insurer to any person without the consent of the
pharmacy benefit manager, except that disclosure may be made by the health
insurer:
(A)
in a court filing under the consumer protection provisions of
9 V.S.A. chapter 63, provided that the information shall be filed under seal and
that prior to the information being unsealed, the court shall give notice and an
opportunity to be heard to the pharmacy benefit manager on why the
information should remain confidential;
(B)
when authorized by 9 V.S.A. chapter 63;
(C)
when ordered by a court for good cause shown; or
(D)
when ordered by the commissioner Commissioner as to a health
insurer as defined in subdivision 9471(2)(A) of this title pursuant to the
provisions of Title 8 and this title.
(2)
Notify a health insurer in writing of any proposed or ongoing
- 2699 -
activity, policy, or practice of the pharmacy benefit manager that presents,
directly or indirectly, any conflict of interest with the requirements of this
section.
(3)
With regard to the dispensation of a substitute prescription drug for a
prescribed drug to a beneficiary in which the substitute drug costs more than
the prescribed drug and the pharmacy benefit manager receives a benefit or
payment directly or indirectly, disclose to the health insurer the cost of both
drugs and the benefit or payment directly or indirectly accruing to the
pharmacy benefit manager as a result of the substitution.
(4)
If Unless the contract provides otherwise, if the pharmacy benefit
manager derives any payment or benefit for the dispensation of prescription
drugs within the state State based on volume of sales for certain prescription
drugs or classes or brands of drugs within the state State, pass that payment or
benefit on in full to the health insurer.
(5)
Disclose to the health insurer all financial terms and arrangements
for remuneration of any kind that apply between the pharmacy benefit manager
and any prescription drug manufacturer that relate to benefits provided to
beneficiaries under or services to the health insurer’s health plan, including
formulary management and drug-switch programs, educational support, claims
processing, and pharmacy network fees charged from retail pharmacies and
data sales fees.
A pharmacy benefit manager providing information under this
subsection may designate that material as confidential.
Information designated
as confidential by a pharmacy benefit manager and provided to a health insurer
under this subsection may not be disclosed by the health insurer to any person
without the consent of the pharmacy benefit manager, except that disclosure
may be made by the health insurer:
(A)
in a court filing under the consumer protection provisions of
9 V.S.A. chapter 63, provided that the information shall be filed under seal and
that prior to the information being unsealed, the court shall give notice and an
opportunity to be heard to the pharmacy benefit manager on why the
information should remain confidential;
(B)
when authorized by 9 V.S.A. chapter 63;
(C)
when ordered by a court for good cause shown; or
(D)
when ordered by the commissioner Commissioner as to a health
insurer as defined in subdivision 9471(2)(A) of this title pursuant to the
provisions of Title 8 and this title.
(d)
At least annually, a pharmacy benefit manager that provides pharmacy
benefit management for a health plan shall disclose to the health insurer, the
- 2700 -
Department of Financial Regulation, and the Green Mountain Care Board the
aggregate amount the pharmacy benefit manager retained on all claims charged
to the health insurer for prescriptions filled during the preceding calendar year
in excess of the amount the pharmacy benefit manager reimbursed pharmacies.
(e)
Compliance with the requirements of this section is required for
pharmacy benefit managers entering into contracts with a health insurer in this
state State for pharmacy benefit management in this state State.
Fourth:
In Sec. 22, report; Blueprint for Health, by striking out the
remainder of the section following the words ―including any‖ and inserting in
lieu
thereof
proposed
evaluation
measures
and
approaches;
funding
constraints; opportunities; availability of appropriate screening tools and
evidence-based interventions for individuals; the additional resources, if any,
that would be necessary to ensure adequate access to the interventions
identified as needed as a result of the use of the screening tools; and additional
security protections that may be necessary for information related to a patient’s
adverse childhood experiences.
Fifth:
In Sec. 25, report; Department of Health; Green Mountain Care
Board, by striking out subdivisions (a)(2) and (3) in their entirety and inserting
in lieu thereof new subdivisions (2) and (3) to read:
(2)
recommendations on the availability of appropriate screening tools
and
evidence-based
interventions
for
individuals
throughout
their
lives,
including expectant parents, and the additional resources, if any, that would be
necessary to ensure adequate access to the interventions identified as needed as
a result of the use of the screening tools; and
(3)
information
about
the
costs
and
availability
of,
and
recommendations on, additional security protections that may be necessary for
information related to a patient’s adverse childhood experiences.
Sixth:
In Sec. 26, Green Mountain Care financing and coverage; report, in
subdivision (a)(7), following the semicolon, by striking out the word ―and‖, in
subdivision (a)(8), following ―Sec. 10 of this act‖, by inserting a semicolon and
the word and, and by adding before the period a subdivision (a)(9) to read as
follows:
(9)
proposals for enhancing loan forgiveness programs and other
opportunities and incentives for health care workforce development and
enhancement
Seventh:
By adding a Sec. 26a to read as follows:
Sec. 26a.
18 V.S.A. § 9491 is amended to read:
§ 9491.
HEALTH CARE WORKFORCE; STRATEGIC PLAN
- 2701 -
* * *
(b)
The director or designee shall collaborate with the area health education
centers, the workforce development council Workforce Development Council
established
in
10
V.S.A.
§
541,
the
prekindergarten-16
council
Prekindergarten-16 Council established in 16 V.S.A. § 2905, the department of
labor, the department of health, the department of Vermont health access
Department of Labor, the Department of Health, the Department of Vermont
Health Access, and other interested parties, to develop and maintain the plan.
The director of health care reform Director of Health Care Reform shall ensure
that the strategic plan includes recommendations on how to develop Vermont’s
health care workforce, including:
* * *
(3)
how state State government, universities and colleges, the state’s
State’s educational system, entities providing education and training programs
related to the health care workforce, and others may develop the resources in
the health care workforce and delivery system to educate, recruit, and retain
health care professionals to achieve Vermont’s health care reform principles
and purposes, including proposals for enhancing loan forgiveness programs
and other opportunities and incentives for health care workforce development
and enhancement.
* * *
Eighth:
In Sec. 26, Green Mountain Care financing and coverage; report, in
subsection (a), following ―Health Care‖ by inserting , on Appropriations, and
following ―Health and Welfare‖ by inserting , on Appropriations,
Ninth:
In Sec. 32, increasing Medicaid rates; report, following ―Health
Care‖ by striking out ―Ways and Mean‖ and inserting in lieu thereof , on
Appropriations, and on Ways and Means and following ―Health and Welfare‖
by inserting , on Appropriations,
Tenth:
In Sec. 34, health care workforce symposium, following the words
―On or before‖, by striking out ―November 15, 2014‖ and inserting in lieu
thereof January 15, 2015
S. 295
An act relating to pretrial services, risk assessments, and criminal justice
programs
Rep.
Haas
of
Rochester,
for
the
Committee
on
Human
Services,
recommends that the House propose to the Senate that the bill be amended by
striking all after the enacting clause and inserting in lieu thereof the following:
Sec. 1.
LEGISLATIVE FINDINGS
(a)
It is the intent of the General Assembly that law enforcement officials
- 2702 -
and criminal justice professionals develop and maintain programs at every
stage of the criminal justice system to provide alternatives to a traditional
punitive criminal justice response for people who, consistent with public
safety, can effectively and justly benefit from those alternative responses.
These programs shall be reflective of the goals and principles of restorative
justice pursuant to 28 V.S.A. § 2a.
Commonly referred to as the sequential
intercept model, this approach was designed to identify five points within the
criminal
justice
system
where
innovative
approaches
to
offenders
and
offending behavior could be taken to divert individuals away from a traditional
criminal justice response to crime.
These intercept points begin in the
community with law enforcement interaction with citizens, proceed through
arrest, the judicial process, and sentencing, and conclude with release back into
communities.
Alternative justice programs may include the employment of
police-social
workers,
community-based
restorative
justice
programs,
community-based dispute resolution, precharge programs, pretrial services and
case management, recovery support, DUI and other drug treatment courts,
suspended fine programs, and offender reentry programs.
(b)
Research
shows
the
risk-need-responsivity
model
approach
to
addressing criminal conduct is successful at reducing recidivism.
The model’s
premise is that the risk and needs of a person charged with or convicted of a
criminal offense should determine the strategies appropriate for addressing the
person’s criminogenic factors.
(c)
Some
studies
show
that
incarceration
of
low-risk
offenders
or
placement of those offenders in programs or supervision designed for high-risk
offenders may increase the likelihood of recidivism.
(d)
The General Assembly recommends use of evidence-based risk
assessments
and
needs
screening
tools
for
eligible
offenses
to
provide
information to the Court for the purpose of determining bail and appropriate
conditions of release and informing decisions by the State’s Attorney and the
Court related to a person’s participation and level of supervision in an
alternative justice program.
(e)
As used in this act:
(1)
―Clinical assessment‖ means, after a client has been screened, the
procedures by which a licensed or otherwise approved counselor identifies and
evaluates an individual’s strengths, weaknesses, problems, and needs for the
development of a treatment plan.
(2)
―Needs screening‖ means a preliminary systematic procedure to
evaluate the likelihood that an individual has a substance abuse or a mental
health condition.
- 2703 -
(3)
―Risk assessment‖ means a pretrial assessment that is predictive of a
person’s failure to appear in court and risk of violating pretrial conditions of
release with a new alleged offense.
(f)
The General Assembly intends this act to be a continuation of justice
reinvestment
efforts
initiated
in
2007
by
the
Legislative,
Judicial,
and
Executive Branches.
Justice reinvestment is a data-driven approach to improve
public safety, reduce corrections and related criminal justice spending, and
reinvest
savings
in
strategies
that
can
decrease
crime
and
strengthen
communities.
(g)
Buprenorphine/Naloxone (Suboxone or Subutex) is a well-known
medication used in the treatment of opioid addiction.
Vermont spends
$8.3 million in Medicaid funds annually on these drugs.
As medicated-assisted
treatment for opiate addiction has increased substantially in the last several
years, so has illegal diversion of these drugs and their misuse.
Suboxone is
currently the number one drug smuggled into Vermont correctional facilities
and evidence suggests that the nonmedical use of such drugs is gaining in
popularity.
The General Assembly urges the administration to prioritize efforts
to ensure that people with opiate addictions are provided access to necessary
medication, while taking all possible measures to prevent the diversion and
misuse of these drugs, including working with drug manufacturers.
(h)
Approximately 54,000 Vermonters have abused, or been dependent on,
alcohol or illicit drugs in the past year, according to the current National
Survey on Drug Use and Health.
More people abuse or are dependent on
alcohol (approximately 39,000) than all illicit drugs combined (18,000).
Many
Vermonters struggle with both alcohol and illicit drugs.
Substance abuse is
expensive, and not solely due to the cost of providing treatment.
Research
indicates that $1.00 invested in addiction treatment saves between $4.00 and
$7.00 in reduced drug-related crime, criminal justice costs, and theft.
Earlier
intervention to provide services before major problems develop can save even
more.
(i)
According to the Agency of Human Services’ Report on Substance
Abuse Continuum of Services and Recommendations, dated January 15, 2014,
despite the number of people with substance use disorders, this condition is
significantly undertreated for many reasons.
In addition, it reports that one of
the challenges associated with attracting and retaining qualified individuals to
the field of substance abuse treatment and prevention is that there are
insufficient training opportunities, no opportunities for private practitioner
Licensed Alcohol and Drug Counselors (LADC) to receive payment for
providing services to Medicaid-eligible patients, and low wages for LADCs
working in community provider settings.
- 2704 -
Sec. 2.
13 V.S.A. § 7554c is added to read:
§ 7554c.
PRETRIAL RISK ASSESSMENTS; NEEDS SCREENINGS
(a)(1)
The objective of a pretrial risk assessment is to provide information
to the Court for the purpose of determining whether a person presents a risk of
nonappearance or a threat to public safety, so the Court can make an
appropriate order concerning bail and conditions of pretrial release.
(2)
The objective of a pretrial needs screening is to obtain a preliminary
indication of whether a person has a substantial substance abuse or mental
health issue that would warrant a subsequent court order for a more detailed
clinical assessment.
(3)
Participation in a risk assessment or needs screening pursuant to this
section does not create any entitlement for the assessed or screened person.
(b)(1)
A person whose offense or status falls into any of the following
categories shall be offered a risk assessment and, if deemed appropriate by the
pretrial monitor, a needs screening prior to arraignment:
(A)
misdemeanor drug offenses cited into court;
(B)
felony drug offenses cited into court;
(C)
felonies that are not listed crimes cited into court;
(D)
persons who are arrested and lodged and unable to post bail
within 24 hours of lodging, excluding persons who are charged with an offense
for which registration as a sex offender is required upon conviction pursuant to
subchapter 3 of chapter 167 of this title or an offense punishable by up to life
imprisonment; and
(E)
persons not charged with a listed crime who are identified by law
enforcement, the prosecution, the defense, probation and parole, the Court, a
treatment provider, or a family member or friend as having a substantial
substance abuse or mental health issue.
(2)
Participation in an assessment or screening shall be voluntary.
(3)
In the event an assessment or screening cannot be obtained prior to
arraignment, the Court shall direct the assessment and screening to be
conducted as soon as practicable.
(4)
A person who qualifies pursuant to subdivision (1)(A)–(E) of this
subsection and who has an additional pending charge or a violation of
probation shall not be excluded from being offered a risk assessment or needs
screening unless the other charge is a listed crime as defined in section 5301 of
this title.
- 2705 -
(5)
Nothing in this section shall be construed to limit the Court’s
authority to order an assessment or screening as a condition of release under
section 7554 of this title.
(6)
The Administrative Judge and Court Administrator, in consultation
with the Secretary of Human Services and the Commissioner of Corrections,
shall develop a statewide plan for the phased, consistent rollout of the
categories identified in subdivisions (1)(A) through (E) of this subsection.
All
persons whose offense or status falls into one of the categories shall be eligible
for a risk assessment or needs screening on or before January 1, 2016.
Prior to
that date, a person shall not be guaranteed the offer of a risk assessment or
needs screening solely because the person’s offense or status falls into one of
the categories.
Criminal justice professionals charged with implementation
shall adhere to the plan.
(c)
The results of the assessment and screening shall be provided to the
prosecutor who, upon filing a criminal charge against the person, shall provide
the results to the person and his or her attorney and the Court.
(d)(1)
In consideration of the assessment and screening, the Court may
order the person to comply with any of the following conditions:
(A)
meet with a pretrial monitor on a schedule set by the Court;
(B)
participate in a clinical assessment by a substance abuse
treatment provider;
(C)
comply with any level of treatment or recovery support
recommended by the provider;
(D)
provide confirmation to the pretrial monitor of the person’s
attendance and participation in the clinical assessment and any recommended
treatment; and
(E)
provide confirmation to the pretrial monitor of the person’s
compliance with any other condition of release.
(2)
If possible, the Court shall set the date and time for the assessment at
arraignment.
In the alternative, the pretrial monitor shall coordinate the date,
time, and location of the clinical assessment and advise the Court, the person
and his or her attorney, and the prosecutor.
(3)
The conditions authorized in subdivision (1) of this subsection shall
be in addition to any other conditions of release permitted by law and shall not
limit the Court in any way.
(e)(1)
Information obtained from the person during the risk assessment or
needs screening shall be exempt from public inspection and copying under the
- 2706 -
Public Records Act and, except as provided in subdivision (2) of this
subsection, only may be used for determining bail, conditions of release, and
appropriate programming for the person in the pending case.
The immunity
provisions of this subsection apply only to the use and derivative use of
information gained as a proximate result of the risk assessment or needs
screening.
(2)
The person shall retain all of his or her due process rights throughout
the assessment and screening process and may release his or her records at his
or her discretion.
(3)
The Vermont Supreme Court and the Department of Corrections
shall
adopt
rules
related
to
the
custody,
control,
and
preservation
of
information consistent with the confidentiality requirements of this section.
(f)
The Vermont Supreme Court or its designee shall develop guidelines for
the appropriate use of court-ordered pretrial monitoring services based upon
the risk and needs of the defendant.
Sec. 3.
RISK ASSESSMENT AND NEEDS SCREENING TOOLS AND
SERVICES
(a)
The Department of Corrections shall select risk and needs assessment
and screening tools for use in the various decision points in the criminal justice
system,
including
pretrial,
community
supervision
screening,
community
supervision, prison screening, prison intake, and reentry.
The Department
shall validate the selected tools for the population in Vermont.
(b)
In selection and implementation of the tools, the Department shall
consider tools being used in other states and shall consult with and have the
cooperation of all criminal justice agencies.
(c)
The Department shall have the tools available for use on or before
September 1, 2014.
The Department, the Judiciary, the Defender General, and
the Executive Director and the Department of State’s Attorneys and Sheriffs
shall conduct training on the risk assessment tools on or before December 15,
2014.
(d)
The Department, in consultation with law enforcement agencies and the
courts, shall contract for or otherwise provide pretrial services described in this
section, including performance of risk assessments, needs screenings, and
pretrial monitoring.
(e)
Pretrial monitoring may include:
(1)
reporting to the Court concerning the person’s compliance with
conditions of release;
- 2707 -
(2)
supporting the person in meeting the conditions imposed by the
Court, including the condition to appear in Court as directed;
(3)
identifying community-based treatment, rehabilitative services,
recovery supports, and restorative justice programs; and
(4)
supporting a prosecutor’s precharge program.
(f)
The Department, in consultation with the Judiciary and the Center for
Criminal Justice Research, shall develop and implement a system to evaluate
performance of the pretrial services described in this section and report to the
General Assembly annually on or before December 15.
(g)
The Secretary of Human Services, with staff and administrative support
from the Criminal Justice Capable Core Team, shall map services and assess
the impact of court referrals and the capacity of the current service provision
system in each region.
The Secretary, in collaboration with service providers
and other stakeholders, shall consider regional resources, including services for
assessment, early intervention, treatment, and recovery support.
Building on
existing models and data, the Secretary and the Criminal Justice Capable Core
Team shall develop recommendations for a system for referral based on the
appropriate level of need, identifying existing gaps to optimize successful
outcomes.
Funding models for those services shall be examined by the
appropriate State departments.
The recommendation for the system for referral
shall be inclusive of all initiatives within the Agency of Human Services,
including
those
within
the
Blueprint
for
Health
and
Screening, Brief
Intervention, and Referral for Treatment (SBIRT), as well as initiatives within
the Green Mountain Care Board and the State Innovation Model (SIM) grant.
* * * Alternative Justice Programs * * *
Sec. 4.
PROSECUTOR PRECHARGE PROGRAM GUIDELINES AND
REPORTING
(a)
The Department of State’s Attorneys and Sheriffs, in consultation with
the Judiciary and the Attorney General, shall develop broad guidelines for
precharge programs to ensure there is probable cause and that there are
appropriate opportunities for victim input and restitution.
(b)
On or before October 1, 2014, and annually thereafter, the Executive
Director of the Department of State’s Attorneys and Sheriffs shall report to the
General Assembly detailing the alternative justice programs that exist in each
county together with the protocols for each program, the annual number of
persons served by the program, and a plan for how a sequential intercept model
can be employed in the county.
The report shall be prepared in cooperation
with the Director of Court Diversion, a co-chair of the Community Justice
- 2708 -
Network of Vermont, and State, municipal, and county law enforcement
officials.
Sec. 5.
[Deleted.]
Sec. 6.
13 V.S.A. § 5362(c) is amended to read:
(c)
The Restitution Unit shall have the authority to:
* * *
(7)
Enter into a repayment contract with a juvenile or adult accepted into
a diversion program or alternative justice program and to bring a civil action to
enforce the contract when a diversion program has referred an individual
pursuant to 3 V.S.A. § 164a or an alternative justice program contract pursuant
to section 7554c of this title or a prosecutor precharge program.
Sec. 7.
13 V.S.A. § 5363(d)(2) is amended to read:
(2)
The Restitution Unit may make advances of up to $10,000.00
$5,000.00 under this subsection to the following persons or entities:
* * *
(B)
A victim who is a natural person or the natural person’s legal
representative in a case where the defendant, before or after an adjudication of
guilt, enters into a drug court contract or an alternative justice program contract
pursuant to section 7554c of this title or a prosecutor precharge program
requiring payment of restitution.
* * * Criminal Provisions * * *
Sec. 8.
18 V.S.A. § 4235b is added to read:
§ 4235b.
TRANSPORTATION OF DRUGS INTO THE STATE;
AGGRAVATING FACTOR
When imposing a sentence for a felony violation of dispensing or selling a
regulated drug in violation of this chapter, the Court shall consider whether the
person knowingly and unlawfully transported the regulated drug into Vermont
with the intent to sell or dispense the drug.
Sec. 9.
13 V.S.A. § 1201 is amended to read:
§ 1201.
BURGLARY
(a)
A person is guilty of burglary if he or she enters any building or
structure knowing that he or she is not licensed or privileged to do so, with the
intent to commit a felony, petit larceny, simple assault, or unlawful mischief.
This provision shall not apply to a licensed or privileged entry, or to an entry
- 2709 -
that takes place while the premises are open to the public, unless the person,
with the intent to commit a crime specified in this subsection, surreptitiously
remains in the building or structure after the license or privilege expires or
after the premises no longer are open to the public.
(b)
As used in this section, the words ―building,‖ ―structure,‖ and
―premises‖:
(1)
―Building,‖ ―premises,‖ and ―structure‖ shall, in addition to their
common meanings, include and mean any portion of a building, structure, or
premises which differs from one or more other portions of such building,
structure, or premises with respect to license or privilege to enter, or to being
open to the public.
(2)
―Occupied dwelling‖ means a building used as a residence, either
full-time or part-time, regardless of whether someone is actually present in the
building at the time of entry.
(c)(1)
A person convicted of burglary into an occupied dwelling shall be
imprisoned not more than 25 years or fined not more than $1,000.00, or both.
Otherwise, a person convicted of burglary shall be imprisoned not more than
15 years or fined not more than $1,000.00, or both.
(2)
When imposing a sentence under this section, the Court shall
consider whether, during commission of the offense, the person:
(A)
entered the building when someone was actually present;
(B)
used or threatened to use force against the occupant; or
(C)
carried a dangerous or deadly weapon, openly or concealed,
during the commission of the offense, and the person has not been convicted of
a violation of section 4005 of this title in connection with the offense.
Sec. 10.
DEPARTMENT OF PUBLIC SAFETY REPORT
The Department of Public Safety, in consultation with the Department of
Health, shall examine 18 V.S.A. § 4234 (depressant, stimulant, narcotic drug)
for the purpose of establishing clear dosage amounts for narcotics as they
relate to unlawful possession, dispensing, and sale.
The Department shall
consider
section
4234
in
relation
to
18
V.S.A.
§ 4233
(heroin).
The
Department
shall
report
its
recommendations
to
the
Senate
and
House
Committees on Judiciary on or before December 15, 2014.
* * * Regulation of Opiates * * *
Sec. 11.
DVHA AUTHORITY; USE OF AVAILABLE SANCTIONS
The Department of Vermont Health Access shall use its authority to
- 2710 -
sanction Medicaid-participating prescribers, whether practicing in or outside
the State of Vermont, operating in bad faith or not in compliance with State or
federal requirements.
Sec. 12.
CONTINUED MEDICATION-ASSISTED TREATMENT FOR
INCARCERATED PERSONS
(a)
The
Department
of
Corrections,
in
consultation
with
the
Medication-Assisted Treatment for Inmates Work Group created by 2013 Acts
and Resolves No. 67, Sec. 11, shall develop and implement a one-year
demonstration
project
to
pilot
the
continued
use
of
medication-assisted
treatment within Department facilities for detainees and sentenced inmates.
(b)
The pilot project shall offer continued medication-assisted treatment for
opioid dependence with methadone or buprenorphine to incarcerated persons
who were participating in medication-assisted treatment in the community
immediately prior to incarceration as follows:
(1)
for a period of 180 days from the date of incarceration for a person
held on detainee status, followed by a prescribed taper; or
(2)
for a period of one year from the date of incarceration for a person
serving a sentence, followed by a prescribed taper.
(c)
As
used
in
this
section,
―prescribed
taper‖
means
a
clinically
appropriate
medication
taper
that
is
designed
to
minimize
withdrawal
symptoms and limit avoidable suffering.
(d)
The Commissioner of Corrections shall publish an interim revision
memorandum
to
replace
Directive 363.01.
The
Medication-Assisted
Treatment for Inmates Work Group shall provide details of the demonstration
project, including:
(1)
an update on the implementation of the recommendations provided
in the ―Medication-Assisted Treatment for Inmates: Work Group Report
and Recommendations‖ submitted to the Vermont General Assembly on
November 26, 2013;
(2)
medication-assisted treatment time frames;
(3)
Department protocols for detainees and inmates transitioning in and
out of treatment settings, or between correctional facilities and treatment
services;
(4)
protocols regarding medical tapers, detoxification, and withdrawal;
(5)
plans and timing for expansion of the pilot project; and
(6)
an evaluation plan that includes appropriate metrics for determining
- 2711 -
treatment
efficacy,
reincarceration
episodes,
Department-
and
community-based collaboration challenges, and system costs.
(e)
On or before July 30, 2014, the Department shall enter into memoranda
of understanding with the Department of Health and with hub treatment
providers regarding ongoing medication-assisted treatment for persons in the
custody of the Department.
(f)
The Department shall collaborate with the Department of Health to
facilitate the provision of opioid overdose prevention training for persons who
are incarcerated and distribution of overdose rescue kits with naloxone at
correctional facilities to persons who are transitioning from incarceration back
into the community.
(g)
The Departments of Corrections and of Health shall continue the
Medication-Assisted Treatment for Inmates Work Group created by 2013 Acts
and Resolves No. 67, Sec. 11 to inform and monitor implementation of the
demonstration project.
The Departments shall evaluate the demonstration
project and provision of medication-assisted treatment to persons who are
incarcerated in Vermont and report their findings, including a proposed
schedule
of
expansion,
to
the
House
Committees
on
Corrections
and
Institutions, on Human Services, and on Judiciary and the Senate Committees
on Health and Welfare and on Judiciary on or before January 1, 2015.
Sec. 13.
VPMS QUERY; RULEMAKING
The Secretary of Human Services shall adopt rules requiring:
(1)
All Medicaid participating providers, whether licensed in or outside
Vermont, who prescribe buprenorphine or a drug containing buprenorphine to
a Vermont Medicaid beneficiary to query the Vermont Prescription Monitoring
System the first time they prescribe buprenorphine or a drug containing
buprenorphine for the patient and at regular intervals thereafter.
Regular
intervals shall exceed the requirements for other Schedule III pharmaceuticals,
and queries shall be done prior to prescribing a replacement prescription.
The
rules shall also include dosage thresholds, which may be exceeded only with
prior approval from the Chief Medical Officer of the Department of Vermont
Health Access or designee.
(2)
All providers licensed in Vermont who prescribe buprenorphine or a
drug containing buprenorphine to a Vermont patient who is not a Medicaid
beneficiary to query the Vermont Prescription Monitoring System the first time
they prescribe buprenorphine or a drug containing buprenorphine for the
patient and at regular intervals thereafter.
Regular intervals shall exceed the
requirements for other Schedule III pharmaceuticals and queries shall be done
prior to prescribing a replacement prescription.
The rules shall also include
- 2712 -
dosage thresholds.
Sec. 14.
MEDICATION-ASSISTED THERAPY; RULEMAKING
The
Commissioner
of
Health
shall
adopt
rules
relating
to
medication-assisted therapy for opioid dependence for physicians treating
fewer than 30 patients, which shall include a requirement that such physicians
ensure that their patients are screened or assessed to determine their need for
counseling and that patients who are determined to need counseling or other
support services are referred for appropriate counseling from a licensed clinical
professional or for other services as needed.
Sec. 15.
26 V.S.A. chapter 36, subchapter 8 is added to read:
Subchapter 8.
Naloxone Hydrochloride
§ 2080.
NALOXONE
HYDROCHLORIDE;
DISPENSING
OR
FURNISHING
(a)
The Board of Pharmacy shall adopt protocols for licensed pharmacists
to dispense or otherwise furnish naloxone hydrochloride to patients who do not
hold an individual prescription for naloxone hydrochloride.
Such protocols
shall be consistent with rules adopted by the Commissioner of Health.
(b)
Notwithstanding any provision of law to the contrary, a licensed
pharmacist may dispense naloxone hydrochloride to any person as long as the
pharmacist complies with the protocols adopted pursuant to subsection (a) of
this section.
Sec. 16.
33 V.S.A. § 813 is added to read:
§ 813.
MEDICAID PARTICIPATING PROVIDERS
The Department of Vermont Health Access shall grant authorization to a
licensed alcohol and drug abuse counselor to participate as a Medicaid
provider to deliver clinical and case
coordination services to Medicaid
beneficiaries, regardless of whether the counselor is a preferred provider.
Sec. 16a.
DEPARTMENT OF CORRECTIONS AND HEALTH CARE
REFORM
(a)
The Agency of Human Services and its departments shall assist the
Department of Corrections in fully enacting the provisions of the Affordable
Care Act and Vermont’s health care reform initiatives as they pertain to
persons
in
the
criminal
justice
population,
including
access
to
health
information technology, the Blueprint for Health, Medicaid enrollment, health
benefit exchange, health plans, and other components under the Department of
Vermont Health Access that support and ensure a seamless process for reentry
- 2713 -
to the community or readmission to a correctional facility.
(b)
The Department of Corrections shall include substance abuse services
in its request for proposal (RFP) process for inmate health services.
Through
the RFP, the Department shall require that substance abuse services be
provided to persons while incarcerated.
Sec. 17.
18 V.S.A. § 4254 is amended to read:
§ 4254.
IMMUNITY FROM LIABILITY
* * *
(d)
A person who seeks medical assistance for a drug overdose or is the
subject of a good faith request for medical assistance pursuant to subsection (b)
or (c) of this section shall not be subject to any of the penalties for violation of
13 V.S.A. § 1030 (violation of a protection order), for a violation of this
chapter or 7 V.S.A §§ 656 and 657, for being at the scene of the drug overdose,
or for being within close proximity to any person at the scene of the drug
overdose.
(e)
A person who seeks medical assistance for a drug overdose or is the
subject of a good faith request for medical assistance pursuant to subsection (b)
or (c) of this section shall not be subject to any sanction for a violation of a
condition of pretrial release, probation, furlough, or parole for a violation of
this chapter or 7 V.S.A §§ 656 and 657, for being at the scene of the drug
overdose, or for being within close proximity to any person at the scene of the
drug overdose.
* * *
Sec. 18.
AGENCY OF HUMAN SERVICES POSITION
One exempt position is created within the Agency of Human Services for
the purpose of overseeing the implementation of the pretrial services of
this act.
Sec. 19.
EFFECTIVE DATES
(a)
Secs. 2, 6, and 7 shall take effect on January 1, 2015.
(b)
This section and Secs. 1 (legislative intent), 3 (risk assessment and
needs screening tools), 4 (prosecutor precharge programs and reporting),
10 (Department of Public Safety report), 13 (VPMS query; rulemaking),
14 (medication assisted therapy, rulemaking), and 17 (immunity from liability)
shall take effect on passage.
(c)
The remaining sections shall take effect on July 1, 2014.
(Committee vote: 10-0-1 )
(For text see Senate Journal 3/12/2014 )
- 2714 -
Rep. Lippert of Hinesburg,
for the Committee on
Judiciary,
recommends
the bill ought to pass when amended as recommended by the Committee on
Human Services
and when further amended as follows:
Sec. 1.
LEGISLATIVE FINDINGS
(a)
It is the intent of the General Assembly that law enforcement officials
and criminal justice professionals develop and maintain programs at every
stage of the criminal justice system to provide alternatives to a traditional
punitive criminal justice response for people who, consistent with public
safety, can effectively and justly benefit from those alternative responses.
These programs shall be reflective of the goals and principles of restorative
justice pursuant to 28 V.S.A. § 2a.
Commonly referred to as the sequential
intercept model, this approach was designed to identify five points within the
criminal
justice
system
where innovative
approaches
to
offenders
and
offending behavior could be taken to divert individuals away from a traditional
criminal justice response to crime.
These intercept points begin in the
community with law enforcement interaction with citizens, proceed through
arrest, the judicial process, and sentencing, and conclude with release back into
communities.
Alternative justice programs may include the employment of
police-social
workers,
community-based
restorative
justice
programs,
community-based dispute resolution, precharge programs, pretrial services and
case management, recovery support, DUI and other drug treatment courts,
suspended fine programs, and offender reentry programs.
(b)
Research
shows
the
risk-need-responsivity
model
approach
to
addressing criminal conduct is successful at reducing recidivism.
The model’s
premise is that the risk and needs of a person charged with or convicted of a
criminal offense should determine the strategies appropriate for addressing the
person’s criminogenic factors.
(c)
Some
studies
show
that
incarceration
of
low-risk
offenders
or
placement of those offenders in programs or supervision designed for high-risk
offenders may increase the likelihood of recidivism.
(d)
The General Assembly recommends use of evidence-based risk
assessments
and
needs
screening
tools
for
eligible
offenses
to
provide
information to the Court for the purpose of determining bail and appropriate
conditions of release and informing decisions by the State’s Attorney and the
Court related to a person’s participation and level of supervision in an
alternative justice program.
(e)
As used in this act:
(1)
―Clinical assessment‖ means the procedures, to be conducted after a
client has been screened, by which a licensed or otherwise approved counselor
- 2715 -
identifies and evaluates and individual’s strengths, weaknesses, problems, and
needs for the development of a treatment plan.
(2)
―Needs screening‖ means a preliminary systematic procedure to
evaluate the likelihood that an individual has a substance abuse or a mental
health condition.
(3)
―Risk assessment‖ means a pretrial assessment that is designed to be
predictive of a person’s failure to appear in court and risk of violating pretrial
conditions of release with a new alleged offense.
(f)
The General Assembly intends this act to be a continuation of justice
reinvestment
efforts
initiated
in
2007
by
the
Legislative,
Judicial,
and
Executive Branches.
Justice reinvestment is a data-driven approach to improve
public safety, reduce corrections and related criminal justice spending, and
reinvest
savings
in
strategies
that
can
decrease
crime
and
strengthen
communities.
(g)
Buprenorphine/Naloxone (Suboxone or Subutex) is a well-known
medication used in the treatment of opioid addiction.
Vermont spends
$8.3 million in Medicaid funds annually on these drugs.
As medicated-assisted
treatment for opiate addiction has increased substantially in the last several
years, so has illegal diversion of these drugs and their misuse.
Suboxone is
currently the number one drug smuggled into Vermont correctional facilities
and evidence suggests that the nonmedical use of such drugs is gaining in
popularity.
The General Assembly urges the administration to prioritize efforts
to ensure that people with opiate addictions are provided access to necessary
medication, while taking all possible measures to prevent the diversion and
misuse of these drugs, including working with drug manufacturers.
(h)
Approximately 54,000 Vermonters have abused or been dependent on
alcohol or illicit drugs in the past year, according to the current National
Survey on Drug Use and Health.
More people abuse or are dependent on
alcohol (approximately 39,000) than all illicit drugs combined (18,000).
Many
Vermonters struggle with both alcohol and illicit drugs.
Substance abuse is
expensive, and not solely due to the cost of providing treatment.
Research
indicates that $1.00 invested in addiction treatment saves between $4.00 and
$7.00 in reduced drug-related crime, criminal justice costs, and theft.
Earlier
intervention to provide services before major problems develop can save even
more.
(i)
According to the Agency of Human Services’ Report on Substance
Abuse Continuum of Services and Recommendations, dated January 15, 2014,
despite the number of people with substance use disorders, this condition is
significantly under-treated for many reasons.
In addition, it reports that one of
- 2716 -
the challenges associated with attracting and retaining qualified individuals to
the field of substance abuse treatment and prevention is that there are
insufficient training opportunities, no opportunities for private practitioner
Licensed Alcohol and Drug Counselors (LADC) to receive payment for
providing services to Medicaid eligible patients, and low wages for LADCs
working in community provider settings.
Sec. 2.
13 V.S.A. § 7554c is added to read:
§ 7554c.
PRETRIAL RISK ASSESSMENTS; NEEDS SCREENINGS
(a)(1)
The objective of a pretrial risk assessment is to provide information
to the Court for the purpose of determining whether a person presents a risk of
nonappearance or a threat to public safety, so the Court can make an
appropriate order concerning bail and conditions of pretrial release.
(2)
The objective of a pretrial needs screening is to obtain a preliminary
indication of whether a person has a substantial substance abuse or mental
health issue that would warrant a subsequent court order for a more detailed
clinical assessment.
(3)
Participation in a risk assessment or needs screening pursuant to this
section does not create any entitlement for the assessed or screened person.
(b)(1)
A person whose offense or status falls into any of the following
categories shall be offered a risk assessment and, if deemed appropriate by the
pretrial monitor, a needs screening prior to arraignment:
(A)
misdemeanor drug offenses cited into court;
(B)
felony drug offenses cited into court;
(C)
felonies that are not listed crimes cited into court;
(D)
persons who are arrested and lodged and unable to post bail
within 24 hours of lodging, excluding persons who are charged with an offense
for which registration as a sex offender is required upon conviction pursuant to
subchapter 3 of chapter 167 of this title or an offense punishable by up to life
imprisonment; and
(E)
persons not charged with a listed crime who are identified by law
enforcement, the prosecution, the defense, probation and parole personnel, the
Court, a treatment provider, or a family member or friend as having a
substantial substance abuse or mental health issue.
(2)
Participation in an assessment or screening shall be voluntary.
(3)
In the event an assessment or screening cannot be obtained prior to
arraignment, the Court shall direct the assessment and screening to be
- 2717 -
conducted as soon as practicable.
(4)
A person who qualifies pursuant to subdivision (1)(A)–(E) of this
subsection and who has an additional pending charge or a violation of
probation shall not be excluded from being offered a risk assessment or needs
screening unless the other charge is a listed crime as defined in section 5301 of
this title.
(5)
Nothing in this section shall be construed to limit the Court’s
authority to order an assessment or screening as a condition of release under
section 7554 of this title.
(6)
The Administrative Judge and Court Administrator, in consultation
with the Secretary of Human Services and the Commissioner of Corrections,
shall develop a statewide plan for the phased, consistent rollout of the
categories identified in subdivisions (1)(A) through (E) of this subsection.
All
persons whose offense or status falls into one of the categories shall be eligible
for a risk assessment or needs screening on or before January 1, 2016.
Prior to
that date, a person shall not be guaranteed the offer of a risk assessment or
needs screening solely because the person’s offense or status falls into one of
the categories.
Criminal justice professionals charged with implementation
shall adhere to the plan.
(c)
The results of the assessment and screening shall be provided to the
prosecutor who, upon filing a criminal charge against the person, shall provide
the results to the person and his or her attorney and the Court.
(d)(1)
In consideration of the assessment and screening, the Court may
order the person to comply with any of the following conditions:
(A)
meet with a pretrial monitor on a schedule set by the Court;
(B)
participate in a clinical assessment by a substance abuse
treatment provider;
(C)
comply
with
any
level
of
treatment
or
recovery
support
recommended by the provider;
(D)
provide confirmation to the pretrial monitor of the person’s
attendance and participation in the clinical assessment and any recommended
treatment; and
(E)
provide confirmation to the pretrial monitor of the person’s
compliance with any other condition of release.
(2)
If possible, the Court shall set the date and time for the assessment at
arraignment.
In the alternative, the pretrial monitor shall coordinate the date,
time, and location of the clinical assessment and advise the Court, the person
- 2718 -
and his or her attorney, and the prosecutor.
(3)
The conditions authorized in subdivision (1) of this subsection shall
be in addition to any other conditions of release permitted by law and shall not
limit the Court in any way.
(e)(1)
Information obtained from the person during the risk assessment or
needs screening shall be exempt from public inspection and copying under the
Public Records Act and, except as provided in subdivision (2) of this
subsection, only may be used for determining bail, conditions of release, and
appropriate programming for the person in the pending case.
The immunity
provisions of this subsection apply only to the use and derivative use of
information gained as a proximate result of the risk assessment or needs
screening.
(2)
The person shall retain all of his or her due process rights throughout
the assessment and screening process and may release his or her records at his
or her discretion.
(3)
The Vermont Supreme Court in accordance with judicial rulemaking
as provided in 12 V.S.A. § 1 shall promulgate and the Department of
Corrections in accordance with the Vermont Administrative Procedure Act
pursuant to 3 V.S.A. chapter 25 shall adopt rules related to the custody,
control, and preservation of information consistent with the confidentiality
requirements of this section.
Emergency rules adopted prior to January 1,
2015 pursuant to this section shall be considered to meet the ―imminent peril‖
standard under 3 V.S.A. § 844(a).
(f)
The Administrative Judge shall develop guidelines for the appropriate
use of court-ordered pretrial monitoring services based upon the risk and needs
of the defendant.
Sec. 3.
RISK ASSESSMENT AND NEEDS SCREENING TOOLS AND
SERVICES
(a)
The Department of Corrections shall select risk and needs assessment
and screening tools for use in the various decision points in the criminal justice
system,
including
pretrial,
community
supervision
screening,
community
supervision, prison screening, prison intake, and reentry.
(b)
In selection and implementation of the tools, the Department shall
consider tools being used in other states and shall consult with and have the
cooperation of all criminal justice agencies.
(c)
The Department shall have the tools available for use on or before
September 1, 2014.
The Department, the Judiciary, the Defender General, and
the Executive Director and the Department of State’s Attorneys and Sheriffs
- 2719 -
shall conduct training on the risk assessment tools on or before December 15,
2014.
(d)
The Department, in consultation with law enforcement agencies and the
courts, shall contract for or otherwise provide pretrial services described in this
section, including performance of risk assessments, needs screenings, and
pretrial monitoring.
The contract shall include requirements to comply with
data collection and evaluation procedures.
(e)
Pretrial monitoring may include:
(1)
reporting to the Court concerning the person’s compliance with
conditions of release;
(2)
supporting the person in meeting the conditions imposed by the
Court, including the condition to appear in Court as directed;
(3)
identifying community-based treatment, rehabilitative services,
recovery supports, and restorative justice programs; and
(4)
supporting a prosecutor’s precharge program.
(f)(1)
The Department, in consultation with the Judiciary and the Crime
Research Group, shall develop and implement a system to evaluate goals and
performance of the pretrial services described in this section and report to the
General Assembly annually on or before December 15.
(2)
The
Agency
of
Human
Services,
in
consultation
with
the
Judiciary, shall ensure that a study is conducted to include an outcome study,
process evaluation and cost benefit analysis.
(g)
The Secretary of Human Services, with staff and administrative support
from the Criminal Justice Capable Core Team, shall map services and assess
the impact of court referrals and the capacity of the current service provision
system in each region.
The Secretary, in collaboration with service providers
and other stakeholders, shall consider regional resources, including services for
assessment, early intervention, treatment, and recovery support.
Building on
existing models and data, the Secretary and the Criminal Justice Capable Core
Team shall develop recommendations for a system for referral based on the
appropriate level of need, identifying existing gaps to optimize successful
outcomes.
Funding models for those services shall be examined by the
appropriate State departments.
The recommendation for the system for referral
shall be inclusive of all initiatives within the Agency of Human Services,
including
those
within
the
Blueprint
for
Health
and
Screening, Brief
Intervention, and Referral for Treatment (SBIRT), as well as initiatives within
the Green Mountain Care Board and the State Innovation Model (SIM) grant.
* * * Alternative Justice Programs * * *
- 2720 -
Sec. 4.
PROSECUTOR PRECHARGE PROGRAM GUIDELINES AND
REPORTING
(a)
The Department of State’s Attorneys and Sheriffs, in consultation with
the Judiciary and the Attorney General, shall develop broad guidelines for
precharge programs to ensure there is probable cause and that there are
appropriate opportunities for victim input and restitution.
(b)
On or before October 1, 2014, and annually thereafter, the Executive
Director of the Department of State’s Attorneys and Sheriffs shall report to the
General Assembly detailing the alternative justice programs that exist in each
county together with the protocols for each program, the annual number of
persons served by the program, and a plan for how a sequential intercept model
can be employed in the county.
The report shall be prepared in cooperation
with the Director of Court Diversion, a co-chair of the Community Justice
Network of Vermont, and State, municipal, and county law enforcement
officials.
Sec. 5.
[Deleted.]
Sec. 6.
13 V.S.A. § 5362(c) is amended to read:
(c)
The Restitution Unit shall have the authority to:
* * *
(7)
Enter into a repayment contract with a juvenile or adult accepted into
a diversion program or alternative justice program and to bring a civil action to
enforce the contract when a diversion program has referred an individual
pursuant to 3 V.S.A. § 164a or an alternative justice program contract pursuant
to section 7554c of this title or a prosecutor precharge program.
Sec. 7.
13 V.S.A. § 5363(d)(2) is amended to read:
(2)
The Restitution Unit may make advances of up to $10,000.00
$5,000.00 under this subsection to the following persons or entities:
* * *
(B)
A victim who is a natural person or the natural person’s legal
representative in a case where the defendant, before or after an adjudication of
guilt, enters into a drug court contract or an alternative justice program contract
pursuant to section 7554c of this title or a prosecutor precharge program
requiring payment of restitution.
* * * Criminal Provisions * * *
Sec. 8.
18 V.S.A. § 4235b is added to read:
- 2721 -
§ 4235b.
TRANSPORTATION OF DRUGS INTO THE STATE;
AGGRAVATING FACTOR
When imposing a sentence for a felony violation of dispensing or selling a
regulated drug in violation of this chapter, the Court shall consider as an
aggravating factor whether the person knowingly and unlawfully transported
the regulated drug into Vermont.
Sec. 9.
13 V.S.A. § 1201 is amended to read:
§ 1201.
BURGLARY
(a)
A person is guilty of burglary if he or she enters any building or
structure knowing that he or she is not licensed or privileged to do so, with the
intent to commit a felony, petit larceny, simple assault, or unlawful mischief.
This provision shall not apply to a licensed or privileged entry, or to an entry
that takes place while the premises are open to the public, unless the person,
with the intent to commit a crime specified in this subsection, surreptitiously
remains in the building or structure after the license or privilege expires or
after the premises no longer are open to the public.
(b)
As used in this section, the words ―building,‖ ―structure,‖ and
―premises‖:
(1)
―Building,‖ ―premises,‖ and ―structure‖ shall, in addition to their
common meanings, include and mean any portion of a building, structure, or
premises which differs from one or more other portions of such building,
structure, or premises with respect to license or privilege to enter, or to being
open to the public.
(2)
―Occupied dwelling‖ means a building used as a residence, either
full-time or part-time, regardless of whether someone is actually present in the
building at the time of entry.
(c)(1)
A person convicted of burglary into an occupied dwelling shall be
imprisoned not more than 25 years or fined not more than $1,000.00, or both.
Otherwise, a person convicted of burglary shall be imprisoned not more than
15 years or fined not more than $1,000.00, or both.
(2)
When imposing a sentence under this section, the Court shall
consider as an aggravating factor whether, during commission of the offense,
the person:
(A)
entered the building when someone was actually present;
(B)
used or threatened to use force against the occupant; or
(C)
carried a dangerous or deadly weapon, openly or concealed,
- 2722 -
during the commission of the offense, and the person has not been convicted of
a violation of section 4005 of this title in connection with the offense.
Sec. 10.
DEPARTMENT OF PUBLIC SAFETY REPORT
The Department of Public Safety, in consultation with the Department of
Health, shall examine 18 V.S.A. § 4234 (depressant, stimulant, narcotic drug)
for the purpose of establishing clear dosage amounts for narcotics as they
relate to unlawful possession, dispensing, and sale.
The Department shall
consider
section
4234
in
relation
to
18
V.S.A.
§ 4233
(heroin).
The
Department
shall
report
its
recommendations
to
the
Senate
and
House
Committees on Judiciary on or before December 15, 2014.
* * * Regulation of Opiates * * *
Sec. 11.
DVHA AUTHORITY; USE OF AVAILABLE SANCTIONS
The Department of Vermont Health Access shall use its authority to
sanction Medicaid-participating prescribers, whether practicing in or outside
the State of Vermont, operating in bad faith or not in compliance with State or
federal requirements.
Sec. 12.
CONTINUED MEDICATION-ASSISTED TREATMENT FOR
INCARCERATED PERSONS
(a)
The
Department
of
Corrections,
in
consultation
with
the
Medication-Assisted Treatment for Inmates Work Group created by 2013 Acts
and Resolves No. 67, Sec. 11, shall develop and implement a one-year
demonstration
project
to
pilot
the
continued
use
of
medication-assisted
treatment within Department facilities for detainees and sentenced inmates.
(b)
The pilot project shall offer continued medication-assisted treatment for
opioid dependence with methadone or buprenorphine and a prescribed taper as
appropriate
to
incarcerated
persons
who
were
participating
in
medication-assisted
treatment
in
the
community
immediately
prior
to
incarceration.
(c)
As
used
in
this
section,
―prescribed
taper‖
means
a
clinically
appropriate
medication
taper
that
is
designed
to
minimize
withdrawal
symptoms and limit avoidable suffering.
(d)
The Commissioner of Corrections shall publish an interim revision
memorandum to replace Directive 363.01 as recommended by the Medication-
Assisted Treatment for Inmates Work Group.
(e)
On or before July 30, 2014, the Department shall enter into memoranda
of understanding with the Department of Health and with hub treatment
providers regarding ongoing medication-assisted treatment for persons in the
- 2723 -
custody of the Department.
(f)
The Department shall collaborate with the Department of Health to
facilitate the provision of opioid overdose prevention training for pilot project
participants who are incarcerated and the distribution of overdose rescue kits
with naloxone at correctional facilities to persons who are transitioning from
incarceration back into the community.
(g)
The Departments of Corrections and of Health shall continue the
Medication-Assisted Treatment for Inmates Work Group created by 2013 Acts
and Resolves No. 67, Sec. 11 to inform and monitor implementation of the
demonstration project.
The Departments shall evaluate the demonstration
project and provision of medication-assisted treatment to persons who are
incarcerated in Vermont and report their findings, including a proposed
schedule
of
expansion,
to
the
House
Committees
on
Corrections
and
Institutions, on Human Services, and on Judiciary, the Senate Committees on
Health and Welfare and on Judiciary, and the Joint Committee on Corrections
Oversight on or before January 1, 2015.
Sec. 13.
VPMS QUERY; RULEMAKING
The Secretary of Human Services shall adopt rules requiring:
(1)
All Medicaid participating providers, whether licensed in or outside
Vermont, who prescribe buprenorphine or a drug containing buprenorphine to
a Vermont Medicaid beneficiary to query the Vermont Prescription Monitoring
System the first time they prescribe buprenorphine or a drug containing
buprenorphine for the patient and at regular intervals thereafter.
Regular
intervals shall exceed the requirements for other Schedule III pharmaceuticals,
and queries shall be done prior to prescribing a replacement prescription.
The
rules shall also include dosage thresholds, which may be exceeded only with
prior approval from the Chief Medical Officer of the Department of Vermont
Health Access or designee.
(2)
All providers licensed in Vermont who prescribe buprenorphine or a
drug containing buprenorphine to a Vermont patient who is not a Medicaid
beneficiary to query the Vermont Prescription Monitoring System the first time
they prescribe buprenorphine or a drug containing buprenorphine for the
patient and at regular intervals thereafter.
Regular intervals shall exceed the
requirements for other Schedule III pharmaceuticals, and queries shall be done
prior to prescribing a replacement prescription.
The rules shall also include
dosage thresholds.
Sec. 14.
MEDICATION-ASSISTED THERAPY; RULEMAKING
The
Commissioner
of
Health
shall
adopt
rules
relating
to
- 2724 -
medication-assisted therapy for opioid dependence for physicians treating
fewer than 30 patients, which shall include a requirement that such physicians
ensure that their patients are screened or assessed to determine their need for
counseling and that patients who are determined to need counseling or other
support services are referred for appropriate counseling from a licensed clinical
professional or for other services as needed.
Sec. 15.
26 V.S.A. chapter 36, subchapter 8 is added to read:
Subchapter 8.
Naloxone Hydrochloride
§ 2080.
NALOXONE
HYDROCHLORIDE;
DISPENSING
OR
FURNISHING
(a)
The Board of Pharmacy shall adopt protocols for licensed pharmacists
to dispense or otherwise furnish naloxone hydrochloride to patients who do not
hold an individual prescription for naloxone hydrochloride.
Such protocols
shall be consistent with rules adopted by the Commissioner of Health.
(b)
Notwithstanding any provision of law to the contrary, a licensed
pharmacist may dispense naloxone hydrochloride to any person as long as the
pharmacist complies with the protocols adopted pursuant to subsection (a) of
this section.
Sec. 16.
33 V.S.A. § 813 is added to read:
§ 813.
MEDICAID PARTICIPATING PROVIDERS
The Department of Vermont Health Access shall grant authorization to a
licensed alcohol and drug abuse counselor to participate as a Medicaid
provider to deliver clinical and case
coordination services to Medicaid
beneficiaries, regardless of whether the counselor is a preferred provider.
Sec. 16a.
DEPARTMENT OF CORRECTIONS AND HEALTH CARE
REFORM
(a)
The Agency of Human Services and its departments shall assist the
Department of Corrections in fully enacting the provisions of the Affordable
Care Act and Vermont’s health care reform initiatives as they pertain to
persons
in
the
criminal
justice
population,
including
access
to
health
information technology, the Blueprint for Health, Medicaid enrollment, the
health benefit exchange, health plans, and other components under the
Department of Vermont Health Access that support and ensure a seamless
process for reentry to the community or readmission to a correctional facility.
(b)
The Department of Corrections shall include substance abuse and
mental health services in its request for proposal (RFP) process for inmate
health services.
Through the RFP, the Department shall require that substance
- 2725 -
abuse and mental health services be provided to persons while incarcerated.
Sec. 17.
18 V.S.A. § 4254 is amended to read:
§ 4254.
IMMUNITY FROM LIABILITY
* * *
(d)
A person who seeks medical assistance for a drug overdose or is the
subject of a good faith request for medical assistance pursuant to subsection (b)
or (c) of this section shall not be subject to any of the penalties for violation of
13 V.S.A. § 1030 (violation of a protection order), for a violation of this
chapter or 7 V.S.A §§ 656 and 657, for being at the scene of the drug overdose,
or for being within close proximity to any person at the scene of the drug
overdose.
(e)
A person who seeks medical assistance for a drug overdose or is the
subject of a good faith request for medical assistance pursuant to subsection (b)
or (c) of this section shall not be subject to any sanction for a violation of a
condition of pretrial release, probation, furlough, or parole for a violation of
this chapter or 7 V.S.A §§ 656 and 657, for being at the scene of the drug
overdose, or for being within close proximity to any person at the scene of the
drug overdose.
* * *
(g)
The immunity provisions of this section apply only to the use and
derivative use of evidence gained as a proximate result of the person’s seeking
medical assistance for a drug overdose, being the subject of a good faith
request for medical assistance, being at the scene, or being within close
proximity to any person at the scene of the drug overdose for which medical
assistance was sought and do not preclude prosecution of the person on the
basis of evidence obtained from an independent source.
Sec. 18.
EFFECTIVE DATES
(a)
Secs. 2, 6, and 7 shall take effect on January 1, 2015.
(b)
This section and Secs. 1 (legislative intent), 3 (risk assessment and
needs screening tools), 4 (prosecutor precharge programs and reporting),
10 (Department of Public Safety report), 13 (VPMS query; rulemaking),
14 (medication assisted therapy, rulemaking), and 17 (immunity from liability)
shall take effect on passage.
(c)
The remaining sections shall take effect on July 1, 2014.
( Committee Vote: 9-0-2)
- 2726 -
Rep. O'Brien of Richmond,
for the Committee on
Appropriations,
recommends the bill ought to pass when amended as recommended by the
Committees on
Human Services and Judiciary
and when further amended as
follows:
First:
In Sec. 1, by striking out subsection (i) in its entirety
Second:
By striking out Secs. 6, 7, and 16 in their entirety
Third:
In Sec. 18 (effective dates), in subsection (a), by striking out
―Secs. 2, 6, and 7‖ and inserting in lieu thereof Sec. 2
( Committee Vote: 10-1-0)
Senate Proposal of Amendment
H. 890
An act relating to approval of amendments to the charter of the City of
Burlington regarding the redistricting of City election areas
The Senate proposes to the House to amend the bill as follows:
The Senate proposes to the House to amend the bill in Sec. 2, 24 App.
V.S.A. chapter 3, in § 2 (election boundaries), in subsection (a) (City districts
described), in subdivision (2) (Central District), in the geographic description
of the district, after ―Central Vermont Railway bridge downstream of the
Lower Winooski Falls and Salmon Hole; thence southerly along the East
District‖, by striking out in its entirety ―eastern boundary‖ and inserting in lieu
thereof western boundary to its intersection with the centerline of Main Street;
continuing southerly along the centerline of South Winooski Avenue.
(No House Amendments )
NEW BUSINESS
Third Reading
H. 883
An act relating to expanded prekindergarten–grade 12 school districts
Amendment to be offered by Rep. Buxton of Tunbridge to H. 883
* * * Prekindergarten Education * * *
Sec. 13.
16 V.S.A. § 829 is amended to read:
§ 829.
PREKINDERGARTEN EDUCATION; RULES
(a)
Definitions.
As used in this section:
(1)
―Prekindergarten
child‖
means
a
child
who,
as
of
the
date
- 2727 -
established by the district of residence for kindergarten eligibility, is three or
four years of age or is five years of age but is not yet enrolled in kindergarten.
(2)
―Prekindergarten education‖ means services designed to provide to
prekindergarten children developmentally appropriate early development and
learning experiences based on Vermont’s early learning standards.
(3)
―Prequalified
private
provider‖
means
a
private
provider
of
prekindergarten education that is qualified pursuant to subsection (c) of this
section.
(b)
Access to publicly funded prekindergarten education.
(1)
No
fewer
than
ten
hours
per
week
of
publicly
funded
prekindergarten education shall be available for 35 weeks annually to each
prekindergarten child whom a parent or guardian wishes to enroll in an
available, prequalified program operated by a public school or a private
provider.
(2)
If a parent or guardian chooses to enroll a prekindergarten child in an
available, prequalified program, then, pursuant to the parent or guardian’s
choice, the school district of residence shall:
(A)
pay tuition pursuant to subsections (d) and (h) of this section
upon the request of the parent or guardian to:
(i)
a prequalified private provider; or
(ii)
a public school located outside the district that operates a
prekindergarten program that has been prequalified pursuant to subsection (c)
of this section; or
(B)
enroll the child in the prekindergarten education program that it
operates.
(3)
If requested by the parent or guardian of a prekindergarten child, the
school district of residence shall pay tuition to a prequalified program operated
by a private provider or a public school in another district even if the district of
residence operates a prekindergarten education program.
(4)
If the supply of prequalified private and public providers is
insufficient to meet the demand for publicly funded prekindergarten education
in any region of the State, nothing in this section shall be construed to require a
district to begin or expand a program to satisfy that demand; but rather, in
collaboration with the Agencies of Education and of Human Services, the local
Building Bright Futures Council shall meet with school districts and private
providers in the region to develop a regional plan to expand capacity.
(c)
Prequalification.
Pursuant to rules jointly developed and overseen by
- 2728 -
the Secretaries of Education and of Human Services and adopted by the State
Board pursuant to 3 V.S.A. chapter 25, the Agencies jointly may determine
that a private or public provider of prekindergarten education is qualified for
purposes of this section and include the provider in a publicly accessible
database of prequalified providers.
At a minimum, the rules shall define the
process by which a provider applies for and maintains prequalification status,
shall identify the minimum quality standards for prequalification, and shall
include the following requirements:
(1)
A program of prekindergarten education, whether provided by a
school district or a private provider, shall have received:
(A)
National Association for the Education of Young Children
(NAEYC) accreditation; or
(B)
at least four stars in the Department for Children and Families
STARS system with at least two points in each of the five arenas; or
(C)
three stars in the STARS system if the provider has developed a
plan, approved by the Commissioner for Children and Families and the
Secretary of Education, to achieve four or more stars in no more than two years
with at least two points in each of the five arenas, and the provider has met
intermediate milestones.
(2)
A licensed provider shall employ or contract for the services of at
least one teacher who is licensed and endorsed in early childhood education or
in early childhood special education under chapter 51 of this title.
(3)
A registered home provider that is not licensed and endorsed in early
childhood education or early childhood special education shall receive regular,
active supervision and training from a teacher who is licensed and endorsed in
early childhood education or in early childhood special education under
chapter 51 of this title.
(d)
Tuition, budgets, and average daily membership.
(1)
On behalf of a resident prekindergarten child, a district shall pay
tuition for prekindergarten education for ten hours per week for 35 weeks
annually to a prequalified private provider or to a public school outside the
district that is prequalified pursuant to subsection (c) of this section; provided,
however, that the district shall pay tuition for weeks that are within the
district’s academic year.
Tuition paid under this section shall be at a statewide
rate, which may be adjusted regionally, that is established annually through a
process jointly developed and implemented by the Agencies of Education and
of Human Services.
A district shall pay tuition upon:
(A)
receiving notice from the child’s parent or guardian that the child
- 2729 -
is or will be admitted to the prekindergarten education program operated by the
prequalified private provider or the other district; and
(B)
concurrent enrollment of the prekindergarten child in the district
of
residence
for
purposes
of
budgeting
and
determining average
daily
membership.
(2)
In addition to any direct costs of operating a prekindergarten
education program, a district of residence shall include anticipated tuition
payments and any administrative, quality assurance, quality improvement,
transition planning, or other prekindergarten-related costs in its annual budget
presented to the voters.
(3)
Pursuant to subdivision 4001(1)(C) of this title, the district of
residence
may
include
within
its
average
daily
membership
any
prekindergarten child for whom it has provided prekindergarten education or
on whose behalf it has paid tuition pursuant to this section.
(4)
A prequalified private provider may receive additional payment
directly from the parent or guardian only for prekindergarten education in
excess of the hours paid for by the district pursuant to this section or for child
care services, or both.
The provider is not bound by the statewide rate
established in this subsection when determining the rates it will charge the
parent or guardian.
(e)
Rules.
The commissioner of education and the commissioner for
children and families Secretary of Education and the Commissioner for
Children and Families shall jointly develop and agree to rules and present them
to the state board of education State Board for adoption under 3 V.S.A.
chapter 25 as follows:
(1)
To ensure that, before a school district begins or expands a
prekindergarten education program that intends to enroll students who are
included in its average daily membership, the district engage the community in
a collaborative process that includes an assessment of the need for the program
in the community and an inventory of the existing service providers; provided,
however, if a district needs to expand a prekindergarten education program in
order to satisfy federal law relating to the ratio of special needs children to
children without special needs and if the law cannot be satisfied by any one or
more qualified service providers with which the district may already contract,
then the district may expand an existing school-based program without
engaging in a community needs assessment.
To permit private providers that
are not prequalified pursuant to subsection (c) of this section to create new or
continue existing partnerships with school districts through which the school
district provides supports that enable the provider to fulfill the requirements of
- 2730 -
subdivision (c)(2) or (3), and through which the district may or may not make
in-kind payments as a component of the statewide tuition established under this
section.
(2)
To
ensure
that,
if
a
school
district
begins
or
expands
a
prekindergarten education program that intends to include any of the students
in its average daily membership, the district shall use existing qualified service
providers to the extent that existing qualified service providers have the
capacity to meet the district’s needs effectively and efficiently.
To authorize a
district to begin or expand a school-based prekindergarten education program
only upon prior approval obtained through a process jointly overseen by the
Secretaries of Education and of Human Services, which shall be based upon
analysis of the number of prekindergarten children residing in the district and
the availability of enrollment opportunities with prequalified private providers
in the region.
Where the data are not clear or there are other complex
considerations, the Secretaries may choose to conduct a community needs
assessment.
(3)
To require that the school district provides opportunities for effective
parental participation in the prekindergarten education program.
(4)
To establish a process by which:
(A)
a parent or guardian residing in the district or a provider, or both,
may request a school district to enter into a contract with a provider located in
or outside the district notifies the district that the prekindergarten child is or
will be admitted to a prekindergarten education program not operated by the
district and concurrently enrolls the child in the district pursuant to subdivision
(d)(1) of this section;
(B)
a district:
(i)
pays tuition pursuant to a schedule that does not inhibit the
ability
of a
parent
or
guardian
to
enroll
a
prekindergarten
child
in
a
prekindergarten education program or the ability of a prequalified private
provider to maintain financial stability; and
(ii)
enters into an agreement with any provider to which it will pay
tuition regarding quality assurance, transition, and any other matters; and
(C)
a provider that has received tuition payments under this section
on behalf of a prekindergarten child notifies a district that the child is no longer
enrolled.
(5)
To identify the services and other items for which state funds may be
expended when prekindergarten children are counted for purposes of average
daily
membership,
such
as
tuition
reduction,
quality
improvements,
or
- 2731 -
professional development for school staff or private providers.
To establish a
process to calculate an annual statewide tuition rate that is based upon the
actual cost of delivering ten hours per week of prekindergarten education that
meets all established quality standards and to allow for regional adjustments to
the rate.
(6)
To ensure transparency and accountability by requiring private
providers
under
contract
with
a
school
districts to
report
costs
for
prekindergarten programs to the school district and by requiring school
districts to report these costs to the commissioner of education.
[Repealed.]
(7)
To require school districts a district to include identifiable costs for
prekindergarten programs and essential early education services in their its
annual budgets and reports to the community.
(8)
To require school districts a district to report to the departments their
Agency of Education annual expenditures made in support of prekindergarten
care and education, with distinct figures provided for expenditures made from
the general fund General Fund, from the education fund Education Fund, and
from all other sources, which shall be specified.
(9)
To provide an appeal administrative process for:
(A)
a parent, guardian, or provider to challenge an action of the a
school district or the State when the appellant complainant believes that the
district or
State is
in
violation
of
state
statute
or
rules
regarding
prekindergarten education; and
(B)
a school district to challenge an action of a provider or the State
when the district believes that the provider or the State is in violation of state
statute or rules regarding prekindergarten education.
(10)
To establish the minimum quality standards necessary for a district
to include prekindergarten children within its average daily membership.
At a
minimum, the standards shall include the following requirements:
(A)
The prekindergarten education program, whether offered by or
through the district, shall have received:
(i)
National Association for the Education of Young Children
(NAEYC) accreditation; or
(ii)
At least four stars in the department for children and families
STARS system with at least two points in each of the five arenas; or
(iii)
Three stars in the STARS system if the provider has
developed a plan, approved by the commissioner for children and families and
the commissioner of education, to achieve four or more stars within three years
- 2732 -
with at least two points in each of the five arenas, and the provider has met
intermediate milestones; and
(B)
A licensed center shall employ or contract for the services of at
least one teacher who is licensed and endorsed in early childhood education or
in early childhood special education under chapter 51 of this title; and
(C)
A registered home shall receive regular, active supervision and
training from a teacher who is licensed and endorsed in early childhood
education or in early childhood special education under chapter 51 of this title.
To establish a system by which the Agency of Education and Department for
Children
and
Families
shall
jointly
monitor
prekindergarten
education
programs to promote optimal outcomes for children and to collect data that
will inform future decisions.
The Agency and Department shall be required to
report annually to the General Assembly in January.
At a minimum, the
system shall monitor and assess:
(A)
programmatic details, including the number of children served,
the number of private and public programs operated, and the public financial
investment made to ensure access to quality prekindergarten education;
(B)
the quality of public and private prekindergarten education
programs and efforts to ensure continuous quality improvements through
mentoring, training, technical assistance, and otherwise; and
(C)
the outcomes for children, including school readiness and
proficiency in numeracy and literacy.
(11)
To establish a process for documenting the progress of children
enrolled in prekindergarten education programs and to require public and
private providers to use the process to:
(A)
help individualize instruction and improve program practice; and
(B)
collect and report child progress data to the commissioner of
education Secretary of Education on an annual basis.
(f)
Other provisions of law.
Section 836 of this title shall not apply to this
section.
(g)
Limitations.
Nothing in this section shall be construed to permit or
require payment of public funds to a private provider of prekindergarten
education in violation of Chapter I, Article 3 of the Vermont Constitution or in
violation of the Establishment Clause of the U.S. Constitution.
(h)
Geographic limitations.
(1)
Notwithstanding the requirement that a district pay tuition to any
prequalified public or private provider in the State, a school board may choose
- 2733 -
to limit the geographic boundaries within which the district shall pay tuition by
paying tuition solely to those prequalified providers in which parents and
guardians choose to enroll resident prekindergarten children that are located
within the district’s ―prekindergarten region‖ as determined in subdivision (2)
of this subsection.
(2)
For purposes of this subsection, upon application from the school
board, a district’s prekindergarten region shall be determined jointly by the
Agencies of Education and of Human Services in consultation with the school
board, private providers of prekindergarten education, parents and guardians of
prekindergarten children, and other interested parties pursuant to a process
adopted by rule under subsection (e) of this section.
A prekindergarten region:
(A)
shall not be smaller than the geographic boundaries of the school
district;
(B)
shall
be
based
in
part
upon
the
estimated
number
of
prekindergarten children residing in the district and in surrounding districts, the
availability of prequalified private and public providers of prekindergarten
education, commuting patterns, and other region-specific criteria; and
(C)
shall be designed to support existing partnerships between the
school district and private providers of prekindergarten education.
(3)
If a school board chooses to pay tuition to providers solely within its
prekindergarten region, and if a resident prekindergarten child is unable to
access publicly funded prekindergarten education within that region, then the
child’s parent or guardian may request and in its discretion the district may pay
tuition at the statewide rate for a prekindergarten education program operated
by a prequalified provider located outside the prekindergarten region.
(4)
Except for the narrow exception permitting a school board to limit
geographic boundaries under subdivision (1) of this subsection, all other
provisions of this section and related rules shall continue to apply.
Sec.
14.
PREKINDERGARTEN
EDUCATION;
CALCULATION
OF
EQUALIZED
PUPILS;
EXCLUSION
FROM
EDUCATION
SPENDING
If a school district did not provide or pay for prekindergarten education
pursuant to 16 V.S.A. § 829 in fiscal year 2015, then:
(1)
for purposes of determining the equalized pupil count for the fiscal
year 2016 budget, the long-term membership of prekindergarten children shall
be the number of prekindergarten children for whom the district anticipates it
will provide prekindergarten education or pay tuition, or both, in fiscal year
2016; and
- 2734 -
(2)
for purposes of determining the equalized pupil count for the fiscal
year 2017 budget, the long-term membership of prekindergarten children shall
be the total number of prekindergarten children for whom the district provided
prekindergarten education or paid tuition, or both, in fiscal year 2016, adjusted
to reflect the difference between the estimated and actual count for that fiscal
year.
Sec. 15.
QUALITY STANDARDS
(a)
The Agencies of Education and of Human Services shall review
existing quality standards for prekindergarten education programs and may
initiate rulemaking under 3 V.S.A. chapter 25 to require higher standards of
quality; provided, however, that no new standards shall take effect earlier than
July 1, 2015.
Changes to the quality standards shall be designed to ensure that
programs are based on intentional, evidence-based practices that create a
developmentally appropriate environment and support the delivery of an
engaging program that supports the social, emotional, intellectual, language,
literacy, and physical development of prekindergarten children.
(b)
In January of the 2015, 2016, and 2017 legislative sessions, the
Agencies shall report to the House and Senate Committees on Education and
on Appropriations, the House Committee on Human Services, and the Senate
Committee on Health and Welfare regarding the quality of prekindergarten
education in the State.
Sec. 16.
REPORT ON ENROLLMENT AND ACCESS
The Agencies of Education and of Human Services and the Building Bright
Futures Council shall monitor and evaluate access to and enrollment in
prekindergarten education programs under Sec. 13 of this act.
On or before
January 1, 2018, they shall report to the House and Senate Committees on
Education and on Appropriations, the House Committee on Ways on Means,
and the Senate Committee on Finance regarding their evaluation, conclusions,
and any recommendations for amendments to statute or related rule.
Sec. 17.
PREKINDERGARTEN REGIONS; PROCESS AND CRITERIA
The Agencies of Education and of Human Services, in consultation with the
Vermont
Superintendents
Association,
the
Vermont
School
Boards
Association, the Vermont Principals’ Association, the Vermont-NEA, and the
Building Bright Futures Council created in 33 V.S.A. chapter 46, shall develop
a detailed proposal outlining the process and criteria by which the Agencies
will determine the prekindergarten region of a school district if requested to do
so pursuant to Sec. 1, 16 V.S.A. § 829(h)(2), of this act.
The Agencies shall
present the proposal to the House and Senate Committees on Education on or
before
January
15,
2015.
The
Agencies
shall
also
present
any
- 2735 -
recommendations
for
amendments
to
statute,
including
repeal
of
or
amendments to subsection (h).
Sec. 18.
CONSTITUTIONALITY
On or before July 1, 2014, the Secretary of Education shall identify the
private prekindergarten education programs to which school districts are
paying tuition on behalf of resident prekindergarten children, determine the
extent to which any program provides religious prekindergarten education, and
establish the steps the Agency will take to ensure that public funds are not
expended in violation of Chapter I, Article 3 of the Vermont Constitution and
the Vermont Supreme Court’s decision in Chittenden Town School District v.
Vermont Department of Education, 169 Vt. 310 (1999) or in violation of the
Establishment Clause of the U.S. Constitution.
Sec. 19.
IMPLEMENTATION
Sec. 13 shall apply to enrollments on July 1, 2015 and after.
and by renumbering the remaining section to be numerically correct.
Amendment to be offered by Rep. Donovan of Burlington to H. 883
By adding a new Section to be Sec. 13 and a related reader assistance
heading to read:
* * * Analysis * * *
Sec. 13.
REGIONAL EDUCATION DISTRICTS; ANALYSIS; REPORT
(a)
The State Board of Education, in consultation with the Agency of
Education, the Vermont School Boards Association, and school districts, shall
identify at least three groups of school districts (Test Sites) in different regions
of the State for an analysis of potential regional education district (RED)
formation pursuant to 2010 Acts and Resolves No. 153, as amended by 2012
Acts and Resolves No. 156.
Both the school districts consulted and those
analyzed shall be diversely representative of geography, size, socioeconomics,
and other factors, including extreme complexity.
(b)
The State Board shall comprehensively analyze the educational and
financial benefits and detriments of consolidation in each of the three Test
Sites, including a review of curriculum, course offerings, special programs,
budgets,
class
sizes
and
student-to-adult
ratios,
collective
bargaining
agreements, district educational policies, relationships between schools and the
community, and other important factors identified during the process.
When
analyzing financial costs, and for the purposes of modeling only, the State
Board shall assume that employees within a RED bargaining unit shall receive
compensation pursuant to the highest-paying fiscal year 2015 compensation
- 2736 -
schedule of the original districts.
The State Board shall develop a possible
administrative structure and budget for the RED, as well as an estimate of a
unified education property tax rate for each of the Test Sites using data from
fiscal year 2015 district budgets.
The State Board shall also explore alternative
governance structures for the REDs and shall consider constitutionally sound
alternatives, such as weighted and nonweighted voting board members.
(c)
When it has finished its analysis, but before it has issued a final report,
the State Board shall meet with the communities analyzed under this section to
present and discuss the results of its work.
(d)
The State Board shall provide a final report of its analysis to the House
and Senate Committees on Education, the House Committee on Ways and
Means, and the Senate Committee on Finance on or before January 15, 2015.
The final report shall serve to inform future legislation related to the
consolidation of existing school districts into larger prekindergarten–grade 12
REDs.
and by renumbering the remaining section to be numerically correct.
Amendment to be offered by Reps. Cross of Winooski, Johnson of
Canaan,
Manwaring
of
Wilmington,
Martin
of
Wolcott,
Toleno
of
Brattleboro, and Woodward of Johnson to H. 883
By striking all after the enacting clause and inserting in lieu thereof the
following:
Sec. 1.
REGIONAL EDUCATION DISTRICTS; SIMULATION; REPORT
(a)
The State Board of Education, in consultation with the Agency of
Education, the Vermont School Boards Association, and school districts, shall
identify at least three groups of school districts (Test Sites) in different regions
of the State for a simulated analysis of regional education district (RED)
formation pursuant to 2010 Acts and Resolves No. 153, as amended by 2012
Acts and Resolves No. 156.
Both the school districts consulted and those
analyzed shall be diversely representative of geography, size, socioeconomics,
and other factors.
(b)
The simulation shall comprehensively analyze the educational and
financial benefits and detriments of consolidation in each of the three Test
Sites, including a review of curriculum, course offerings, special programs,
budgets,
class
sizes
and
student-to-adult
ratios,
collective
bargaining
agreements, district educational policies, relationships between schools and the
community, and other important factors identified during the process.
When
analyzing financial costs, the simulation shall assume that employees within a
RED bargaining unit shall receive compensation pursuant to the highest-paying
- 2737 -
fiscal
year 2015
compensation
schedule
of
the
original
districts.
The
simulation shall develop a possible administrative structure and budget for the
RED, as well as an estimate of a unified education property tax rate for each of
the Test Sites using data from fiscal year 2015 district budgets.
The simulation
shall also explore alternative governance structures for the REDs and shall
consider constitutionally sound alternatives, such as weighted and nonweighted
voting board members.
(c)
When it has finished its analysis, but before it has issued a final report,
the State Board shall meet with the communities analyzed under this section to
present and discuss the results of its work.
(d)
The State Board shall provide an interim report regarding the work
required by this section to the House and Senate Committees on Education, the
House Committee on Ways and Means, and the Senate Committee on Finance
on or before January 15, 2015.
(e)
The State Board shall provide a final report of its analysis to the
committees identified in subsection (d) of this section on or before November
15, 2015.
The final report shall provide the comprehensive data needed to
inform future legislation related to the consolidation of existing school districts
into larger prekindergarten–grade 12 REDs.
Sec. 2
POSITION; AGENCY OF EDUCATION
The General Assembly authorizes the establishment of one new limited
service position in the Agency of Education in fiscal year 2015 to coordinate
the activities and prepare the report required in Sec. 1 of this act on behalf of
the State Board of Education.
Sec. 3.
APPROPRIATION
The sum of $85,250.00 is appropriated from the Supplemental Property Tax
Relief Fund created by 32 V.S.A. § 6075 to the Agency of Education in fiscal
year 2015 to hire the limited services employee authorized in Sec. 2 of this act.
Sec. 4.
EFFECTIVE DATE
This act shall take effect on passage.
and that after passage the title of the bill be amended to read:
―An act relating
to requiring a simulation of regional education district formation‖.
J.R.H. 23
Joint resolution relating to the cleanup of Lake Champlain
S. 208
An act relating to solid waste management
- 2738 -
S. 220
An act relating to furthering economic development
Amendment to be offered by Rep. Pugh of South Burlington to S. 220
That the House Proposal of Amendment be amended in Sec. 34, in 16
V.S.A.
§ 2888(b)(1)(A),
following
―the
Vermont
Student
Assistance
Corporation,‖ by adding the Secretary of Human Services,
Amendment to be offered by Rep. Johnson of Canaan to S. 220
That the House Proposal of Amendment be amended by adding four new
sections to be Secs. 20g–20j to read:
Sec. 20g.
23 V.S.A. § 4(82) is amended to read:
(82)
―Portable electronic device‖ means
a portable electronic or
computing device, including a cellular telephone, personal digital assistant
(PDA), or laptop computer.
―Portable electronic device‖ does not include a
two-way or Citizens Band radio, or equipment used by a licensed Amateur
Radio operator in accordance with 47 C.F.R. part 97.
Sec. 20h.
23 V.S.A. § 1095b is amended to read:
§ 1095b.
HANDHELD USE OF PORTABLE ELECTRONIC DEVICE IN
WORK ZONE PROHIBITED
(a)
Definition.
As used in this section, ―hands-free use‖ means the use of a
portable electronic device without use of either hand and outside the immediate
proximity of the user’s ear, by employing an internal feature of, or an
attachment to, the device.
(b)
Use of handheld portable electronic device in work zone prohibited.
A person shall not use a portable electronic device while operating a moving
motor vehicle within on a highway work zone in this State.
The prohibition of
this subsection shall not apply unless the work zone is properly designated
with warning devices in accordance with subdivision 4(5) of this title, and shall
not apply:
(1)
to hands-free use; or
(2)
to activation or deactivation of hands-free use as long as the device
is in a cradle or otherwise securely mounted in the vehicle;
(2)(3)
when use of a portable electronic device is necessary for a person
to communicate with law enforcement or emergency service personnel under
emergency circumstances;
(4)
to communications of law enforcement or emergency service
- 2739 -
personnel in the performance of their official duties;
(5)
to use of an ignition interlock device, as defined in section 1200 of
this title; or
(6)
to use of a portable electronic device by an operator of a registered
farm truck or a farm truck or farm tractor not required to be registered, if:
(A)
the farm truck or farm tractor is being used in connection with
the operation of a farm; and
(B)
the device is used to receive a communication relating to the
dispatch of the farm truck or farm tractor to a work location.
(c)
Penalty.
A person who violates this section commits a traffic violation
and shall be subject to a penalty of not less than $100.00 and not more than
$200.00 upon adjudication of for a first violation, and of not less than $250.00
and not more than $500.00 upon adjudication of for a second or subsequent
violation within any two-year period.
(d)(1)
Operators of commercial motor vehicles shall be governed by the
provisions of chapter 39 of this title (Commercial Driver License Act) instead
of the provisions of this chapter with respect to the handheld use of mobile
telephones and texting while operating a commercial motor vehicle.
(2)
A person shall not be issued more than one complaint for any
violation of this section, section 1095a of this title (junior operator use of
portable electronic devices), or section 1099 of this title (texting prohibited)
that arises from the same conduct.
Sec. 20i.
23 V.S.A. § 2502 is amended to read:
§ 2502.
POINT ASSESSMENT; SCHEDULE
(a)
Any person operating a motor vehicle shall have points assessed against
his or her driving record for convictions for moving violations of the indicated
motor vehicle statutes in accord with the following schedule:
(All references
are to Title 23 of the Vermont Statutes Annotated.)
(1)
Two points assessed for:
* * *
(LL)(i)
§ 1095.
Entertainment picture visible to operator;
(ii)
§ 1095b.
Use of portable electronic device in work
zone— first offense;
* * *
- 2740 -
(4)
Five points assessed for:
* * *
(D)
§ 1095b.
Use of portable electronic device in work
zone— second and subsequent offenses;
* * *
Sec. 20j.
23 V.S.A. § 1095a is amended to read:
§ 1095a.
JUNIOR OPERATOR USE OF PORTABLE ELECTRONIC
DEVICES
A person under 18 years of age shall not use any portable electronic device
as defined in subdivision 4(82) of this title while operating a moving motor
vehicle on a highway.
This prohibition shall not apply if it is necessary to
place an emergency 911 call:
(1)
when use of a portable electronic device is necessary for a person to
communicate with law enforcement or emergency service personnel under
emergency circumstances; or
(2)
to communications of law enforcement or emergency service
personnel in the performance of their official duties.
S. 239
An act relating to the regulation of toxic substances
Amendment to be offered by Reps. Komline of Dorset and Wright of
Burlington to S. 239
By striking out Sec. 4, effective date, in its entirety and inserting in lieu
thereof two new sections to be Secs. 4–5 to read as follows:
Sec. 4.
7 V.S.A. § 1012 is added to read:
§ 1012.
LIQUID NICOTINE; PACKAGING
(a)
Unless
specifically
preempted
by
federal
law,
no
person
shall
manufacture, regardless of location, for sale in; offer for sale in; sell in or into
the stream of commerce in; or otherwise introduce into the stream of
commerce in Vermont any liquid or gel substance containing nicotine unless
that product is contained in child-resistant packaging.
(b) As used in this section, ―child-resistant packaging‖ means packaging
that is designed or constructed to be significantly difficult for children under
five years of age to open or obtain a toxic or harmful amount of the substance
contained therein within a reasonable time and not difficult for normal adults
- 2741 -
to use properly, but does not mean packaging which all such children cannot
open or obtain a toxic or harmful amount within a reasonable time.
Sec. 5.
EFFECTIVE DATES
(a)
Secs. 1–3 and this section shall take effect on passage.
(b)
Sec. 4 (liquid nicotine; packaging) shall take effect on January 1, 2015.
Amendment to be offered by Rep. Deen of Westminster to S. 239
That the House Proposal of Amendment be amended in Sec. 2, in 18 V.S.A.
§ 1775, by striking out subdivision (b)(3) in its entirety and inserting in lieu
thereof the following to read:
(3)
the amount of the chemical contained in each unit of the product or
product component, reported by weight or parts per million as authorized by
the Commissioner;
and in subdivision (d)(2), after ―the Interstate Chemicals Clearinghouse,‖ and
before ―or other independent third party‖ by inserting a federal governmental
agency
Amendment to be offered by Rep. Marcotte of Coventry to S. 239
First:
In Sec. 2, in 18 V.S.A. § 1775, by striking out subsection (a) in its
entirety and inserting in lieu thereof the following:
(a)
Notice requirement.
Beginning July 1, 2015, and biennially thereafter,
a manufacturer of a children’s product or a trade association representing a
manufacturer of a children’s product shall, according to the requirements for
phased-in reporting adopted under subsection 1776(f) of this title, submit to the
Department the notice described in subsection (b) of this section if a chemical
of high concern to children is:
(1)
intentionally added to a children’s product at a level above the PQL
produced by the manufacturer; or
(2)
present in a children’s product produced by the manufacturer as a
contaminant at a concentration of 100 parts per million or greater.
Second:
In Sec. 2, in 18 V.S.A. § 1776, by adding a new subsection (f) to
read as follows:
(f)
Phased-in reporting.
On or before January 1, 2015, the Commissioner
shall adopt by rule phased-in reporting requirements for chemicals of high
concern
to
children
in
children’s
products
based
on
the
size
of
the
manufacturer, aggregate sales of children’s products, the exposure profile of
the chemical of high concern to children in the children’s product, or other
criteria determined to be appropriate.
- 2742 -
and by releterring the remaining subsections to be alphabetically correct.
and in subsection (g), as relettered, by striking subdivision (3) in its entirety.
S. 241
An act relating to binding arbitration for State employees
S. 291
An act relating to the establishment of transition units at State correctional
facilities
S. 293
An act relating to reporting on population-level outcomes and indicators and
on program-level performance measures
Amendment to be offered by Reps. Donahue of Northfield, French of
Randolph, Haas of Rochester, and Pugh of South Burlington to S. 293
That the House Proposal of Amendment be amended in Sec. 3 (initial
population-level indicators), in subdivision (7) (Vermont’s elders and people
with disabilities and people with mental conditions live with dignity and
independence in settings they prefer), by striking out subdivisions (A) and (B)
and inserting in lieu thereof the following:
(A)
rate of confirmed reports of abuse and neglect of vulnerable
adults per 1,000 vulnerable adults;
(B)
percent of elders living in institutions versus receiving home
care; and
(C)
number of people with disabilities and people with mental
conditions receiving State services living in each of the following:
institutions,
residential or group facilities, or independently.
Favorable with Amendment
S. 184
An act relating to eyewitness identification policy
Rep. Grad of Moretown,
for the Committee on
Judiciary,
recommends
that the House propose to the Senate that the bill be amended by striking all
after the enacting clause and inserting in lieu thereof the following:
Sec. 1.
13 V.S.A. chapter 182, subchapter 3 is added to read:
Subchapter 3.
Law Enforcement Practices
§ 5581.
EYEWITNESS IDENTIFICATION POLICY
- 2743 -
(a)
On or before January 1, 2015, every State, county, and municipal law
enforcement agency and every constable who exercises law enforcement
authority pursuant to 24 V.S.A. § 1936a and who is trained in compliance with
20 V.S.A. § 2358 shall adopt an eyewitness identification policy.
(b)
The written policy shall contain, at a minimum, the following essential
elements as identified by the Law Enforcement Advisory Board:
(1) Protocols guiding the use of a show-up identification procedure.
(2) The photo or live lineup shall be conducted by a blind administrator
who does not know the suspect’s identity.
For law enforcement agencies with
limited
staff,
this
can
be
accomplished
through
a
procedure
in
which
photographs are placed in folders, randomly numbered and shuffled, and then
presented to an eyewitness such that the administrator cannot see or track
which photograph is being presented to the witness until after the procedure is
completed.
(3) Instructions to the eyewitness, including that the perpetrator may or
may not be among the persons in the identification procedure.
(4) In
a
photo
or live
lineup,
fillers
shall
possess
the
following
characteristics:
(A)
All fillers selected shall resemble the eyewitness’s description of
the perpetrator in significant features such as face, weight, build, or skin tone,
including any unique or unusual features such as a scar or tattoo.
(B)
At least five fillers shall be included in a photo lineup, in addition
to the suspect.
(C)
At least four fillers shall be included in a live lineup, in addition
to the suspect.
(5) If the eyewitness makes an identification, the administrator shall
seek and document a clear statement from the eyewitness, at the time of the
identification and in the eyewitness’s own words, as to the eyewitness’s
confidence level that the person identified in a given identification procedure is
the perpetrator.
(c)
The model policy issued by the Law Enforcement Advisory Board shall
encourage ongoing law enforcement training in eyewitness identification
procedures for State, county, and municipal law enforcement agencies and
constables who exercise law enforcement authority pursuant to 24 V.S.A.
§ 1936a and are trained in compliance with 20 V.S.A. § 2358.
(d)
If a law enforcement agency does not adopt a policy by January 1, 2015
in
accordance
with
this
section,
the
model
policy
issued
by
the
Law
- 2744 -
Enforcement Advisory Board shall become the policy of that law enforcement
agency or constable.
Sec. 2.
REPORTING EYEWITNESS IDENTIFICATION POLICIES
The Vermont Criminal Justice Training Council shall report to the General
Assembly
on
or
before
April
15,
2015
regarding
law
enforcement’s
compliance with Sec. 1 of this act.
Sec. 3.
20 V.S.A. § 2366 is amended to read:
§ 2366.
LAW ENFORCEMENT AGENCIES; BIAS-FREE POLICING
POLICY; RACE DATA COLLECTION
(a)
No later than January 1, 2013 On or before September 1, 2014, every
State, local, county, and municipal law enforcement agency that employs one
or more certified law enforcement officers, and every law enforcement officer
who exercises law enforcement authority pursuant to 24 V.S.A. § 1936a and
who is trained in compliance with section 2358 of this title, shall adopt a
bias-free policing policy.
The policy shall contain the following essential
substantially the same elements of such a policy as determined by the Law
Enforcement Advisory Board after its review of either the current Vermont
State Police Policy and bias-free policing policy or the most current model
policy issued by the Office of the Attorney General.
(b)
The policy shall encourage ongoing bias-free law enforcement training
for State, local, county, and municipal law enforcement agencies If a law
enforcement agency or officer that is required to adopt a policy pursuant to
subsection (a) of this section fails to do so on or before September 1, 2014, that
agency or officer shall be deemed to have adopted, and shall follow and
enforce, the model policy issued by the Office of the Attorney General.
(c)
On or before September 7, 2014, and annually thereafter as part of their
annual training report to the Council, every State, local, county, and municipal
law enforcement agency, and every law enforcement officer who exercises law
enforcement authority pursuant to 24 V.S.A. § 1936a and who is trained in
compliance with section 2358 of this title, shall report to the Council whether
the agency or officer has adopted a bias-free policing policy in accordance
with subsections (a) and (b) of this section and which policy has been adopted.
The Criminal Justice Training Council shall determine, as part of the Council’s
annual certification of training requirements, if current officers have received
training on bias-free policing.
(d)
On or before October 15, 2014, and annually thereafter on April 1, the
Criminal Justice Training Council shall report to the House and Senate
Committees on Judiciary which departments and officers have adopted a
- 2745 -
bias-free policing policy, which policy has been adopted, and whether officers
have received training on bias-free policing.
(e)
On or before September 1, 2014, every State, local, county, and
municipal law enforcement agencies that employ one or more certified law
enforcement officers are encouraged to work with the Vermont Association of
Chiefs of Police to extend the collection of roadside-stop race data uniformly
throughout state law enforcement agencies, with the goal of obtaining uniform
roadside-stop race data for analysis agency shall collect roadside stop data,
including the age, gender, race, and ethnicity of drivers.
Law enforcement
agencies shall work with the Vermont Criminal Justice Training Council with
the goals of collecting uniform data, adopting uniform storage methods and
periods, and ensuring that data can be analyzed.
Roadside stop data shall be
public.
Sec. 4.
13 V.S.A. chapter 182, subchapter 3 of is added to read:
Subchapter 3.
Law Enforcement Practices
§ 5581.
ELECTRONIC RECORDING OF A CUSTODIAL
INTERROGATION
(a)
As used in this section:
(1)
―Custodial interrogation‖ means any interrogation:
(A)
involving questioning by a law enforcement officer that is
reasonably likely to elicit an incriminating response from the subject; and
(B)
in which a reasonable person in the subject’s position would
consider himself or herself to be in custody, starting from the moment a person
should have been advised of his or her Miranda rights and ending when the
questioning has concluded.
(2)
―Electronic recording‖ or ―electronically recorded‖ means an audio
and visual recording that is an authentic, accurate, unaltered record of a
custodial interrogation, or if law enforcement does not have the current
capacity to create a visual recording, an audio recording of the interrogation.
(3)
―Place of detention‖ means a building or a police station that is a
place of operation for the State police, a municipal police department, county
sheriff department, or other law enforcement agency that is owned or operated
by a law enforcement agency at which persons are or may be questioned in
connection with criminal offenses or detained temporarily in connection with
criminal charges pending a potential arrest or citation.
(4)
―Statement‖ means an oral, written, sign language, or nonverbal
communication.
- 2746 -
(b)(1)
A custodial interrogation that occurs in a place of detention
concerning the investigation of a felony violation of chapter 53 (homicide) or
72 (sexual assault) of this title shall be electronically recorded in its entirety.
(2)
In consideration of best practices, law enforcement shall strive to
record simultaneously both the interrogator and the person being interrogated.
(c)(1)
The following are exceptions to the recording requirement in
subsection (b) of this section:
(A)
exigent circumstances;
(B)
a person’s refusal to be electronically recorded;
(C)
interrogations conducted by other jurisdictions;
(D)
a reasonable belief that the person being interrogated did not
commit a felony violation of chapter 53 (homicide) or 72 (sexual assault) of
this title and, therefore, an electronic recording of the interrogation was not
required;
(E)
the safety of a person or protection of his or her identity; and
(F)
equipment malfunction.
(2) If law enforcement does not make an electronic recording of a
custodial interrogation as required by this section, the prosecution shall prove
by a preponderance of the evidence that one of the exceptions identified in
subdivision (1) of this subsection applies. If the prosecution does not meet the
burden of proof, the evidence is still admissible, but the Court shall provide
cautionary
instructions
to
the
jury
regarding
the
failure
to
record
the
interrogation.
Sec. 5.
LAW ENFORCEMENT ADVISORY BOARD
(a)
The Law Enforcement Advisory Board (LEAB) shall develop a plan for
the implementation of Sec. 1 of this act, 13 V.S.A. § 5581 (electronic recording
of a custodial interrogation).
(b)
The LEAB, in consultation with practitioners and experts in recording
interrogations, including the Innocence Project, shall:
(1)
assess the scope and location of the current inventory of recording
equipment in Vermont;
(2)
develop recommendations, including funding options, regarding how
to equip adequately law enforcement with the recording devices necessary to
carry out Sec. 1 of this act, 13 V.S.A. § 5581 (electronic recording of a
custodial interrogation); and
- 2747 -
(3)
develop recommendations for expansion of recordings to questioning
by a law enforcement officer that is reasonably likely to elicit an incriminating
response from the subject regarding any felony offense.
(c)
On or before October 1, 2014, the LEAB shall submit a written report to
the Senate and House Committees on Judiciary with its recommendations for
the implementation of Sec. 1 of this act, 13 V.S.A. § 5581 (electronic recording
of a custodial interrogation).
Sec. 6.
EFFECTIVE DATES
This act shall take effect on passage except for Sec. 4 which shall take
effect on October 1, 2015.
and that after passage the title of the bill be amended to read:
―An act relating
to law enforcement policies on eyewitness identification and bias-free policing
and on recording of custodial interrogations in homicide and sexual assault
cases‖.
(Committee vote: 7-0-4 )
(For text see Senate Journal 2/5/2014 )
S. 287
An act relating to involuntary treatment and medication
Rep. Koch of Barre Town,
for the Committee on
Judiciary,
recommends
that the House propose to the Senate that the bill be amended by striking all
after the enacting clause and inserting in lieu thereof the following:
Sec. 1.
18 V.S.A. § 7101(9) is amended to read:
(9)
―Interested party‖ means a guardian, spouse, parent, adult child,
close adult relative, a responsible adult friend, or person who has the individual
in his or her charge or care.
It also means a mental health professional, a law
enforcement officer, a licensed physician, or a head of a hospital, a selectman,
a town service officer, or a town health officer.
Sec. 2.
18 V.S.A. § 7256 is amended to read:
§ 7256.
REPORTING REQUIREMENTS
Notwithstanding
2
V.S.A.
§
20(d),
the department
of
mental
health
Department of Mental Health shall report annually on or before January 15 to
the senate committee on health and welfare and the house committee on human
services Senate Committee on Health and Welfare and the House Committee
on Human Services regarding the extent to which individuals with mental
health conditions receive care in the most integrated and least restrictive setting
available.
The Department shall consider measures from a variety of sources,
- 2748 -
including the Joint Commission, the National Quality Forum, the Centers for
Medicare and Medicaid Services, the National Institute of Mental Health, and
the Substance Abuse and Mental Health Services Administration.
The report
shall address:
(1)
Utilization use of services across the continuum of mental health
services;
(2)
Adequacy adequacy of the capacity at each level of care across the
continuum of mental health services;
(3)
Individual individual experience of care and satisfaction;
(4)
Individual individual recovery in terms of clinical, social, and legal
outcomes; and
(5)
Performance performance of the state’s State’s mental health system
of care as compared to nationally recognized standards of excellence;
(6)
ways
in
which
patient
autonomy
and
self-determination
are
maximized within the context of involuntary treatment and medication;
(7)
outcome measures and other data on individuals for whom petitions
for involuntary medication are filed; and
(8)
progress on alternative treatment options across the system of care
for individuals seeking to avoid or reduce reliance on medications, including
supported withdrawal from medications.
Sec. 3.
18 V.S.A. § 7257 is amended to read:
§ 7257.
REPORTABLE ADVERSE EVENTS
(a)
An acute inpatient hospital, an intensive residential recovery facility, a
designated agency, or a secure residential facility shall report to the department
of mental health
Department of Mental Health instances of death or serious
bodily injury to individuals with a mental health condition in the custody or
temporary custody of the commissioner Commissioner.
(b)
An acute inpatient hospital shall report to the Department of Mental
Health any staff injuries caused by a person in the custody or temporary
custody of the Commissioner that are reported to both the Department of Labor
and to the hospital’s workers’ compensation carrier.
Sec. 4.
18 V.S.A. § 7259 is amended to read:
§ 7259.
MENTAL HEALTH CARE OMBUDSMAN
(a)
The department of mental health Department of Mental Health shall
establish the office of the mental health care ombudsman Office of the Mental
- 2749 -
Health Care Ombudsman within the agency designated by the governor
Governor as the protection and advocacy system for the state State pursuant to
The agency may execute the duties of the office of
the
mental
health
care
ombudsman Office
of
the
Mental
Health
Care
Ombudsman, including authority to assist individuals with mental health
conditions and to advocate for policy issues on their behalf; provided,
however, that nothing in this section shall be construed to impose any
additional
duties
on
the
agency
in
excess
of
the
requirements
under
federal law.
(b)
The agency may provide a report annually to the general assembly
General Assembly regarding the implementation of this section.
(c)
In the event the protection and advocacy system ceases to provide
federal funding to the agency for the purposes described in this section, the
general assembly General Assembly may allocate sufficient funds to maintain
the office of the mental health care ombudsman Office of the Mental Health
Care Ombudsman.
(d)
The Department of Mental Health shall provide a copy of the certificate
of need for all emergency involuntary procedures performed on a person in the
custody or temporary custody of the Commissioner to the Office of the Mental
Health Care Ombudsman on a monthly basis.
Sec. 5.
18 V.S.A. § 7504 is amended to read:
§
7504.
APPLICATION AND
CERTIFICATE FOR
EMERGENCY
EXAMINATION
(a)
A
Upon written application by an interested party made under the pains
and penalties of perjury and accompanied by a certificate by a licensed
physician who is not the applicant, a person shall be admitted to a designated
held for admission to a hospital for an emergency examination to determine if
he or she is a person in need of treatment upon written application by an
interested party accompanied by a certificate by a licensed physician who is
not the applicant.
The application and certificate shall set forth the facts and
circumstances which that constitute the need for an emergency examination
and which that show that the person is a person in need of treatment.
(b)
The application and certificate shall be authority for transporting the
person to a designated
hospital for an emergency examination, as provided in
section 7511 of this title.
(c)
For the purposes of admission of an individual to a designated hospital
for care and treatment under this section, a head of a hospital, as provided in
subsection (a) of this section, may include a person designated in writing by
- 2750 -
the head of the hospital to discharge the authority granted in this section.
A designated person must be an official hospital administrator, supervisory
personnel, or a licensed physician on duty on the hospital premises other than
the certifying physician under subsection (a) of this section.
Sec. 6.
18 V.S.A. § 7505 is amended to read:
§
7505.
WARRANT
AND
CERTIFICATE
FOR
IMMEDIATE
EMERGENCY EXAMINATION
(a)
In emergency circumstances where a certification by a physician is not
available
without
serious
and
unreasonable
delay,
and
when
personal
observation of the conduct of a person constitutes reasonable grounds to
believe that the person is a person in need of treatment, and he or she presents
an immediate risk of serious injury to himself or herself or others if not
restrained, a law enforcement officer or mental health professional may make
an application, not accompanied by a physician’s certificate, to any district or
superior Superior judge
for
a
warrant
for
an immediate emergency
examination.
(b)
The law enforcement officer or mental health professional may take the
person into temporary custody and shall apply to the court Court without delay
for the warrant.
(c)
If the judge is satisfied that a physician’s certificate is not available
without serious and unreasonable delay, and that probable cause exists to
believe that the person is in need of an immediate emergency examination, he
or she may order the person to submit to an immediate examination at a
designated hospital evaluation by a physician for that purpose.
(d)
If necessary, the court Court may order the law enforcement officer or
mental health professional to transport the person to a designated hospital for
an immediate examination evaluation by a physician to determine if the person
should be certified for an emergency examination.
(e)
Upon
admission
to
a
designated
hospital,
the
person
shall
be
immediately examined by a
A person transported pursuant to subsection (d) of
this section shall be evaluated as soon as possible after arrival at the hospital.
If after evaluation the licensed physician determines that the person is a person
in need of treatment, he or she shall issue an initial certificate that sets forth the
facts and circumstances constituting the need for an emergency examination
and showing that the person is a person in need of treatment.
If the physician
certifies that the person is a person in need of treatment
Once the physician
has issued the initial certificate, the person shall be held for an emergency
examination in accordance with section 7508 of this title.
If the physician does
not certify that the person is a person in need of treatment, he or she shall
- 2751 -
immediately discharge the person and cause him or her to be returned to the
place from which he or she was taken, or to such place as the person
reasonably directs.
Sec. 7.
18 V.S.A. § 7508 is amended to read:
§ 7508.
EMERGENCY EXAMINATION AND SECOND CERTIFICATION
(a)
When a person is admitted to a designated hospital an initial
certification is issued for an emergency examination of a person in accordance
with section 7504 or subsection 7505(e) of this title, he or she shall be
examined and certified by a psychiatrist as soon as practicable, but not later
than one working day 24 hours after admission initial certification.
(b)
If the person is admitted held for admission on an application and
physician’s certificate, the examining psychiatrist shall not be the same
physician who signed the certificate.
(c)
If the psychiatrist does not certify issue a second certification stating
that the person is a person in need of treatment, he or she shall immediately
discharge or release the person and cause him or her to be returned to the place
from which he or she was taken or to such place as the person reasonably
directs.
(d)
If the psychiatrist does certify issue a second certification that the
person is a person in need of treatment, the person’s hospitalization person
may
continue to
be
held for
an
additional
72
hours,
at
which
time
hospitalization shall terminate the person shall be discharged or released,
unless within that period:
(1)
the person has been accepted for voluntary admission under section
7503 of this title; or
(2)
an application for involuntary treatment is filed with the appropriate
court under section 7612 of this title, in which case the patient shall remain
hospitalized continue to be held pending the court’s decision on the application
Court’s finding of probable cause on the application.
(e)(1)(A)
A person shall be deemed to be in the temporary custody of
the Commissioner when the first of the following occurs:
(i)
a physician files an initial certification for the person while the
person is in a hospital; or
(ii)
a person is certified by a psychiatrist to be a person in need of
treatment during an emergency examination.
(B)
Temporary custody under this subsection shall continue until the
Court issues an order pursuant to subsection 7617(b) of this title or the person
- 2752 -
is discharged or released.
(2)
The Commissioner shall make every effort to ensure that a person
held for an emergency examination pending a hospital admission is receiving
temporary care and treatment that:
(A)
uses the least restrictive manner necessary to protect the safety of
both the person and the public;
(B)
respects the privacy of the person and other patients; and
(C)
prevents physical and psychological trauma.
(3)
All persons admitted or held for admission shall receive a notice of
rights as provided for in section 7701 of this title, which shall include contact
information for Vermont Legal Aid, the Office of the Mental Health Care
Ombudsman, and the mental health patient representative.
The Department of
Mental Health shall develop and regularly update informational material on
available peer-run support services, which shall be provided to all persons
admitted or held for admission.
(4)
A person held for an emergency examination may be admitted at an
appropriate hospital at any time after the second certification occurs.
Sec. 8.
18 V.S.A. § 7509 is amended to read:
§ 7509.
TREATMENT; RIGHT OF ACCESS
(a)
Upon admission to the hospital pursuant to section 7503, 7508, 7617, or
7624 of this title, the person shall be treated with dignity and respect and shall
be given such medical and psychiatric treatment as is indicated.
(b)
The person All persons admitted or held for admission shall be given
the opportunity, subject to reasonable limitations, to communicate with others,
including visits by a peer support person designated by the person, presence of
the presence the peer support person at all treatment team meetings the person
is entitled to attend, the reasonable use of a telephone, and the reasonable use
of electronic mail and the Internet.
(c)
The person shall be requested to furnish the names of persons he or she
may want notified of his or her hospitalization and kept informed of his or her
status.
The head of the hospital shall see that such persons are notified of the
status of the patient, how he or she may be contacted and visited, and how they
may obtain information concerning him or her.
Sec. 9.
18 V.S.A. § 7612 is amended to read:
§ 7612.
APPLICATION FOR INVOLUNTARY TREATMENT
(a)
An interested party may, by filing a written application, commence
- 2753 -
proceedings for the involuntary treatment of an individual by judicial process.
(b)
The application shall be filed in the criminal division of the superior
court of the proposed patient’s residence or, in the case of a nonresident, in any
district court Family Division of the Superior Court.
(c)
If the application is filed under section 7508 or 7620 of this title, it shall
be filed in the criminal division of the superior court unit of the Family
Division of the Superior Court in which the hospital is located.
In all other
cases, it shall be filed in the unit in which the proposed patient resides.
In the
case of a nonresident, it may be filed in any unit.
The Court may change the
venue of the proceeding to the unit in which the proposed patient is located at
the time of the trial.
(d)
The application shall contain:
(1)
The name and address of the applicant; and.
(2)
A statement of the current and relevant facts upon which the
allegation of mental illness and need for treatment is based.
The application
shall be signed by the applicant under penalty of perjury.
(e)
The application shall be accompanied by:
(1)
A a certificate of a licensed physician, which shall be executed under
penalty of perjury stating that he or she has examined the proposed patient
within five days of the date the petition is filed, and is of the opinion that the
proposed patient is a person in need of treatment, including the current and
relevant facts and circumstances upon which the physician’s opinion is
based; or
(2)
A a written statement by the applicant that the proposed patient
refused to submit to an examination by a licensed physician.
(f)
Before an examining physician completes the certificate of examination,
he or she shall consider available alternative forms of care and treatment that
might be adequate to provide for the person’s needs, without requiring
hospitalization.
The examining physician shall document on the certificate the
specific alternative forms of care and treatment that he or she considered and
why those alternatives were deemed inappropriate, including information on
the availability of any appropriate alternatives.
Sec. 10.
18 V.S.A. § 7612a is added to read:
§ 7612a.
PROBABLE CAUSE REVIEW
(a)
Within three days after an application for involuntary treatment is filed,
the Family Division of the Superior Court shall conduct a review to determine
whether there is probable cause to believe that the person was a person in need
- 2754 -
of treatment at the time of his or her admission.
The review shall be based
solely on the application for an emergency examination and accompanying
certificate
by
a
licensed
physician
and
the
application
for
involuntary
treatment.
(b)
If, based on a review conducted pursuant to subsection (a) of this
section the Court finds probable cause to believe that the person was a person
in need of treatment at the time of his or her admission, the person shall be
ordered held for further proceedings in accordance with Part 8 of this title.
If
probable cause is not established, the person shall be ordered discharged or
released from the hospital and returned to the place from which he or she was
transported or to such place as the person may reasonably direct.
(c)
An application for involuntary treatment shall not be dismissed solely
because the probable cause review is not completed within the time period
required by this section if there is good cause for the delay.
Sec. 11.
18 V.S.A. § 7615 is amended to read:
§
7615.
HEARING
ON
APPLICATION
FOR
INVOLUNTARY
TREATMENT
(a)(1)
Upon receipt of the application, the court Court shall set a date for
the hearing to be held within 10 days from the date of the receipt of the
application or 20 days from the date of the receipt of the application if a
psychiatric examination is ordered under section 7614 of this title unless the
hearing is continued by the court Court pursuant to subsection (b) of this
section.
(2)(A)
The applicant or a person who is certified as a person in need of
treatment pursuant to section 7508 may file a motion to expedite the hearing.
The motion shall be supported by an affidavit, and the Court shall rule on the
motion on the basis of the filings without holding a hearing.
After viewing the
evidence in the light most favorable to the moving party:
(i)
The Court shall grant the motion if it finds that the person
demonstrates a significant risk of causing the person or others serious bodily
injury as defined in 13 V.S.A. § 1021 even while hospitalized and clinical
interventions have failed to address the risk of harm to the person or others.
(ii)
The Court may grant the motion if it finds that the person has
received involuntary medication pursuant to section 7624 of this title during
the past two years and, based upon the person’s response to previous and
ongoing treatment, there is good cause to believe that additional time will not
result in the person establishing a therapeutic relationship with providers or
regaining competence.
- 2755 -
(B)
If the Court grants the motion for expedited hearing pursuant to
this subdivision, the hearing shall be held within ten days from the date of the
order for expedited hearing.
(b)(1)
The court For hearings held pursuant to subdivision (a)(1) of this
section, the Court may grant either each party an a onetime extension of time
of up to seven days for good cause.
(2)
The
Court
may
grant
one
or
more
additional
seven-day
continuances if:
(A)
the Court finds that the proceeding or parties would be
substantially prejudiced without a continuance; or
(B)
the parties stipulate to the continuance.
(c)
The hearing shall be conducted according to the rules of evidence
Vermont Rules of Evidence applicable in civil actions in the criminal division
of the superior courts of the state, and to an extent not inconsistent with this
part, the rules of civil procedure of the state Vermont Rules of Civil Procedure
shall be applicable.
(d)
The applicant and the proposed patient shall have a right to appear at
the hearing to testify.
The attorney for the state State and the proposed patient
shall have the right to subpoena, present, and cross-examine witnesses, and
present oral arguments.
The court Court may, at its discretion, receive the
testimony of any other person.
(e)
The proposed patient may at his or her election attend the hearing,
subject to reasonable rules of conduct, and the court Court may exclude all
persons, except a peer support person designated by the proposed patient, not
necessary for the conduct of the hearing.
Sec. 12.
18 V.S.A. § 7624 is amended to read:
§ 7624.
PETITION FOR INVOLUNTARY MEDICATION
(a)
The commissioner Commissioner may commence an action for the
involuntary medication of a person who is refusing to accept psychiatric
medication and meets any one of the following three five conditions:
(1)
has been placed in the commissioner’s Commissioner’s care and
custody pursuant to section 7619 of this title or subsection 7621(b) of this title;
(2)
has previously received treatment under an order of hospitalization
and is currently under an order of nonhospitalization, including a person on an
order of nonhospitalization who resides in a secure residential recovery
facility; or
- 2756 -
(3)
has been committed to the custody of the commissioner of
corrections Commissioner of Corrections as a convicted felon and is being held
in a correctional facility which is a designated facility pursuant to section 7628
of this title and for whom the department of corrections Departments of
Corrections and the department of mental health of Mental Health have jointly
determined jointly that involuntary medication would be appropriate pursuant
to 28 V.S.A. § 907(4)(H);
(4)
has an application for involuntary treatment pending for which
the Court
has
granted
a
motion
to
expedite
pursuant
to
subdivision
7615(a)(2)(A)(i) of this title; or
(5)(A)
has an application for involuntary treatment pending;
(B)
waives the right to a hearing on the application for involuntary
treatment until a later date; and
(C)
agrees to proceed with an involuntary medication hearing without
a ruling on whether he or she is a person in need of treatment.
(b)(1)
A Except as provided in subdivision (2) and (3) of this subsection, a
petition for involuntary medication shall be filed in the family division of the
superior court Family Division of the Superior Court in the county in which
the person is receiving treatment.
(2)
If the petition for involuntary medication is filed pursuant to
subdivision (a)(4) of this section:
(A)
the petition shall be filed in the county in which the application
for involuntary treatment is pending; and
(B)
the Court shall consolidate the application for involuntary
treatment with the petition for involuntary medication and rule on the
application
for
involuntary
treatment
before
ruling
on
the
petition
for
involuntary medication.
(3)
If the petition for involuntary medication is filed pursuant to
subdivision (a)(5) of this section, the petition shall be filed in the county in
which the application for involuntary treatment is pending.
(c)
The petition shall include a certification from the treating physician,
executed under penalty of perjury, that includes the following information:
(1)
the nature of the person’s mental illness;
(2)
that the person is refusing medication proposed by the physician;
(3)
that the person lacks the competency to decide to accept or refuse
medication and appreciate the consequences of that decision;
- 2757 -
(4)
the necessity for involuntary medication, including the person’s
competency to decide to accept or refuse medication;
(3)(5)
any proposed medication, including the method, dosage range,
and length of administration for each specific medication;
(4)(6)
a statement of the risks and benefits of the proposed medications,
including the likelihood and severity of adverse side effects and its effect on:
(A)
the
person’s
prognosis
with
and
without
the
proposed
medications; and
(B)
the person’s health and safety, including any pregnancy;
(5)(7)
the current relevant facts and circumstances, including any history
of psychiatric treatment and medication, upon which the physician’s opinion is
based;
(6)(8)
what alternate treatments have been proposed by the doctor, the
patient, or others, and the reasons for ruling out those alternatives, including
information on the availability of any appropriate alternatives; and
(7)(9)
whether the person has executed a durable power of attorney for
health
care an
advance
directive in
accordance
with
the
provisions
of
18 V.S.A. chapter 111, subchapter 2 chapter 231 of this title, and the identity
of the health care agent or agents designated by the durable power of attorney
advance directive.
(d)
A copy of the durable power of attorney advance directive, if available,
shall be attached to the petition.
Sec. 13.
18 V.S.A. § 7625 is amended to read:
§ 7625.
HEARING ON PETITION FOR INVOLUNTARY MEDICATION;
BURDEN OF PROOF
(a)
A Unless consolidated with an application for involuntary treatment
pursuant to subdivision 7624(b)(2) of this title, a hearing on a petition for
involuntary medication shall be held within seven days of filing and shall be
conducted in accordance with sections 7613, 7614, 7615(b)–(e), and 7616 and
subsections 7615(b)–(e) of this title.
(b)
In a hearing conducted pursuant to this section, section 7626, or section
7627 of this title, the commissioner Commissioner has the burden of proof by
clear and convincing evidence.
(c)
In determining whether or not the person is competent to make a
decision regarding the proposed treatment, the court Court shall consider
whether the person is able to make a decision and appreciate the consequences
- 2758 -
of that decision.
Sec. 14.
18 V.S.A. § 7626 is amended to read:
§ 7626.
DURABLE POWER OF ATTORNEY ADVANCE DIRECTIVE
(a)
If a person who is the subject of a petition filed under section 7624 of
this title has executed a durable power of attorney an advance directive in
accordance with the provisions of 18 V.S.A. chapter 111 chapter 231 of this
title, subchapter 2 for health care, the court Court shall suspend the hearing and
enter an order pursuant to subsection (b) of this section, if the court Court
determines that:
(1)
the person is refusing to accept psychiatric medication;
(2)
the person is not competent to make a decision regarding the
proposed treatment; and
(3)
the decision regarding the proposed treatment is within the scope of
the valid, duly executed durable power of attorney for health care advance
directive.
(b)
An order entered under subsection (a) of this section shall authorize the
commissioner Commissioner to administer treatment to the person, including
involuntary medication in accordance with the direction set forth in the durable
power of attorney advance directive or provided by the health care agent or
agents acting within the scope of authority granted by the durable power of
attorney advance directive.
If hospitalization is necessary to effectuate the
proposed treatment, the court Court may order the person to be hospitalized.
(c)
In the case of a person subject to an order entered pursuant to
subsection (a) of this section, and upon the certification by the person’s
treating physician to the court that the person has received treatment or no
treatment consistent with the durable power of attorney for health care for
45 days after the order under subsection (a) of this section has been entered,
then the court shall reconvene the hearing on the petition.
(1)
If the court concludes that the person has experienced, and is likely
to continue to experience, a significant clinical improvement in his or her
mental state as a result of the treatment or nontreatment directed by the durable
power of attorney for health care, or that the patient has regained competence,
then the court shall enter an order denying and dismissing the petition.
(2)
If the court concludes that the person has not experienced a
significant clinical improvement in his or her mental state, and remains
incompetent then the court shall consider the remaining evidence under the
factors described in subdivisions 7627(c)(1)-(5) of this title and render a
decision on whether the person should receive medication.
[Repealed.]
- 2759 -
(d)(1)
The Commissioner of Mental Health shall develop a protocol for use
by designated hospitals for the purpose of educating hospital staff on the use
and applicability of advance directives pursuant to chapter 231 of this title and
other
written
or
oral
expressions
of
treatment
preferences
pursuant
to
subsection 7627(b) of this title.
(2)
Prior to a patient’s discharge or release, a hospital shall provide
information
to
a
patient
in
the
custody
or
temporary
custody
of
the
Commissioner regarding advance directives, including relevant information
developed by the Vermont Ethics Network and Office of the Mental Health
Care Ombudsman.
Sec. 15.
18 V.S.A. § 7627 is amended to read:
§ 7627.
COURT FINDINGS; ORDERS
* * *
(b)
If a person who is the subject of a petition filed under section 7625 of
this title has not executed a durable power of attorney an advance directive, the
court Court shall follow the person’s competently expressed written or oral
preferences
regarding
medication,
if
any,
unless
the
commissioner
Commissioner demonstrates that the person’s medication preferences have not
led to a significant clinical improvement in the person’s mental state in the past
within an appropriate period of time.
(c)
If the court Court finds that there are no medication preferences or that
the person’s medication preferences have not led to a significant clinical
improvement in the person’s mental state in the past within an appropriate
period of time, the court Court shall consider at a minimum, in addition to the
person’s expressed preferences, the following factors:
(1)
The the person’s religious convictions and whether they contribute
to the person’s refusal to accept medication.;
(2)
The the impact of receiving medication or not receiving medication
on the person’s relationship with his or her family or household members
whose opinion the court Court finds relevant and credible based on the nature
of the relationship.;
(3)
The the likelihood and severity of possible adverse side-effects side
effects from the proposed medication.;
(4)
The the risks and benefits of the proposed medication and its
effect on:
(A)
the person’s prognosis; and
(B)
the person’s health and safety, including any pregnancy.; and
- 2760 -
(5)
The the various treatment alternatives available, which may or may
not include medication.
(d)
As
a
threshold
matter,
the
Court
shall
consider
the
person’s
competency.
If the court Court finds that the person is competent to make a
decision regarding the proposed treatment or that involuntary medication is not
supported by the factors in subsection (c) of this section, the court Court shall
enter a finding to that effect and deny the petition.
(e)
As
a
threshold
matter,
the
Court
shall
consider
the
person’s
competency.
If the court Court finds that the person is incompetent to make a
decision regarding the proposed treatment and that involuntary medication is
supported by the factors in subsection (c) of this section, the court Court shall
make specific findings stating the reasons for the involuntary medication by
referencing those supporting factors.
(f)(1)
If the court Court grants the petition, in whole or in part, the court
Court shall enter an order authorizing the commissioner Commissioner to
administer involuntary medication to the person.
The order shall specify the
types of medication, the permitted dosage range, length of administration, and
method of administration for each.
The order for involuntary medication shall
not include electric convulsive therapy, surgery, or experimental medications.
Long-acting injections and nasogastric intubation shall not be ordered without
clear and convincing evidence, particular to the patient, that these treatments
are appropriate.
(2)
The order shall require the person’s treatment provider to conduct
monthly weekly reviews of the medication to assess the continued need for
involuntary medication, the effectiveness of the medication, the existence of
any side effects, and whether the patient has become competent pursuant to
subsection 7625(c) of this title, and shall document this review in detail in the
patient’s
chart and
provide
the
person’s
attorney
with
a
copy
of
the
documentation within five days of its production.
(g)
For a person receiving treatment pursuant to an order of hospitalization,
the commissioner Commissioner may administer involuntary medication as
authorized by this section to the person for up to 90 days, unless the court
Court finds that an order is necessary for a longer period of time.
Such an
order
shall
not
be longer
than
the
duration
of
the
current
order
of
hospitalization.
If at any time a treatment provider finds that a person subject
to an order for involuntary medication has become competent pursuant to
subsection 7625(c) of this title, the order shall no longer be in effect.
* * *
Sec. 16.
18 V.S.A. § 7629 is amended to read:
- 2761 -
§ 7629.
LEGISLATIVE INTENT
(a)
It is the intention of the general assembly to recognize the right of a
legally competent person to determine whether or not to accept medical
treatment,
including
involuntary
medication,
absent
an
emergency
or
a
determination that the person is incompetent and lacks the ability to make a
decision and appreciate the consequences.
The State of Vermont recognizes
the fundamental right of an adult to determine the extent of health care the
individual will receive, including treatment provided during periods of lack of
competency that the individual expressed a desire for when he or she was
competent.
(b)
This act protects this right through a judicial proceeding prior to the use
of nonemergency involuntary medication and by limiting the duration of an
order for involuntary treatment to no more than one year. The least restrictive
conditions consistent with the person’s right to adequate treatment shall be
provided in all cases.
The General Assembly adopts the goal of high-quality,
patient-centered health care, which the Institute of Medicine defines as
―providing care that is respectful of and responsive to individual patient
preferences, needs, and values and ensuring that patient values guide all
clinical decisions.‖
(c)
It is the policy of the general assembly General Assembly to work
towards toward a mental health system that does not require coercion or the
use of involuntary medication when a person is opposing it.
The distress and
insult to human dignity that results from compelling a person to participate in
medical procedures against his or her will are real regardless of how poorly
the person may understand the procedures or how confused or mistaken the
person may be about the procedures.
(d)
This act will render the J. L. v. Miller consent judgment no longer
applicable.
This chapter protects the rights and values described in this section
through a judicial process to determine competence prior to an order for
nonemergency involuntary medication and by limiting the duration of an order
for involuntary treatment to no more than one year.
The least restrictive order
consistent with the person’s right to adequate treatment shall be provided in all
cases.
Sec. 17.
18
V.S.A. § 9701 is amended to read:
§ 9701.
DEFINITIONS
As used in this chapter:
* * *
(21)
―Ombudsman‖ means an individual appointed as a long-term care
- 2762 -
ombudsman
under
the
Program
contracted
through
the
Department
of
Disabilities, Aging, and Independent Living pursuant to the Older Americans
Act of 1965, as amended or the agency designated as the Office of the Mental
Health Care Ombudsman Pursuant to section 7259 of this title.
* * *
(32)
―Patient
representative‖
means
the
mental
health
patient
representative established by section 7253 of this title.
Sec. 18.
18 V.S.A. § 9703 is amended to read:
§ 9703.
FORM AND EXECUTION
* * *
(d)
An advance directive shall not be effective if, at the time of execution,
the principal is being admitted to or is a resident of a nursing home as defined
in 33 V.S.A. § 7102 or a residential care facility unless an ombudsman, a
patient representative, a recognized member of the clergy, an attorney licensed
to practice in this state State, or a probate division of the superior court Probate
Division of the Superior Court designee signs a statement affirming that he or
she has explained the nature and effect of the advance directive to the
principal.
It is the intent of this subsection to ensure that residents of nursing
homes and residential care facilities are willingly and voluntarily executing
advance directives.
(e)
An advance directive shall not be effective if, at the time of execution,
the principal is being admitted to or is a patient in a hospital, unless an
ombudsman, a patient representative, a recognized member of the clergy, an
attorney licensed to practice in this state State, a probate division of the
superior
court Probate
Division
of
the Superior
Court designee,
or an
individual designated under subsection 9709(c) of this title by the hospital
signs a statement that he or she has explained the nature and effect of the
advance directive to the principal.
* * *
Sec. 19.
18 V.S.A. § 9706(c) is amended to read:
(c)
Upon a determination of need by the principal’s clinician, or upon the
request of the principal, agent, guardian, ombudsman, a patient representative,
health care provider, or any interested individual, the principal’s clinician,
another clinician, or a clinician’s designee shall reexamine the principal to
determine whether the principal has capacity.
The clinician shall document the
results of the reexamination in the principal’s medical record and shall make
reasonable efforts to notify the principal and the agent or guardian, as well as
the individual who initiated the new determination of capacity, of the results of
- 2763 -
the reexamination, if providing such notice is consistent with the requirements
of HIPAA.
Sec. 20.
18 V.S.A. § 9707(h) is amended to read:
(h)(1)
An advance directive executed in accordance with section 9703 of
this title may contain a provision permitting the agent, in the event that the
principal lacks
capacity, to
authorize or withhold health care over the
principal’s objection.
In order to be valid, the provision shall comply with the
following requirements:
(A)
An agent shall be named in the provision.
(B)
The agent shall accept in writing the responsibility of authorizing
or withholding health care over the principal’s objection in the event the
principal lacks capacity.
(C)
A clinician for the principal shall sign the provision and affirm
that the principal appeared to understand the benefits, risks, and alternatives to
the health care being authorized or rejected by the principal in the provision.
(D)(i)
An ombudsman, a patient representative recognized member
of the clergy, attorney licensed to practice law in this state State, or probate
division of the superior court Probate Division of the Superior Court designee
shall sign a statement affirming that he or she has explained the nature and
effect of the provision to the principal, and that the principal appeared to
understand the explanation and be free from duress or undue influence.
(ii)
If the principal is a patient in a hospital when the provision is
executed, the ombudsman, patient representative recognized member of the
clergy, attorney, or probate division of the superior court Probate Division of
the Superior Court designee shall be independent of the hospital and not an
interested individual.
(E)
The provision shall specify the treatments to which it applies, and
shall include an explicit statement that the principal desires or does not desire
the proposed treatments even over the principal’s objection at the time
treatment is being offered or withheld.
The provision may include a statement
expressly granting to the health care agent the authority to consent to the
principal’s voluntary hospitalization, and to agree that the principal’s discharge
from the hospital may be delayed, pursuant to section 8010 of this title.
(F)
The provision shall include an acknowledgment that the principal
is knowingly and voluntarily waiving the right to refuse or receive treatment at
a time of incapacity, and that the principal understands that a clinician will
determine capacity.
(2)
A provision executed in compliance with subdivision (1) of this
- 2764 -
subsection shall be effective when the principal’s clinician and a second
clinician have determined pursuant to subdivision 9706(a)(1) of this title that
the principal lacks capacity.
(3)
If an advance directive contains a provision executed in compliance
with this section:
(A)
The agent may, in the event the principal lacks capacity, make
health care decisions over the principal’s objection, provided that the decisions
are made in compliance with subsection 9711(d) of this title.
(B)
A clinician shall follow instructions of the agent authorizing or
withholding health care over the principal’s objection.
Sec. 21.
18 V.S.A. § 9718(a) is amended to read:
(a)
A petition may be filed in probate division of the superior court Probate
Division of the Superior Court under this section by:
(1)
a principal, guardian, agent, ombudsman, a patient representative, or
interested individual other than one identified in an advance directive, pursuant
to subdivision 9702(a)(10) of this title, as not authorized to bring an action
under this section;
(2)
a social worker or health care provider employed by or directly
associated with the health care provider, health care facility, or residential care
facility providing care to the principal;
(3)
the defender general Defender General if the principal is in the
custody of the department of corrections Department of Corrections;
(4)
a representative of the state-designated State-designated protection
and advocacy system if the principal is in the custody of the department of
health Department of Health; or
(5)
an individual or entity identified in an advance directive, pursuant to
subdivision 9702(a)(10) of this title, as authorized to bring an action under this
section.
Sec. 22.
Rule 12 of the Vermont Rules for Family Proceedings is amended to
read:
Rule 12.
STAY OF PROCEEDINGS TO ENFORCE A JUDGMENT
(a)
Automatic Stay Prior to Appeal; Exceptions.
(1)
Automatic Stay.
Except as provided in paragraph (2) of this
subdivision and in subdivision (c), no execution shall issue upon a judgment
nor shall proceedings be taken for its enforcement until the expiration of
30 days after its entry or until the time for appeal from the judgment as
- 2765 -
extended by Appellate Rule 4 has expired.
(2)
Exceptions.
Unless otherwise ordered by the court, none of the
following orders shall be stayed during the period after its entry and until an
appeal is taken:
(A)
In an action under Rule 4 of these rules, an order relating to
parental rights and responsibilities and support of minor children or to separate
support of a spouse (including maintenance) or to personal liberty or to the
dissolution of marriage;
(B)
An order of involuntary treatment, involuntary medication,
nonhospitalization, or hospitalization, in an action pursuant to 18 V.S.A.
§§ 7611-7623 chapter 181;
(C)
Any order of disposition in a juvenile case, including an order
terminating residual parental rights; or
(D)
Any order in an action under Rule 9 of these rules for prevention
of abuse, including such an action that has been consolidated or deemed
consolidated with a proceeding for divorce or annulment pursuant to Rule 4(n).
The provisions of subdivision (d) of this rule govern the modification or
enforcement of the judgment in an action under Rule 4 of these rules, during
the pendency of an appeal.
* * *
(d)
Stay Pending Appeal.
(1)
Automatic Stay.
In any action in which automatic stay prior to
appeal is in effect pursuant to paragraph (1) or subdivision (a) of this rule, the
taking of an appeal from a judgment shall operate as a stay of execution upon
the judgment during the pendency of the appeal, and no supersedeas bond or
other security shall be required as a condition of such stay.
(2)
Other Actions.
(A)
When an appeal has been taken from judgment in an action under
Rule 4 of these rules in which no stay pursuant to paragraph (1) of
subdivision (a) of this rule is in effect, the court in its discretion may, during
the pendency of the appeal, grant or deny motions for modification or
enforcement of that judgment.
(B)(i)
When an appeal has been taken from an order for involuntary
treatment, nonhospitalization, or hospitalization or involuntary treatment, in an
action pursuant to chapter 181 of Title 18 V.S.A. chapter 181, the court in its
discretion may, during the pendency of the appeal, grant or deny applications
for continued treatment, modify its order, or discharge the patient, as provided
- 2766 -
(ii)(I)
If an order of involuntary medication is appealed, the
appellant may file a motion in the Family Division to stay the order during the
pendency of the appeal.
A motion to stay filed under this subdivision shall
stay the involuntary medication order while the motion to stay is pending.
(II)
The Family Division’s ruling on a motion to stay filed
under subdivision (I) of this subdivision (ii) may be modified or vacated by the
Supreme Court upon motion by a party filed within seven days after the ruling
is issued.
If the appellant is the moving party, the order for involuntary
medication shall remain stayed until the Supreme Court rules on the motion to
vacate or modify the stay.
A motion to vacate or modify a stay under this
subdivision shall be determined by a single Justice of the Supreme Court, who
may hear the matter or at his or her discretion refer it to the entire Supreme
Court for hearing.
No further appeal may lie from the ruling of a single Justice
in matters to which this subdivision applies.
The motion shall be determined
as soon as practicable and to the extent possible shall take priority over other
matters.
* * *
Sec. 23.
REPORT; EMERGENCY INVOLUNTARY PROCEDURES
On or before January 15, 2015, the Office of Legislative Council shall
submit a report to the House Committee on Human Services and to the Senate
Committee on Health and Welfare that:
(1)
identifies provisions in 2012 Acts and Resolves No. 79 which
require that protections for psychiatric hospital patients meet or exceed those at
the former Vermont State Hospital; and
(2)
identifies policies that may require clarification of legislative intent
in order for the Department of Mental Health to proceed with rulemaking
pursuant to 2012 Acts and Resolves No.79, Sec. 33a.
Sec. 24.
AVAILABILITY OF PSYCHIATRISTS FOR EXAMINATIONS
The Agency of Human Services shall ensure that Vermont Legal Aid’s
Mental Health Law Project has a sufficient number of psychiatrists to conduct
psychiatric examinations pursuant to 18 V.S.A. § 7614 in the time frame
established by 18 V.S.A. § 7615.
Sec.
25.
LEGISLATIVE
COUNCIL
STATUTORY
REVISION
AUTHORITY
The Office of Legislative Council, in its statutory revision capacity, is
authorized and directed to make such amendments to the Vermont Statutes
- 2767 -
Annotated as are necessary to effect the purpose of this act, including, where
applicable, substituting the words ―application for involuntary medication‖ and
―application,‖
as
appropriate,
for
the
words
―petition
for
involuntary
medication‖ and ―petition.‖
Sec. 26.
EFFECTIVE DATE
This act shall take effect on July 1, 2014.
(Committee vote: 8-0-3 )
(For text see Senate Journal 2/26/2014 & 2/27/2014 )
Amendment to be offered by Reps. Donahue of Northfield, Batchelor of
Derby, French of Randolph, Haas of Rochester, McFaun of Barre Town,
and Pugh of South Burlington to the recommendation of amendment of
the Committee on Judiciary to S. 287
First:
By striking Sec. 1 in its entirety and inserting in lieu thereof a new
Sec. 1 as follows:
Sec. 1.
18 V.S.A. § 7101 is amended to read;
§ 7101.
DEFINITIONS
As used in this part of this title, the following words, unless the context
otherwise requires, shall have the following meanings:
* * *
(9)
―Interested party‖ means a guardian, spouse, parent, adult child,
close adult relative, a responsible adult friend, or person who has the individual
in his or her charge or care.
It also means a mental health professional, a law
enforcement officer, a licensed physician, or a head of a hospital, a selectman,
a town service officer, or a town health officer.
* * *
(29)
―Peer‖ means an individual who has a personal experience of living
with a mental health condition or psychiatric disability.
(30)
―Peer services‖ means support services provided by trained peers or
peer-managed organizations focused on helping individuals with mental health
and other co-occurring conditions to support recovery.
Second:
By adding a new Sec. 2 after Sec. 1 to read as follows:
Sec. 2.
18 V.S.A. § 7252 is amended to read:
§ 7252.
DEFINITIONS
As used in this chapter:
- 2768 -
* * *
(10)
―Peer‖ means an individual who has a personal experience of living
with a mental health condition or psychiatric disability.
[Repealed.]
(11)
―Peer services‖ means support services provided by trained peers or
peer-managed organizations focused on helping individuals with mental health
and other co-occurring conditions to support recovery.
[Repealed.]
* * *
and by renumbering the remaining sections accordingly
Third:
In the new Sec. 8, 18 V.S.A. § 7508, by striking out subdivision
(e)(4) in its entirety and inserting in lieu thereof the following:
(4)
A person held for an emergency examination may be admitted to an
appropriate hospital at any time.
Fourth:
In the new Sec. 9, 18 V.S.A. § 7509, in subsection (b), by striking
out ―the presence‖ before ―the peer support person‖.
Fifth:
In the new Sec. 12, 18 V.S.A. § 7615, by striking subdivision
(a)(2)(A) in its entirety and inserting in lieu thereof the following:
(2)(A)
The applicant or a person who is certified as a person in need of
treatment pursuant to section 7508 of this title may file a motion to expedite
the hearing.
The motion shall be supported by an affidavit, and the Court shall
rule on the motion on the basis of the filings without holding a hearing.
The
Court:
(i)
shall grant the motion if it finds that the person demonstrates a
significant risk of causing the person or others serious bodily injury as defined
in 13 V.S.A. § 1021 even while hospitalized, and clinical interventions have
failed to address the risk of harm to the person or others;
(ii)
may grant the motion if it finds that the person has received
involuntary medication pursuant to section 7624 of this title during the past
two years and, based upon the person’s response to previous and ongoing
treatment, there is good cause to believe that additional time will not result in
the person establishing a therapeutic relationship with providers or regaining
competence.
Sixth:
In the new Sec. 13, 18 V.S.A. § 7624, in subdivision (c)(3), by
striking out ―competency‖ and inserting in lieu thereof competence.
Seventh:
In the new Sec. 16, 18 V.S.A. § 7627, in subdivision (f)(1), by
striking out the last sentence and inserting in lieu thereof the following:
A long-acting injection shall not be ordered without clear and convincing
- 2769 -
evidence, particular to the patient, that this treatment is the most appropriate
under the circumstances.
Eighth:
In the new Sec. 17, 18 V.S.A. § 7629, in subsection (c), in the first
sentence, by striking out ―involuntary‖ before ―medication‖.
Ninth:
In the new Sec. 18, 18 V.S.A. § 9701, in subdivision (21), by
striking out ―Pursuant‖ and inserting in lieu thereof pursuant.
Tenth:
By inserting a new Sec. 27 after Sec. 26 to read as follows:
Sec. 27.
1998 Acts and Resolves No. 114, Sec. 6 is amended to read:
Sec. 6.
STUDY AND REPORT
(a)
An annual independent study shall be commissioned by the department
of developmental and mental health services Department of Mental Health
which shall:
(1)
evaluate and critique the performance of the institutions and staff of
those institutions that are implementing the provisions of this act;
(2)
include interviews with persons subjected to orders of involuntary
medication subject to proceedings under 18 V.S.A. § 7624, regardless of
whether involuntarily medicated, and their families on the outcome and effects
of the order;
(3)
include the steps taken by the department Department to achieve a
mental health system free of coercion; and
(4)
include any recommendations to change current practices or statutes.
(b)
The person who performs the study shall prepare a report of the results
of the study, which shall be filed with the general assembly General Assembly
and the department Department annually on or before January 15.
(c)
Interviews with patients pursuant to this section may be conducted with
the assistance of the mental health patient representative established in
and by renumbering the remaining section to be Sec. 28.
Eleventh:
By striking out renumbered Sec. 28 in its entirety and inserting in
lieu thereof the following:
Sec. 28.
EFFECTIVE DATES
(a)
Except
for
Secs.
6
(application
and
certificate
for
emergency
examination), 7 (warrant and certificate for emergency examination), and 8
(emergency examination and second certification), this act shall take effect on
July 1, 2014.
- 2770 -
(b)
Secs. 6–8 shall take effect on November 1, 2014.
Action Postponed Until May 1, 2014
Senate Proposal of Amendment
H. 758
An act relating to notice of potential layoffs
The Senate proposes to the House to amend the bill by striking all after the
enacting clause and inserting in lieu thereof the following:
Sec. 1.
FINDINGS
The General Assembly finds:
(1)
The 21st century workplace is fundamentally different from the 20th
century workplace.
Along with a changing workplace comes a different
workforce.
Policies and resources must be updated to reflect the changing
workplace and workforce.
(2)
Businesses
retain
sensitive
information
for
proprietary
and
competitive reasons.
(3)
When the State requires this information, the sensitivity of this
information must be respected and protected.
(4)
The Department, as well as other agencies, are able to access federal
and
State
resources
to
mitigate
adverse
employment
impacts
affecting
employers, employees, communities, and the Unemployment Insurance Trust
Fund.
(5)
The Department and the Agency of Commerce and Community
Development, as well as other agencies, must be able to respond to and assist
with economic and workforce training and retention initiatives in a timely
fashion.
(6)
Municipalities, school districts, and local for-profit and nonprofit
businesses are all affected by plant closings and mass layoffs.
In order to
mitigate
adverse
impacts,
communities
and
stakeholders
need
timely
information pertaining to plant closings and mass layoffs.
Private and public
sectors need to work together to reduce the volatility and disruptions that come
with layoffs.
Sec. 2.
21 V.S.A. chapter 5, subchapter 3A is added to read:
Subchapter 3A.
Notice of Potential Layoffs Act
§ 411.
DEFINITIONS
- 2771 -
As used in this subchapter:
(1)
―Affected employees‖ means employees who may be expected to
experience an employment loss as a consequence of a proposed or actual
business closing or mass layoff by their employer.
(2)
―Business closing‖ means:
(A)
the permanent shutdown of a facility;
(B)
the permanent cessation of operations at one or more worksites in
the State that results in the layoff of 50 or more employees over a 90-day
period; or
(C)
the cessation of work or operations not scheduled to resume
within 90 days that affects 50 or more employees.
(3)
―Commissioner‖ means the Commissioner of Labor.
(4)
―Department‖ means the Department of Labor.
(5)
―Employer‖ means any person that employs:
(A)
50 or more full-time employees;
(B)
50 or more part-time employees who work at least 1,040 hours
per employee per year; or
(C)
a combination of 50 or more:
(i)
full-time employees; and
(ii)
part-time employees who work at least 1,040 hours per
employee per year.
(6)
―Employment loss‖ means the termination of employment that is the
direct result of a business closing or mass layoff.
An employee will not be
considered to have suffered an employment loss if the employee is offered a
transfer to a different site of employment within 35 miles; or if prior to the
layoff notice to the employee, the employee voluntarily separates or retires or
was separated by the employer for unsatisfactory performance or misconduct.
(7)
―Mass layoff‖ means a permanent employment loss of at least
50 employees at one or more worksites in Vermont during any 90-day period.
In determining whether a mass layoff has occurred or will occur, employment
losses for two or more groups of employees, each of which is below this
threshold but which in the aggregate exceed this threshold and which occur
within any 90-day period shall be considered to be a mass layoff unless the
employer demonstrates that the employment losses are the result of separate
and distinct actions and causes.
- 2772 -
(8)
―Representative‖ means an exclusive bargaining agent as legally
recognized under State or federal labor laws.
§ 412.
EDUCATION AND OUTREACH
The
Department
and
the
Agency
of
Commerce
and
Community
Development shall prepare information and materials for the purpose of
informing and educating Vermont employers with regard to programs and
resources that are available to assist with economic and workforce retention
initiatives in order to avoid business closings and mass layoffs.
The
Department and the Agency of Commerce and Community Development shall
also inform Vermont employers of the employers’ obligations that will be
required for proper notice under the provisions of this act.
§ 413.
NOTICE AND WAGE PAYMENT OBLIGATIONS
(a)
An employer who will engage in a closing or mass layoff shall provide
notice to the Secretary of Commerce and Community Development and the
Commissioner in accordance with this section to enable the State to present
information on potential support for the employer and separated employees.
(b)
Notwithstanding subsection (a) of this section, an employer who will
engage in a closing or mass layoff shall provide notice to the Secretary of
Commerce and Community Development and the Commissioner 45 days prior
to the effective date of the closing or layoffs that reach the thresholds defined
in section 411 of this subchapter, and shall provide 30-days’ notice to the local
chief elected official or administrative officer of the municipality, affected
employees, and bargaining agent, if any.
(c)
The employer shall send to the Commissioner and the Secretary the
approximate number and job titles of affected employees, the anticipated date
of the employment loss, and the affected worksites within the time allotted for
notice to the Commissioner and Secretary under subsection 413(b) or 414(b) of
this subchapter.
Concurrent with the notification to the affected employees, in
accordance with subsection 413(b) of this subchapter, the employer shall send
to the Commissioner in writing the actual number of layoffs, job titles, date of
layoff, and other information as the Commissioner deems necessary for the
purposes of unemployment insurance benefit processing and for accessing
federal and State resources to mitigate adverse employment impacts affecting
employers, employees, and communities.
(d)
In the case of a sale of part or all of an employer’s business where mass
layoffs will occur, the seller and the purchaser are still required to comply with
the notice requirements under subsection (b) of this section.
(e)
Nothing in this subchapter shall abridge, abrogate, or restrict the right of
- 2773 -
the State to require an employer that is receiving State economic development
funds or incentives from being required to provide additional or earlier notice
as a condition for the receipt of such funds or incentives.
(f)
An employer is required to pay all unpaid wage and compensation owed
to any laid-off worker, as required under this title.
(g)
This section shall not apply to a nursing home in situations where Rules
2.8 and 3.14 of the Vermont Licensing and Operating Rules for Nursing
Homes apply or where the CMS Requirements for Long-Term Care Facilities
apply, pursuant to 42 C.F.R. §§ 483.12 and 483.75.
§ 414.
EXCEPTIONS
(a)
In the case of a business closing or mass layoff, an employer is not
required to comply with the notice requirement in subsection 413 of this
subchapter and may delay notification to the Department if:
(1)
the business closing or mass layoff results from a strike or a lockout;
(2)
the employer is actively attempting to secure capital or investments
in order to avoid closing or mass layoffs; and the capital or investments sought,
if obtained, would have enabled the employer to avoid or postpone the
business closing or mass layoff, and the employer reasonably and in good faith
believed that giving the notice would have precluded the employer from
securing the needed capital or investment;
(3)
the
business
closing
or
mass
layoff
is
caused
by
business
circumstances that were not reasonably foreseeable at the time the 45-day
notice would have been required;
(4)
the business closing or mass layoff is due to a disaster beyond the
control of the employer; or
(5)(A)
the business closing or the mass layoff is the result of the
conclusion of seasonal employment or the completion of a particular project or
undertaking; or
(B)
the affected employees were hired with the understanding that
their employment was limited to the duration of the season, facility, project, or
undertaking.
(b)
An employer that is unable to provide the notice otherwise required by
this subchapter as a result of circumstances described in subsection (a) of this
section shall provide as much notice as is practicable and at that time shall
provide a brief statement to the Commissioner regarding the basis for failure to
meet the notification period.
In such situations, the mailing of the notice by
certified mail or any other method approved by the Commissioner shall be
- 2774 -
considered acceptable in the fulfillment of the employer’s obligation to give
notice to each affected employee under this subchapter.
At the time of notice
to the Commissioner, the employer shall provide the required information
under subdivisions 413(c) of this subchapter.
§ 415.
VIOLATIONS
(a)
An employer who violates subsection 413(b) or 414(b) of this
subchapter is liable to each employee who lost his or her employment for:
(1)
one day of severance pay for each day after the first day in the 45 -
day notice period required in subsection 413(b) of this subchapter, up to a
maximum of ten days severance pay; and
(2)
the continuation, not to exceed one month after an employment loss,
of existing medical or dental coverage under an employment benefit plan, if
any, necessary to cover any delay in an employee’s eligibility for obtaining
alternative coverage resulting directly from the employer’s violation of notice
requirements.
(b)
The amount of an employer’s liability under subsection (a) of this
section shall be reduced by the following:
(1)
any voluntary and unconditional payments made by the employer to
the employee that were not required to satisfy any legal obligation;
(2)
any payments by the employer to a third party or trustee, such as
premiums for health benefits or payments to a defined contribution pension
plan, on behalf of and attributable to the employee for the period of the
violation; and
(3)
any liability paid by the employer under any applicable federal law
governing notification of mass layoffs, business closings, or relocations.
(c)
If an employer proves to the satisfaction of the Commissioner that the
act
or
omission
that
violated
this
subchapter
was
in
good
faith,
the
Commissioner may reduce the amount of liability provided for in this section.
In determining the amount of such a reduction, the Commissioner shall
consider any efforts by the employer to mitigate the violation.
(d)
If, after an administrative hearing, the Commissioner determines that an
employer has
violated
any
of
the
requirements
of
this
subchapter,
the
Commissioner shall issue an order including any penalties assessed by the
Commissioner under sections 415 and 417 of this subchapter.
The employer
may appeal a decision of the Commissioner to the Superior Court within
30 days of the date of the Commissioner’s order.
§ 416.
POWERS OF THE COMMISSIONER
- 2775 -
(a)
The Commissioner may adopt rules as necessary, pursuant to 3 V.S.A.
chapter 25, to carry out this subchapter.
The rules shall include provisions that
allow the parties access to administrative hearings for any actions of the
Department under this subchapter.
(b)
In
any
investigation
or
proceeding
under
this
subchapter,
the
Commissioner has, in addition to all other powers granted by law, the authority
to subpoena and examine information of an employer necessary to determine
whether a violation of this subchapter has occurred, including to determine the
validity of any defense.
(c)
Information obtained through administration of this subchapter by the
Commissioner and the Secretary of Commerce and Community Development
shall be confidential, except that the number of layoffs, the types of jobs
affected, and work locations affected shall cease to be confidential after local
government and the affected employees have been notified.
The Department
may provide the information collected pursuant to subsection 413(c) of this
subchapter to the U.S. Department of Labor and any other governmental
entities for the purposes of securing benefits for the affected employees.
(d)
Neither the Commissioner nor any court shall have the authority to
enjoin a business closing, relocation, or mass layoff under this subchapter.
§ 417.
ADMINISTRATIVE PENALTY
An employer who fails to give notice as required by subsection 413(b) or
414(b) of this subchapter shall be subject to an administrative penalty of
$500.00 for each day that the employer was deficient in the notice to the
Department.
The Commissioner may waive the administrative penalty if the
employer:
(1)
demonstrates good cause under subsection 414(b) of this subchapter;
(2)
pays to all affected employees the amounts for which the employer
is liable under section 415 of this title within 30 days from the date the
employer enacts the business closing or mass layoff; and
(3)
pays to all affected employees any unpaid wage and compensation
owed to any laid-off worker, as required under this title.
§ 418.
OTHER RIGHTS
The rights and remedies provided to employees by this subchapter do not
infringe upon or alter any other contractual or statutory rights and remedies of
the employees.
Nothing in this section is intended to alter or diminish or
replace any federal or State regulatory mandates for a shutdown or closure of a
regulated business or entity.
- 2776 -
Sec. 3.
EFFECTIVE DATES
(a)
This section, Sec. 1, and in Sec. 2, 21 V.S.A. §§
412 (education and
outreach) and 416(a) shall take effect on passage.
(b)
Sec. 2, except for 21 V.S.A. §§
412 and 416(a), shall take effect on
January 15, 2015.
(For text see House Journal 3/19/2014 )
NOTICE CALENDAR
Favorable with Amendment
S. 281
An act relating to vision riders and a choice of providers for vision and eye
care services
Rep. Dakin of Chester,
for the Committee on
Health Care,
recommends
that the House propose to the Senate that the bill be amended by striking all
after the enacting clause and inserting in lieu thereof the following:
Sec. 1.
8 V.S.A. § 4088j is added to read:
§ 4088j.
CHOICE OF PROVIDERS FOR VISION CARE AND MEDICAL
EYE CARE SERVICES
(a)
To the extent a health insurance plan provides coverage for vision care
or medical eye care services, it shall cover those services whether provided by
a licensed
optometrist or by a licensed ophthalmologist, provided the health
care professional is acting within his or her authorized scope of practice and
participates in the plan’s network.
(b)
A
health
insurance
plan
shall
impose
no
greater
co-payment,
coinsurance, or other cost-sharing amount for services when provided by an
optometrist than for the same service when provided by an ophthalmologist.
(c)
A health insurance plan shall provide to a licensed health care
professional acting within his or her scope of practice the same level of
reimbursement or other compensation for providing vision care and medical
eye care services that are within the lawful scope of practice of the professions
of medicine, optometry, and osteopathy, regardless of whether the health care
professional is an optometrist or an ophthalmologist.
(d)(1)
A health insurer shall permit a licensed optometrist to participate in
plans or contracts providing for vision care or medical eye care to the same
extent as it does an ophthalmologist.
(2)
A health insurer shall not require a licensed optometrist or
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ophthalmologist to provide discounted materials benefits or to participate as a
provider in another medical or vision care plan or contract as a condition or
requirement for the optometrist’s or ophthalmologist’s participation as a
provider in any medical or vision care plan or contract.
(e)(1)
An agreement between a health insurer or an entity that writes vision
insurance and an optometrist or ophthalmologist for the provision of vision
services to plan members or subscribers in connection with coverage under a
stand-alone vision plan or other health insurance plan shall not require that an
optometrist or ophthalmologist provide services or materials at a fee limited or
set by the plan or insurer unless the services or materials are reimbursed as
covered services under the contract.
(2)
An optometrist or ophthalmologist shall not charge more for services
and materials that are noncovered services under a vision plan than his or her
usual and customary rate for those services and materials.
(3)
Reimbursement paid by a vision plan for covered services and
materials shall be reasonable and shall not provide nominal reimbursement in
order to claim that services and materials are covered services.
(f)
As used in this section:
(1)
―Covered
services‖
means
services
and
materials
for
which
reimbursement from a vision plan or other health insurance plan is provided by
a member’s or subscriber’s plan contract, or for which a reimbursement would
be available but for application of the
deductible, co-payment, or coinsurance
requirements under the member’s or subscriber’s health insurance plan.
(2)
―Health insurance plan‖ means any health insurance policy or health
benefit plan offered by a health insurer or a subcontractor of a health insurer,
as well as Medicaid and any other public health care assistance program
offered or administered by the State or by any subdivision or instrumentality of
the State.
The term includes vision plans but does not include policies or plans
providing coverage for a specified disease or other limited benefit coverage.
(3)
―Health insurer‖ shall have the same meaning as in 18 V.S.A.
(4)
―Materials‖ includes lenses, devices containing lenses, prisms, lens
treatments and coatings, contact lenses, and prosthetic devices to correct,
relieve, or treat defects or abnormal conditions of the human eye or its adnexa.
(5)
―Ophthalmologist‖ means a physician licensed pursuant to 26 V.S.A.
chapter 23 or an osteopathic physician licensed pursuant to 26 V.S.A. chapter
33 who has had special training in the field of ophthalmology.
(6)
―Optometrist‖ means a person licensed pursuant to 26 V.S.A.
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chapter 30.
Sec. 2.
EFFECTIVE DATE
This act shall take effect on January 1, 2015.
(Committee vote: 9-0-2 )
(For text see Senate Journal 2/28/2014 )
Favorable
J.R.S. 27
Joint resolution relating to an application of the General Assembly for
Congress to call a convention for proposing amendments to the U.S.
Constitution
Rep. Townsend of South Burlington,
for the Committee on
Government
Operations
, recommends that the bill ought to pass in concurrence.
(Committee Vote: 9-2-0)
(For text see Senate Journal March 20, 2014 )
Senate Proposal of Amendment
H. 297
An act relating to duties and functions of the Department of Public Service
The Senate proposes to the House to amend the bill by striking all after the
enacting clause and inserting in lieu thereof the following:
* * * Legislative Purpose; Intent * * *
Sec. 1.
LEGISLATIVE PURPOSE; FINDINGS
It is the intent of the General Assembly to maintain a robust and modern
telecommunications network in Vermont by making strategic investments in
improved technology for all Vermonters.
To achieve that goal, it is the
purpose of this act to upgrade the State’s telecommunications objectives and
reorganize government functions in a manner that results in more coordinated
and efficient State programs and policies, and, ultimately, produces operational
savings that may be invested in further deployment of broadband and mobile
telec