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VCDR 2018 Legislative WRAP-UP FY 2019 Budget and Policy JULY 2018

 

VCDR Legislative WRAP-UP, July 2018

 2018 Special Session – Budget Documents

http://www.leg.state.vt.us/jfo/budget_fy2019.aspx 

 Control – Left Click (Below)

 

H.16 As Passed the House and Senate June 2018
H.16 Senate Amendment – June 21 Senate Calendar June 21, 2018
H.16 Senate Amendment Tax Provisions – Sec by Sec Summary June 21, 2018
Highlights – FY2019 Budget, Income Tax, and Education June 2018
Summary – H.16 Education Finance June 21, 2018OnOne-time Summary June 15, 20e-time Summary June 15, 2018
H.16 Ed Rate Comparison to H.911 and Governor June 2018
H.16 Senate Amendment Vital Records Provisions Secs.I.1-11 June 21, 2018
H.16 – FY2019 Budget Web Report June 2018
H.16 – FY14 to FY19 House and Senate Passed 5-year Web Report

 

One-time Summary June 15, 2018

 

Legislative Highlights from Joint Fiscal:

 PROTECTING VULNERABLE VERMONTERS

  • Reverses Administration’s proposed cuts to Developmental Services Program, restores $4.3M total ($2M GF)
  • Reverses Administration’s proposed elimination of attendant care services to people with severe disabilities (e.g. quadriplegia, paraplegia, MS)
  • Provides a 2% ($1.8M total) reimbursement increase to community service providers like the visiting nurses that enable elderly or individuals with disabilities to remain in their homes and communities (includes Adult Day, Meals on Wheels, Homemaker, Respite, Companion Services, Choices for Care, Hospice, Personal Care, and Enhanced Residential Care)

 

    • Provides funding for evaluation of PFOA cleanup options for Bennington and blood draw clinics for affected residents
    • Funds strategic reform in the adjudication of Child Welfare cases to better protect children and assist families and increases judicial system resources to respond to growing child welfare workloads related to the opioid epidemic
  • Reverses Administration’s proposed cuts to Primary Care doctors and Community Health Clinics
  • Provides funding for Brattleboro Retreat to make capital improvements to add 12 Level 1 mental health beds
  • Funds Medication Assisted Treatment for inmates; improves reentry support for inmates

 

    • Provides $1M in funds for tobacco control programs with special focus on reducing smoking prevalence among pregnant women
  • Provides $200,000 for supportive housing vouchers in mental health

 

 AFFORDABILITY INITIATIVES

  •  Reverses proposed elimination of loan repayment to make it economically attractive for medical professionals to practice in VT
  • Maintains cost sharing assistance for health insurance deductibles and out of pocket costs for 6,100 working families
  • Increases child care provider reimbursement for infants and toddlers; maintains grant program to providers with high volume of subsidized children and for infant care; updates income eligibility standards to current Federal Poverty Level

ECONOMIC AND WORKFORCE DEVELOPMENT

 

  • Adds $4.3M to increase compensation to mental health clinical and direct service staff at Designated Agencies

 

    • Increases funding to the Vermont Youth Conservation Corps to serve more out-of-school youth
  • Provides $5M to fund an initiative to address the workforce shortage of mental health and substance use disorder treatment professionals

 

  • Funds tuition for National Guard members at UVM, or other public and private colleges.
  • Provides $500,000 to UVM to fund financial assistance to Vermont students pursuing health careers
  • Authorizes Treasurer to utilize $5M revolving State funds to expand weatherization and related home improvement activities

 PERSONAL INCOME AND SOCIAL SECURITY TAX RATES

  • Collapses top two income tax brackets and lowers all personal income tax rates by 0.2%
  • Creates a Vermont standard deduction equal to $6,000 for single filers and $12,000 for married couples
  • Creates a Vermont personal exemption equal to $4,150 per exemption
  • Expands the Vermont earned income tax credit from 32% of the Federal EITC to 36%

 

    • Creates a 5% tax credit for the total amount of charitable contributions up to $20,000 – $20k contributions = $1,000 tax credit
  • Exempts taxable social security benefits from State income taxes for single filers with less than $45,000 in adjusted gross income and married filers with less than $60,000 in adjusted gross income. Phases out the exemption over the next $10,000 in income.

 

  

EDUCATION FUNDING PROVISIONS

Dedicates $20.4M One-Time GF to the EF for FY19 (this is in addition to the $9.8M already dedicated for reserves in FY18)

Sets education tax rates for FY2019:

FY2018 FY2019

    • Average homestead tax rate $1.500 $1.500
    • Average tax rate on household income 2.55% 2.49%
    • Uniform nonresidential tax rate $1.535 $1.580
    • Reduces the property tax adjustment (PTA):
  • Lowers the maximum house site value for a full PTA from $500,000 to $400,000
  • Lowers the maximum house site value limit for a partial PTA from $250,000 to $225,000

 

  • Requires separate presentation of education and municipal property tax bills beginning in FY2020
  • Separates the homeowner rebate into its education and municipal property tax components beginning in FY2020
  • Modifies the reporting dates for JFO’s Tax Increment Financing report
  • Establishes statewide bargaining for school employees’ health care contract excluding vision and dental and reconstitutes the VEHI Board
  • Repeals the GF transfer to the EF in a revenue neutral way:
  • Dedicates to the EF: 100% of Sales & Use Tax and 25% of Rooms & Meals Tax
  • Transfers to the GF: Adult Education, Flexible Pathways, Community High School of VT, and the Renter Rebate
  • Establishes a commission to study student/staff ratios

  

Bills Vetoed by the Governor:   https://legislature.vermont.gov/bill/vetoed/2018

Of Note:

Paid Family Leave

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/H-0196/H-0196%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf  Passed House and Senate – Vetoed by Governor

Minimum Wage Increase

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/S-0040/S-0040%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf  Passed House and Senate – Vetoed by Governor

LEGISLATION PASSED

 Act No. 172 (H.608). An act relating to creating an Older Vermonters Act working group

This act creates an Older Vermonters Act working group to develop recommendations for an Older Vermonters Act that aligns with the federal Older Americans Act, the Vermont State Plan on Aging, and the Choices for Care Program. The working group’s recommendations are due to the legislative committees of jurisdiction by December 1, 2019. Effective Date: July 1, 2018

 Act No. 173 (H.897). Special Education Funding – An act relating to enhancing the effectiveness, availability, and equity of services provided to students who require additional support

This act changes the State funding model for special education for all supervisory unions in fiscal year 2021, for school year 2020-2021, from a reimbursement model to a census-based model. It also (1) creates an advisory group to assist the State Board of Education in developing its rules to implement these statutory changes and to advise the General Assembly of any statutory changes it determines are necessary or advisable to meet the goals of the act; (2) requires the Agency of Education to conduct a study of weighting factors used to determine education property tax rates and to consider whether the census grant amount should be increased for supervisory unions that have, in any year, relatively higher costs in supporting students who require additional support; (3) requires the Agency of Education, for the 2018–2019, 2019–2020, and 2020–2021 school years, to assist supervisory unions to expand and improve their delivery of services to students who require additional supports; and (4) creates three new positions within the Agency of Education to support special education services.

This act provides the State Board of Education with further tools to deal with an approved independent school’s lack of financial capacity and requires approved independent schools that accept public tuition to enroll students on individualized education programs if placed by the local education agency (which in Vermont is the supervisory union). This enrollment requirement does not apply to an independent school that limits enrollment to students who are on an individualized education program or a plan under Section 504 of the Rehabilitation Act of 1973. Multiple effective dates, beginning on May 25, 2018

 Act No. 207 (S.280). An act relating to the Advisory Council on Child Poverty and Strengthening Families

This act establishes the Advisory Council on Child Poverty Strengthening Families for the purpose of examining structural issues in Vermont that lead to families living in poverty and prevent families from moving out of poverty. The Advisory Council is composed of 15 members, including six legislators. The act requires the Advisory Council to submit annually to the General Assembly its compilation of meeting minutes and recommendations for legislative action. The Advisory Council ceases to exist on July 1, 2028. VCDR Representative added to this Council.

This act also extends the sunset date of the Joint Legislative Child Protection Oversight Committee to June 1, 2022 and updates the charge of that Committee.

Effective Date: May 30, 2018

 Act No. 109 (H.673). An act relating to miscellaneous amendments to the Reach Up program

This act makes four changes to Vermont’s Reach Up program. First, in determining eligibility for the Reach Up program, it excludes the equity value of an operable motor vehicle for any child of driving age who needs a vehicle to attend school or work. Second, it removes the requirement that a Reach Up program director or designee conduct 18- and 36-month reviews with participating families. Third, it amends the work requirements for participating families to better align with federal work requirements. Fourth, the act expands the education deferment up to 18 months for participants over 20 years of age who are engaged in 15 hours of classes a week related to attaining a high school diploma, GED, or completion of a literacy program.

Effective Date: July 1, 201

Act No. 188 (H.907). An act relating to improving rental housing safety

 

This act adopts provisions relating to rental housing safety, including creating a rental housing advisory board; improving effectiveness of local health officers; enabling rental housing safety inspection reports; creating a database of rental housing units; and creating an accelerated weatherization and housing improvement program.

Multiple effective dates, beginning on May 28, 2018

Act No. 189 (H.919). An act relating to workforce development

This act adopts multiple provisions relating to workforce development, including: creating a stakeholder alignment, coordination, and engagement process; adopting provisions relating to career pathways, Career Technical Education programs, adult training programs, and workforce training; creating the Vermont Returnship Program; adopting provisions to grow the workforce and increase participation in it; and adopting provisions relating to data collection and monitoring of programs. Effective Date: July 1, 2018

Act No. 204 (S.261). An act relating to ensuring a coordinated public health approach to addressing childhood adversity and promoting resilience

This act aims to build upon 2017 Acts and Resolves No. 43 to better coordinate services throughout the State that address childhood adversity and toxic stress and build resiliency. It establishes a Director of Trauma Prevention and Resilience Development within the Office of the Secretary of Human Services for the purpose of directing and coordinating systemic approaches across State government that build childhood resiliency and mitigate toxic stress by implementing a public health approach. In addition to the Director’s other responsibilities, he or she is responsible for submitting a status update to the General Assembly on the response plan required pursuant to 2017 Acts and Resolves No. 43, Sec. 4. This act amends some of the reporting requirements in the response plan.

The act adds a principle to the Blueprint for Health, which suggests that providers assess trauma and toxic stress to ensure the whole needs of the person are addressed and opportunities to build resilience and community supports are maximized. It further amends the criteria required to certify an accountable care organization to operate in the State to include the provision of connections and incentives to existing community services for preventing and addressing the impact of childhood adversity.

The act also requires the Agency of Human Services, in collaboration with Vermont Care Partners, to identify opportunities to streamline and better coordinate the provision of services provided pursuant to 1988 Acts and Resolves No. 264. Effective Date: July 1, 2018

 Act No. 88 (S.19). An act relating to allowing silver-level nonqualified health benefit plans to be offered outside the Vermont Health Benefit Exchange

This act allows health insurers to offer silver-level nonqualified health benefit plans outside the Vermont Health Benefit Exchange in the event that federal cost-sharing reduction payments to insurers are suspended or discontinued. These “reflective” silver plans must be similar to, but contain at least one variation from, silver-level qualified health benefit plans offered through the Exchange. Reflective silver plans do not include funding to offset the loss of the federal cost-sharing reduction payments. Effective Date: February 20, 201

Act No. 91 (H.150). An act relating to parole eligibility

This act amends the eligibility standard for an inmate’s release on parole or furlough for a medical condition from a “debilitating” medical condition to a “serious” medical condition. This act also requires that in order for an inmate to be eligible for release on parole for a serious medical condition, an inmate must authorize release of his or her personal health information. In addition, the act defines a serious medical condition as a condition that is not caused by noncompliance with a medical treatment plan. Effective Date: July 1, 2018

Act No. 104 (H.271). An act relating to administration of the Supplemental Nutrition Assistance Program

This act requires the Department for Children and Families to report to the Chairs of the House Committee on Human Services and the Senate Committee on Health and Welfare within 30 days after a substantive change to the federal law governing the Supplemental Nutrition Assistance Program (SNAP) that restricts or improves eligibility; increases or reduces barriers or creates or eliminates hardships to access; or inhibits or increases benefit usage. The act further requires the Department to provide the Chairs with an analysis of any anticipated administrative costs to the Department and impacts to SNAP applicants and participants as a result of the change within 90 days. Effective Date: July 1, 2018

 Act No. 114 (S.164). An act relating to establishing the Unused Prescription Drug Repository Program

This act directs the Agency of Human Services, in consultation with the Board of Pharmacy, the Board of Medical Practice, and other interested stakeholders, to evaluate the feasibility of implementing an unused prescription drug repository program to accept and dispense donated prescription drugs and supplies to Vermont residents who meet specified eligibility standards.

Effective Date: May 1, 2018

Act No. 116 (S.282). An act relating to health care providers participating in Vermont’s Medicaid program

This act requires that, by July 1, 2019, the Department of Vermont Health Access (DVHA) must be completing the screening and enrollment process for an applicant to be a Medicaid participating provider within 60 days after receiving the provider’s completed application. If DVHA will be unable to meet the 60-day time frame requirement by July 1, 2019, the Commissioner of DVHA must convene a meeting of interested stakeholders by February 1, 2019 to provide them with an update on the status of DVHA’s screening and enrollment efforts. The act also requires DVHA to consult with Medicaid participating providers to identify their main concerns about the Medicaid program and its administration. It directs DVHA to consult with the Attorney General’s Office in evaluating its implementation of State and federal Medicaid fraud and abuse provisions and to assess the feasibility of creating an exception to recoupment in some instances. DVHA must convene a meeting of interested stakeholders by December 15, 2018 to provide them with a summary of DVHA’s responses to provider concerns and of DVHA’s findings regarding the potential for changes to the Medicaid fraud and abuse statutes and for creating exceptions to recoupment.

Effective Date: May 1, 2018

Act No. 124 (H.914). An act relating to reporting requirements for the second year of the Vermont Medicaid Next Generation ACO Pilot Project

This act requires the Department of Vermont Health Access to provide written updates to the legislative committees of jurisdiction, the Green Mountain Care Board, the Medicaid and Exchange Advisory Committee, and the Office of the Health Care Advocate by June 15, September 15, and December 15, 2018 on implementation of the Vermont Medicaid Next Generation ACO Pilot Project and to testify on the Pilot Project at meetings of the Health Reform Oversight Committee during 2018. The act requires the Green Mountain Care Board to provide written updates to the same recipients by the same dates on the Board’s progress in meeting benchmarks for implementing the All-Payer Model and the Board’s regulation of accountable care organizations.

Effective Date: May 10, 2018

Act No. 125 (H.921). An act relating to nursing home oversight

This act creates the Nursing Home Oversight Working Group to examine the oversight of nursing homes in Vermont, including their financial stability and licensing criteria. The Working Group must report to the General Assembly by January 15, 2019 with its findings and any recommendations for legislative action. The act eliminates a requirement to obtain a certificate of need from the Green Mountain Care Board for the transfer of ownership of a nursing home. It directs the Secretary of Human Services to develop a process by which the Agency of Human Services will accept and review applications for transfers of nursing home ownership in lieu of the certificate of need process. It allows applicants who filed a letter of intent or application for a certificate of need with the Green Mountain Care Board for transfer of nursing home ownership on or before July 1, 2018 to choose to use the Agency of Human Services’ process instead of continuing with the certificate of need process.

Multiple effective dates, beginning on May 10, 2018

Act No. 131 (H.892). An act relating to regulation of short-term, limited-duration health insurance coverage and association health plans

This act defines association health insurance plans and directs the Commissioner of Financial Regulation to adopt rules regulating association health plans to protect Vermont consumers and promote the stability of Vermont’s health insurance markets. It defines short-term, limited-duration health insurance as health insurance with an expiration date that is three months or less after the original effective date of the policy or contract. It specifies that a short-term, limited duration health insurance policy or contract is nonrenewable and that an insurer cannot issue a short-term, limited duration health insurance policy or contract to any person if it would result in the person being covered by short-term, limited-duration health insurance for more than three months in any 12-month period. The act requires prominent disclosures in short-term, limited duration health insurance policies, contracts, and application materials about the scope of the coverage, including the types of benefits and consumer protections that are and are not included. It also directs the Commissioner of Financial Regulation to adopt rules regarding short-term, limited duration health insurance, including requirements to file rates, forms, and advertising materials with the Department for the Commissioner’s approval.

Effective Date: May 16, 2018.

[The full text of Act 132 is not yet available but it will be posted to the Legislative Council website when it is available.]

Act No. 133 (S.175). An act relating to the wholesale importation of prescription drugs into Vermont

This act directs the Agency of Human Services, in consultation with interested stakeholders and appropriate federal officials, to design a program for wholesale importation of prescription drugs into Vermont from Canada that complies with federal requirements. The proposed design must be submitted to the General Assembly by January 1, 2019, and the Agency must apply to the federal government by July 1, 2019 for certification of the program. The program cannot be implemented until the General Assembly enacts legislation establishing a charge per prescription or another method of financial support for the program. The Agency must begin implementing the program upon the last to occur of the General Assembly enacting a method of financial support and receipt of federal certification and approval, with program operations commencing within six months after implementation begins. The Agency must report annually to the legislative committees of jurisdiction regarding operation of the program during the previous calendar year. The act specifies that the Agency is required to design the program only to the extent that funds are appropriated for that purpose in the 2019 budget act or are otherwise made available. Effective Date: July 1, 2018

 Act No. 141 (H.639). An act relating to eliminating cost-sharing for certain breast imaging services

This act requires health insurance coverage for screening by ultrasound without cost-sharing requirements for patients whose screening mammograms were inconclusive or who have dense breast tissue, or both. It also directs the Department of Financial Regulation to issue a bulletin by October 1, 2018 providing clarification to health insurers regarding the coding structure for screening mammograms and ultrasounds and for call-back screenings, including clarifying that call-back mammograms and ultrasounds for patients whose screening mammograms were inconclusive or who have dense breast tissue, or both, must be covered without cost-sharing. Multiple effective dates, beginning on May 21, 2018

Act No. 147 (H.727). An act relating to the admissibility of a child’s hearsay statements in a proceeding before the Human Services Board

This act creates an exemption to the hearsay rule with respect to statements made by a child 12 years of age or under who is alleged to have been abused or neglected and provides that such a child shall not be required to testify or give evidence at any hearing before the Human Services Board regarding a substantiation proceeding. Evidence shall be admissible if the time, content, and circumstances of the statements provide substantial indicia of trustworthiness. The exemption applies to statements made by a child who is at least 13 years of age and under 16 years of age who is alleged to have been abused or neglected in either of the following circumstances: 1) The hearing officer determines, based on a preponderance of the evidence, that requiring the child to testify will present a substantial risk of trauma to the child. 2) The hearing officer determines that the child is physically unavailable to testify or the Department has made diligent efforts to locate the child and was unsuccessful. Effective Date: July 1, 2018

 Act No. 153 (H.874). An act relating to inmate access to prescription drugs

This act amends the process for providing inmates access to prescription drugs after admission to a correctional facility as follows:

Sec. 1 requires that an inmate be screened for substance abuse disorders, including opioid use disorders, within 24 hours after admission to a correctional facility. Sec. 1 also requires that, at the time of admission to a correctional facility, an inmate who is under the care of certain community-based medical professionals and is taking medication, including medication prescribed in the course of medicated-assisted treatment, be entitled to continue use of the medication. In addition, Sec. 1 provides a process for the Department of Corrections to make exceptions for continuing to provide inmates access to medications that were prescribed prior to admission to a correctional facility.

Sec. 1a amends 18 V.S.A. § 4750 to include a definition for “medication-assisted treatment.”

Sec. 2 requires the Department of Corrections to collect certain information on the use of prescription drugs by inmates in a correctional facility. After consultation with the Prisoners’ Rights Office, the Department is required to report its findings to the House Committee on Corrections and Institutions and the Senate Committee on Institutions by January 31, 2019.

Multiple effective dates, beginning on May 21, 2018

Act No. 159 (S.225). An act relating to pilot programs for coverage by commercial health insurers of costs associated with medication-assisted treatment

This act directs the Commissioner of Vermont Health Access to develop pilot programs that engage one or more health insurers in contributing to the funding of licensed alcohol and drug counselors and other medical professionals who serve individuals receiving medication-assisted treatment within Vermont’s spoke practices. By January 15, 2019, the Commissioner shall deliver a report to the General Assembly regarding the design and construction of the pilot programs and any recommendations for legislative action. Effective Date: July 1, 2018

 Act No. 167 (H.912). An act relating to the regulatory duties of the Green Mountain Care Board

This act revises the scope of the Health Resource Allocation Plan to focus it on the identification of Vermont’s critical health needs, goods, services, and resources. The act directs the Green Mountain Care Board (GMCB) to use the revised Health Resource Allocation Plan to inform its regulatory processes, cost containment and statewide quality of care efforts, health care payment and delivery system reform initiatives, and any allocation of health care resources in the State. The act updates and revises requirements for the GMCB to develop an annual expenditure analysis and an estimate of future health care spending needs. It updates and modifies certain elements of the certificate of need (CON) process for new health care projects, including:

Increasing certain monetary thresholds that trigger a CON requirement

  • Requiring a hospital to get a CON before offering any home health service, as was already required for non-hospitals
  • Allowing the GMCB to adjust the monetary thresholds that trigger a CON requirement periodically by up to the rate of inflation and eliminating a rulemaking requirement
  • Excluding from a CON requirement the routine replacement of nonmedical equipment and fixtures
  • Modifying the criteria that the GMCB uses in deciding whether to grant a CON
  • Making changes to the expedited review process and creating a presumption of expedited review for certain projects
  • Replacing a requirement that public notice of an application be published in newspapers with a requirement that notice be provided on the GMCB’s website
  • Increasing the maximum penalty amounts for entities that violate the CON laws
  • The act specifies that the GMCB can delegate to its members, officers, and employees any service within the GMCB’s jurisdiction except final decisions in regulatory matters. It requires the GMCB to review and release annually an advisory opinion on any all-inclusive population-based payment arrangement between the Department of Vermont Health Access and an accountable care organization for the following calendar year. The act modifies requirements for annual Medicaid budget estimates and revises the billback formula by which the GMCB assesses regulated entities for costs associated with their regulation. It also directs the Agency of Human Services to convene a working group to make recommendations on the regulation of freestanding health care facilities, including ambulatory surgical centers, freestanding birth centers, urgent care clinics, and retail health clinics, and on the role of these facilities in a coordinated and cohesive health care delivery system. The working group’s recommendations are due to the legislative committees of jurisdiction by February 1, 2019. Multiple effective dates, beginning on May 22, 2018

 

Act No. 176 (S.166). Corrections; health care

An act relating to the provision of medication-assisted treatment for inmates

This act authorizes State correctional facilities to continue medication-assisted treatment to those inmates who enter a facility while undergoing medication-assisted treatment and for whom the continuation of medication-assisted treatment is deemed medically necessary. It further authorizes State correctional facilities to facilitate the commencement of medication-assisted treatment using buprenorphine among inmates for whom medication-assisted treatment is medically necessary and who were not receiving medication-assisted treatment on their entry into a facility. An inmate receiving buprenorphine may transfer to methadone if it is deemed medically necessary by a provider authorized to prescribe methadone and the inmate elects to commence methadone. An inmate may continue to receive medication-assisted treatment as long as medically necessary. Discontinuance of medication-assisted treatment, or any medication, by a licensed practitioner requires the practitioner to enter the reason for discontinuation in an inmate’s medical record. An inmate must receive a specific explanation of the decision to discontinue a medication along with notice of the right to have his or her community-based prescriber notified of the decision.

The act authorizes the Departments of Corrections and of Health to enter into a memorandum of understanding with opioid treatment programs throughout the State in which a State correctional facility is located for the purpose of providing medication-assisted treatment to those inmates for whom a licensed practitioner has determined such treatment is medically necessary.

By January 15, 2022, the Department of Corrections must present to the House Committee on Corrections and Institutions and to the Senate Committee on Institutions an evaluation of the effectiveness of the medication-assisted treatment program facilitated by correctional facilities. Effective Date:July 1, 2018

Act No. 182 (H.696). Health; health insurance; individual mandate

An act relating to establishing a State individual mandate

This act establishes an individual mandate for Vermont residents to maintain minimum essential health insurance coverage beginning on January 1, 2020. It expresses legislative intent to enforce the individual mandate through a financial penalty or other enforcement mechanism to be enacted by the General Assembly during the 2019 legislative session. It creates the Individual Mandate Working Group to develop recommendations regarding administration and enforcement of the individual mandate, with the recommendations due to the legislative committees of jurisdiction by November 1, 2018. The act also requires the Department of Vermont Health Access and others to engage in outreach and education efforts before and during the open enrollment periods for health insurance coverage for the 2019 and 2020 plan years regarding the importance of health insurance coverage and Vermonters’ responsibilities under the individual mandate. Multiple effective dates, beginning on May 28, 2018

Act No. 190 (H.923). Appropriations and finance; bonding; capital construction; budget adjustment; State buildings

An act relating to capital construction and State bonding budget adjustment

  • $100,000 to the Agency of Transportation in fiscal year 2019 for the Downtown Transportation Fund pilot project
  • $4,000,000 to the Department of Public Safety for the School Safety and Security Grant Program in fiscal year 2019
  • $400,000 to the Department of Labor for the Adult Career and Technical Education Equipment Grant Pilot Program in fiscal year 2019 to provide equipment to support adult tech programs
  • Corrections
  • Directs the Department of Buildings and General Services to construct a therapeutic environment, including three beds at the Chittenden County Regional Correctional Facility and ten or more beds in the Alpha unit at the Northwest State Correctional Facility, for persons under the custody of the Department of Corrections who do not meet
  • the clinical criteria for inpatient hospitalization but would benefit from therapeutic placement
  • Amends the procedure for appointing legislative members to the State Council on Adult Offender Supervision ..
  • May not expend any funds for the Brattleboro Retreat renovations until the Commissioner and the Secretary of Human Services notifies the Commissioner of Finance and Management, the House Committees on Corrections and Institutions and on Health Care, and the Senate Committees on Health and Welfare and on Institutions that an agreement has been executed between the State and the Brattleboro Retreat …

Human Services

  • Restricts the use of funds appropriated to the Brattleboro Restricts to capital renovations and fit-up costs and prohibits any funds from being used for periodic lease payments, usage fees, or other operation expenses
  • Requires that the State execute an agreement with the Brattleboro Retreat, which shall include certain provisions:
  • the Brattleboro Retreat must provide a minimum of an additional 12 level-1 beds to the State for a period of time determined by the Secretary to be in the best interest of the State,
  • a targeted completion date for the renovation and fit-up project of December 2019; and
  • terms and conditions that ensures the protection of State investment of capital appropriations.
  • Authorizes the State Treasurer to approve the agreement prior to execution to ensure it is in compliance with applicable tax-exempt bond requirements.
  •  Labor
  • Establishes, under the direction of the Department of Labor, the Adult Career and Technical Education Equipment Grant Pilot Program for the delivery of occupational training for students enrolled in a postsecondary course offered by Vermont’s career and technical education centers

 Act No. 193 (S.92). Health; prescription drugs; pharmacists; health insurers; pharmacy benefit managers

An act relating to prescription drug price transparency and cost containment

This act directs a pharmacist who receives a patient’s prescription for a biological product to dispense to the patient the lowest-price interchangeable biological product, if one exists, and to notify the prescriber about the specific biological product dispensed. It requires health insurance plans to apply the same cost-sharing requirements to interchangeable biological products as apply to generic drugs under the plan. It also requires health insurers to report certain information to the Green Mountain Care Board about their plans’ spending on prescription drugs and the effect of prescription drug costs on the premiums for their plans.

The act expands the provisions of Vermont’s prescription drug transparency law to require the Department of Vermont Health Access and health insurers with more than 5,000 covered lives in Vermont to create lists of 10 prescription drugs for which the payer’s net cost has increased by 50 percent or more over the past five years or 15 percent or more over the past calendar year. Of the drugs listed by the Department and the insurers, the Office of the Attorney General will identify 15 drugs for which the drugs’ manufacturers must provide a justification for the price increase or increases. Each manufacturer must also provide a separate version of its justification that will be made public.

The act requires prescription drug manufacturers to notify the Office of the Attorney General if they are introducing a new, high-cost prescription drug to the market. It prohibits pharmacy benefit managers from prohibiting or penalizing a pharmacy or pharmacist for providing information to an insured about the insured’s cost-sharing amount for a prescription drug, disclosing to an insured the cash price of a prescription drug, or selling a lower-cost drug to an insured if one is available. The act also creates a working group to look at prescription drug pricing throughout the supply chain to identify opportunities for savings and for increasing price transparency.

Multiple effective dates, beginning on May 30, 2018

Act No. 200 (S.203). Health; mental health

An act relating to systemic improvements of the mental health system

This act makes numerous miscellaneous changes to the State’s mental health laws, including several provisions related to mental health parity and evolving plans to increase inpatient capacity. It expresses legislative intent to increase the number of inpatient psychiatric beds in a manner that ensures clinical best practice, support the development of UVM Health Network’s proposal to expand capacity at the Central Vermont Medical Center campus, and replace the temporary secure residential recovery facility with a permanent facility. The act requires the Secretary of Human Services to provide regular updates to the Health Reform Oversight Committee pertaining to the status of proposed renovations at the Brattleboro Retreat and the UVM Health Network’s proposal.

The act waives the certificate of need requirements for the implementation of renovations at the Brattleboro Retreat as authorized in the fiscal year 2019 capital budget adjustment bill to ensure the renovations will not be considered a “new health care project.” Similarly, it waives the conceptual development phase certificate of need for the UVM Health Network’s proposal to expand capacity at the Central Vermont Medical Center campus if certain criteria are met.

The act establishes an Order of Non-Hospitalization Study Committee for the purposes of improving patient care and possibly proposing a pilot project to redress any existing weaknesses and build upon existing strengths related to this judicial proceeding.

The act specifies that if the Department of Disabilities, Aging, and Independent Living were to amend its secure residential recovery facility rules to allow the use of emergency involuntary procedures, the rules adopted must be identical to the rules adopted by the Department of Mental Health that govern the use of emergency involuntary procedures in inpatient psychiatric units.

By January 15, 2019, the act requires that the Secretary of Human Services submit a report to the General Assembly on the secure transport of patients by sheriffs’ departments, particularly with regard to contract provisions required by 2017 Acts and Resolves No. 85, Sec. E.314 (transporting patients). By the same date, the Secretary shall present a proposal, in collaboration with the Green Mountain Care Board and designated and specialized service agencies, for providing the designated and specialized service agency budgets to the Board for informational purposes for its work on health care system costs. The act requires the Commissioner of Mental Health to collect data from hospitals in the State that have either an inpatient psychiatric unit or emergency department receiving patients with psychiatric health needs and to report those findings to the General Assembly annually between 2019 and 2021. The act amends the reporting requirements of 2017 Acts and Resolves No. 82, Sec. 3(c). The act requires the Secretary to submit a series of reports pertaining to the State’s response to the Centers for Medicare and Medicaid Services’ requirement to begin reducing federal Medicaid spending at “institutions for mental disease.”

The remaining provisions of the act require the inclusion of mental health parity at various stages of decision making, including as part of the criteria for accountable care organizations, as part of each hospital’s strategic planning process, and as part of the certificate of need application process.

Effective Date: July 1, 2018

Act No. 201 (S.234). Judiciary; human services; juvenile delinquency; youthful offender

An act relating to adjudicating all teenagers in the Family Division, except those charged with a serious violent felony

  • This act:
  • Creates a new section of law, providing for automatic expungement of criminal history records of qualifying crimes for people who were 18-21 years old at the time they committed the offense, as long as certain criteria are met.
  • Requires courts to keep a special index of expunged cases and limits inspection of an expunged record to the person who is the subject of the expunged record.
  • Charges the Department for Children and Families (DCF) as the designated agency for supervising preparation and administration of the State plan for the Juvenile Justice and Delinquency Prevention Act.
  • Requires the State’s Attorney to consider the results of the risk and needs screening in determining whether to file a charge in a juvenile delinquency or youthful offender proceeding, with the presumption that low-to-moderate risk offenders will be referred to diversion.
  • Provides that a person placed at Woodside Juvenile Rehabilitation Center can continue to receive treatment past his or her 18th birthday if he or she meets certain criteria.
  • Requires DCF and others to report to the General Assembly on the plan for expanding juvenile delinquency and youthful offender status to encompass 18- and 19-year-olds, and requires the Joint Legislative Justice Oversight and Child Protection Oversight Committees to issue findings as to whether key milestones have been met and whether appropriate funding exists for the expansion.
  • Expands jurisdiction of the Family Division to 18- and 19-year-olds over the next four years.
  • Appropriates funding to DCF for the purpose of the expansion of services to 18- and 19-year-olds.
  •  Multiple effective dates, beginning on May 30, 2018

Act No. 210 (S.262). Health; Medicaid; Department of Vermont Health Access; Vermont Health Benefit Exchange; provider taxes; Human Services Board –

An act relating to miscellaneous changes to the Medicaid program and the Department of Vermont Health Access

This act makes several changes concerning Vermont’s Medicaid program, the duties of the Department of Vermont Health Access (DVHA), health care provider taxes, bronze-level qualified health benefit plans offered through the Vermont Health Benefit Exchange, and other programs and entities. It extends certain timelines relating to provider tax redeterminations and changes from March 31 to June 1 the date by which ambulance agencies must remit their provider tax annually to DVHA. It requires financial institutions, when requested by the DVHA Commissioner, to provide DVHA with financial information regarding any person or a person’s spouse who is applying for or is receiving assistance or benefits from DVHA, and specifies that the financial institution will not be subject to criminal or civil liability for doing so.

The act requires the application for certain Medicaid programs to contain a form of authorization executed by the applicant or beneficiary giving DVHA the authority to obtain financial information about the applicant’s or beneficiary’s assets. It directs State governmental officials and agencies, when requested by the DVHA Commissioner, to provide DVHA with information regarding any aid given or money paid to any person or a person’s spouse who is applying for or receiving assistance or benefits from DVHA. The act requires the Commissioner of Taxes, when requested by the DVHA Commissioner, to compare information provided by applicants for or recipients of assistance with State income tax returns and report his or her findings to the DVHA Commissioner. It also requires each unit of the Superior Court to provide the DVHA Commissioner monthly with a list of all new estates opened during the previous month.

The act eliminates a requirement that DVHA apply by March 1, 2019 for a federal waiver of the cost-sharing limitations or actuarial value limitations, or both, for bronze-level qualified health plans offered through the Vermont Health Benefit Exchange. It allows one or more bronze plans that do not meet Vermont’s out-of-pocket prescription drug limit to be offered annually through the Vermont Health Benefit Exchange as long as there will be at least two bronze plans that include the out-of-pocket prescription drug limit, and the Green Mountain Care Board finds that offering plans without the limit will not adversely impact the plan options for consumers with high prescription drug needs who benefit from the limit.

The act specifies that for expedited Medicaid fair hearings, the Human Services Board must delegate both its fact-finding and final decision-making authority to a hearing officer, whose written findings and order will constitute the Board’s decision and order. It narrows the circumstances under which the Secretary of Human Services may reverse a decision of the Human Services Board and requires beneficiaries appealing Medicaid covered service decisions to exhaust DVHA’s internal appeals process before filing a request for a fair hearing with the Human Services Board. The act directs the Agency of Human Services to adopt rules establishing a process by which the Agency will ensure that a Medicaid beneficiary who files a request for a fair hearing with the Human Services Board before exhausting DVHA’s internal appeals process will receive consideration as if the beneficiary had properly filed an internal appeal with DVHA and will receive assistance in filing a timely request for a fair hearing with the Human Services Board if the internal appeal 2018 results in an adverse determination. The act also modifies the membership of the legislative Health Reform Oversight Committee by removing the Chair of the Senate Committee on Economic Development, Housing and General Affairs as a member and adding instead one member of the Senate appointed by the Committee on Committees.

Multiple effective dates, beginning retroactively to January 1, 2018

 

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Vermont Coalition for Disability Rights Legislative UPDATE

Special Session – May 23

The Vermont 2017-2019 Legislative Session has ended, with     overwhelming support for the budget and tax bills, but the Governor has indicated he will Veto the above bills along with a number of others.

He has called for a special session this week beginning on Wednesday May 23rd to deal with the vetoes and new legislation. It is expected that the Republicans will be able to sustain the Governor’s Vetoes.

Legislative leaders called back to the special session have indicated they will meet as a whole on Wednesday, but plan on coming back next week after committees of jurisdiction work on changes to legislation that must be passed before July first of this year.

As you can read in some of the articles below the Governor wants to use the additional revenues (“one time”) to eliminate any increase in property taxes that local voters authorized when passing their school budgets. The Budget bill passed uses those funds to pay down existing debt in teacher’s retirement and reduce property taxes.

The Budget passed does restore some of the most harmful cuts to disabilities and other human services that the Governor originally proposed.

The Governor already vetoed S.40 Minimum Wage increase, and H.196 Paid Family Leave.

Below are a number of news articles about the legislature, links to the Budget documents and excerpts, and some selected bills passed by the House and Senate

It generally takes a number of weeks after the session for legislative council to review and summarize all of the legislation past. With the special session and new legislation coming forth it could be a few more weeks before final results get posted.

VCDR will continue to publish any updates and a final report when available.

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Scott whips out veto pen before special session

By Elizabeth Hewitt   May 22 2018

https://vtdigger.org/2018/05/22/scott-whips-veto-pen-special-session/

UPDATED: Senate leader says no negotiations with Scott behind closed doors By Xander Landen    May 16 2018, 10:46 PM

https://vtdigger.org/2018/05/16/senate-leader-says-no-negotiations-scott-behind-closed-doors/

Scott to call lawmakers back for special session May 23

By Xander Landen    May 15 2018

https://vtdigger.org/2018/05/15/scott-call-lawmakers-back-special-session-next-week/

Vermont Legislature passes tax rate hike despite veto threat, goes home April McCullum, Burlington  Free Press ET May 14, 2018 https://www.burlingtonfreepress.com/story/news/politics/government/2018/05/14/vt-legislature-leaves-montpelier-despite-tax-standoff/606770002/

Senate Pro-Tem Letter to Governor                                                                                               https://www.documentcloud.org/documents/4464248-Sen-Tim-Ashe-Letter-to-Governor-Scott.html#document/p1

Budget Passes – Governor will veto

https://www.sevendaysvt.com/OffMessage/archives/2018/05/13/walters-team-scott-achieves-a-talking-point

https://vtdigger.org/2018/05/13/analysis-lawmakers-leave-without-deal-taxes-budget/

Final tax bill proposes low property tax increases – VTDigger

https://vtdigger.org/2018/05/12/final-tax-bill-proposes-low-property-tax-increases/

 

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BUDGET DOCUMENTS:

FY 2019 Budget Web Report: http://www.leg.state.vt.us/jfo/webreports/webreports/Web/FY2019%20Big%20Bill%20Web%20Report%205-12-2018%2012_56_26%20PM.html#id3400001000

Committee of Conference Report (Budget as Passed): http://www.leg.state.vt.us/jfo/appropriations/fy_2019/H__924_-_Committee_of_Conference_Report_Official_Signed_Copy.pdf

FY 2019 Committee of Conference Budget Highlights: http://www.leg.state.vt.us/jfo/appropriations/fy_2019/H_924_COC_Highlight_Floor_Handout.pdf

FY 2019 One-Time Budget Expenditures from FY 2018 surplus & Tobacco Settlement:  

http://www.leg.state.vt.us/jfo/appropriations/fy_2019/H.924%20General%20Fund%20-%202018%20One-time%20Appropriations.pdf

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Selected Human Services Sections:

Sec. B.300 AHS Secretary’s Office: Removed Gov’s $500k for dental and home visits, restores $71k proposed reduction to legal aid and 110k to Health Care Advocate

Sec. B.301 Secretary’s office – global commitment: Added $2m state match for MH DA increase for direct care staff pay increases, 2,328,068 federal match.

Sec. B.307 Department of Vermont health access – Medicaid program – global commitment:      No change from the Senate that added 565,670, This funding combined with $1.6m in restored PCCM funding is directed to FQHC and physician base primary care rates and payments

Sec. B.311 Health – administration and support: Agreed to a $170k state and $170k federal increase for clinics for the uninsured

Sec. B.312 Health – public health: Maintains $170k increase for clinics for the uninsured, Federal and state match moved to Sec.B. 311

Sec. B.314 Mental health – mental health: Conference Committee agreed to $200k GF increase for Supportive Housing, provided $4.32m for DA to increase pay for direct care staff, did not fund the warm line, did not fund  discretionary new Rutland supportive housing new program.

Sec. B.318 DCF Child Development: No change from Senate that added $295,000 Federal funds Increase to reflect available federal funding and maintained subsidy levels consistent with FPL level.

Sec. B. 325 Office of Economic Opportunity: Increase $35k for Individual Development Accounts in Base (Matched savings). Micro-Business Development Program “one time” increase of $100k.(C.105.1)

 Sec. B.330 DAIL Advocacy and Independent Living Grants: Conference Committee agreed to $8,484 GF for a %2 meals on wheels increase, 40,925 for a 2% adult day rehab increase, and restores the state funded Personally Directed Attendant Care (PDAC) program for non- Medicaid eligible persons as proposed by Gov.

Sec. B.333 DAIL Developmental Services: Conference Committee agreed to restore $4,328,067 to fund existing developmental services, and fully funds the caseload increase for developmental services ($2m-GF).

Sec. C.105.1 Fiscal Year 2018 One-time Transfers and Appropriations from Tobacco Litigation Settlement: Conference Committee appropriated $100k for Micro-Business Development Program, $1m for to be used for renovation and fit up at the Brattleboro Retreat to provide a minimum of 12 beds, including level 1 beds, and $500k to UVM. Conference Committee appropriated $100k for DCF to analyze how Vermont’s families make early care and education arrangements and $100k for AOE to conduct a Pre-K study.

Sec. C.106 Substance Use Disorder: Conference Committee appropriated $7m in one time funds to support systematic changes to how CHINS proceedings are conducted.

Sec. C.106.1 Substance Use Disorder Response Fund Working Group: Changed to “Expanding workforce for substance use disorder treatment and mental health professionals”

Sec. C.106.2 Substance Use Disorder Response Initiatives: Conference Committee appropriated $2.5m for one time or self-sustaining substance use disorder initiatives relating to prevention, intervention, harm reduction, treatment, and recovery as determined by AHS.

Sec. E300.2 Funding for the office of the health care advocate: Funded the Health Care Advocate at $1,457,406.

Sec. E.323 Reach up; ratable reduction report

Sec. E.324 Expedited crisis fuel assistance

Sec. E.324.1 LIHEAP and weatherization

Sec. E.325.1 Individual development savings program

Sec. E.326 DCF OEO weatherization assistance

Sec. E.330 Personal Directed Attendant Care Services: Charged AHS with continuing the PDAC program for FY19

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

TOP TEN BILLS PASSED THIS YEAR, per vtdigger https://vtdigger.org/2018/05/15/top-10-bills-approved-vermont-legislature-2018/

 

SUMMARY of BILLS PASSED THIS YEAR, from VPR http://digital.vpr.net/post/5-minute-wrapup-what-got-done-during-5-month-long-legislative-session?mc_cid=fb4b9e6560&mc_eid=b0c46436d5#stream/0

 

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Bills of Interest as passed by the House and the Senate

 

H.897 An act relating to enhancing the effectiveness, availability, and equity of services provided to students who require additional support

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/H-0897/H-0897%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf

H.911 An act relating to changes in Vermont’s personal income tax and education financing system – As passed by House and Senate

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/H-0911/H-0911%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf

Summary of Changes H.911:

https://legislature.vermont.gov/assets/Documents/2018/WorkGroups/Senate%20Finance/Bills/H.911/H.911~Peter%20Griffin~Summary~4-30-2018.pdf

 

 

H.911 Tax Changes and Education funding

Working well into Saturday evening, the House and Senate finalized versions of the tax and budget bills.

The Legislature used $9.8 million in surplus tax receipts to fill the education fund reserve and raised property tax rates. They rejected Scott’s plan to use $58 million of one-time money to buy down the rates and carry forward deficit spending in the education fund.

Instead, they approved a 2.5 cent hike in residential property tax rates and a 5 cent hike in non-residential rates. This represents a last-minute compromise reached by a conference committee. The House had originally proposed an income tax surcharge and the Senate had proposed higher property tax increases to cover the gap.

The property tax hikes face an all but certain veto from the governor, who opposes increases to property tax rates.

(S.229 Independent Schools – Incorporated into H.911)

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/S-0229/S-0229%20As%20Passed%20by%20the%20Senate%20Unofficial.pdf

 

S.40 Minimum wage – As passed by House and Senate

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/S-0040/S-0040%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf

The Legislature passed the minimum wage bill, S.40 last week. The bill would gradually raise Vermont’s minimum wage from $10.50 an hour to $15 an hour by 2024. Proponents have said that increased wages will boost Vermont’s economy as workers will spend more money at local businesses and send more tax dollars back to the state’s coffers.

Opponents of the bill, including Gov. Phil Scott, say if the higher wage becomes law, workers will lose jobs as businesses look to shed employees with higher salaries. The governor has said he will veto the bill when it comes to his desk. The bill passed by a narrow margin in the House; a number of Democrats joined Republicans in opposing the minimum wage hike.

 

  1. 196 Paid family leave – As passed by House and Senate

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/H-0196/H-0196%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf

The House gave final approval to the paid family leave bill on Friday, but a veto from the governor is expected. H.196 relies on a new payroll tax to enable Vermont workers to take up to 12 weeks of paid parental and family leave, with a cap on six weeks of family leave per year.

Employees would pay a 0.136 percent payroll tax for a parental and family leave insurance program. Workers who take the benefit would receive 70 percent of their income during the leave period.

Supporters of the bill say that paid family leave will reduce stress for families and attract young people to Vermont who want to start families. The bill has faced opposition from Republicans and some Democrats, who say working Vermonters cannot afford to pay a tax for a program they may not use. Scott, who opposes any new taxes, has vowed to veto the legislation.

 

S.203 An act relating to systemic improvements of the mental health system

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/S-0203/S-0203%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf

 

H.912 An act relating to the health care regulatory duties of the Green Mountain Care Board

https://legislature.vermont.gov/assets/Documents/2018/Docs/BILLS/H-0912/H-0912%20As%20Passed%20by%20Both%20House%20and%20Senate%20Unofficial.pdf

 

 

 

Submitted by Karen Lafayette kmlafayette@aol.com