We are back in session and have hit the ground running – an indication that we will have a fast paced session this year. In the Healthcare committee, on which I serve, our most pressing issue this week was hearing testimony from the Brattleboro Retreat and Agency of Human Services.  With cash on hand of only 30-40 days and utilization of only 60% (acute care beds are close to 90-95% capacity) - the Brattleboro Retreat asked Agency of Human Services for additional funding or they may need to close, sell or downsize. Just a few days before the session started it was reported that the Secretary of the Agency of Humans Services turned down that request. The Brattleboro Retreat is not only a primary element of our mental health system and is 100% of the State’s capacity for inpatient children’s beds, but is also an economic engine in Windham County. Steps towards a productive collaborative conversation were made last week between the two parties and the legislature will continue to stay abreast of the situation. 

We reviewed the administration’s budget adjustments for the departments under our jurisdiction – Department of Vermont Health Access and Department of Mental Health. This is an annual mid-year process that starts in the House.  We review the Administration’s budget adjustments recommendations to provide House Appropriations policy feedback.  One area that stood out in this review - The Department of Mental Health has ongoing pressure in residential treatment for children.  Although many factors cause this pressure, primarily it’s due to an increase in the acuity of clinical need for children. Our committee will continue to work with DMH and other stakeholders on both children and adult needs and the system of mental health.

The Vermont’s healthcare system is considered a “merged market”.  This means individuals and small businesses are combined into one market for assessing risk and offering plans through Vermont Health Connect. This merged market includes approximately 74,000 people.  Act 63 of 2019 required the Agency of Human Services to evaluate the impact of health insurance premiums from fully separating the merged individual and small group markets and to develop a strategy for making health insurance more affordable for all Vermont residents.  Stakeholders met over the summer and fall and presented their findings to our committee. What ensured was a lively and thoughtful discussion on several proposals including fully unmerging or partially unmerging the markets. This was the first of what will be many committee discussions this year on Vermont’s health insurance structure.

In the first week no bills were voted on, but I expect that to change quickly.  Both paid family leave and minimum wage legislation moved to conference committee’s this week. Should the committee’s reach agreement on their respective legislation, both chambers then have an opportunity to vote up or down (the chambers cannot make changes to the legislation).

This past weekend in Essex - myself and a small group of planners, along with many, many volunteers with support from area organizations hosted our first annual Gather at The Table dinner.  This free event included a delicious dinner, an open gym, music, board games and the opportunity to chat with new and old neighbors.  Our intention was to gather our Essex and Westford neighbors, to connect the non-school and school communities and to enjoy an evening together.  Well over 400 people attended! We’ve already started our planning for next year.  My heart is full!
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I hope these weekly updates will remain informative.  Please reach out with questions and comment to Houghton.lori@gmail.com or 802-373-0599.  

A bill that received little attention outside of the Statehouse was signed into law today by Governor Scott.  H524 originated in the House Healthcare committee after weeks of testimony and thoughtful discussion.  It is a broad marketplace stability bill that seeks to protect Vermont's insurance exchange and to protect Vermonters from the dismantling of the affordable care act.  

In the health care world, we are often working to balance two opposing schools of thought.  One side looks for an expansion of government, and simplification of the existing system by limiting payers.  Conversely, another point of view looks to enhance competition, and subject the health care market to a fully free market system.  While the visions from each side may be worth pursuing in the long term, it is important for Vermonters to have a functioning and accessible health care system today.  This legislation looks to address the pressing concerns of today, while continuing to consider more systemic reforms to how we provide - and pay for - health care in our state.

Although this legislation covers many pieces of health care, the most important to me is the consumer protections, that are in the affordable care act, but were not in state statute.  If the affordable care act is repealed or dismantled, now, in Vermont we will have the following protections:

• Prohibit preexisting exclusions
• Imposes annual limitations on costing sharing
• Bans annual and lifetime limits on the dollar amount of essential health benefits
• Prohibits cost sharing for preventive services
• Requires major medical insurance plans to cover an insured adult child up to age 26

In my short 3 years in the legislator, the house healthcare committee has continued to battle against the threats at the federal level to dismantle the affordable care act.  H524 is a giant step forward in protecting Vermonters.  Yes, we still have a lot of work to do on cost and access.  But I will rest a little bit easier tonight knowing we have these protections.

​Well our goal was to be finished with the 2019 legislative session on May 18th.  As we all know sometimes deadlines must be pushed out.  Although only the budget and revenue bills must pass prior to adjournment there are still several priority initiatives we are hoping to finalize this week.  Below is a recap of the legislative session thus far:
 
55 bills have been passed by both the House and Senate while 26 of those bills have been enacted into law. 
 
Bills enacted into law include (but not limited to):

• H26 which restricts retail and internet sales of electronic cigarettes, liquid nicotine and tobacco paraphernalia in Vermont
• S86 increases the legal age for buying and using cigarettes, electronic cigarettes and other tobacco products from age 18 to 21.
• S49 regulates polyfluoroalkyl substances in drinking and surface waters
• H528 creates the Rural Health Services Task Force
• S68 changes Columbus Day to Indigenous Peoples’ Day
• H3 relating to ethnic and social equity studies standards for public schools

 
Bills awaiting the Governor’s action include (but not limited to):

• S169 establishes a 24 hour waiting period for the purchase of handguns and updates and provides clarity on several restrictions on the transfer and use of high capacity ammunition feeding devices. 
• H47 relating to the taxation of electronic cigarettes (was delivered to the Governor on May 17)
• S43 limiting prior authorization requirements for medication-assisted treatment
• H513 Broadband deployment (House concurred with Senate on Friday)

 
Bills yet to be resolved between House and Senate include (but not limited to):

• H542 Budget
• H541 Revenue bill
• S23 Raising the Minimum
• H107 Paid Family and Medical Leave
• H531 Child Care and Early Learning System
• S96 Clean Water Funding
• S113 Single-use Products/Plastics
• S40 Testing and remediation of lead in the drinking water of schools and child care facilities
• H511 Statute of Limitation Reform
• H533 Work Force Development

 
Fortunately this is year one of the biennium so unresolved bills will carry forth to next year. 
 
I’m happy to talk further about any of the bills listed here and those not listed.  I can always be reached at lhoughton@leg.state.vt.us or 373-0599.  June 1st is the next Essex/Westford community conversation from 8:30am to 10:00am at The Nest Café located on Main St in the Village. 
 
The time we spend in Montpelier is productive and important, but so is spending time in the community.  I look forward to adjourning this week and seeing everyone around the Village.  Please don’t ever hesitate to stop me in the street, at the grocery store or anywhere else – I’m always happy to chat.  Thank you for the continued opportunity to serve Essex Junction!

Please join us for our next community conversation June 1st from 8:30am to 10:00 am at The Nest located at 17 Main St in the Village.  We will provide a wrap up of the session (hopefully!) and answer questions.  Come early, come late – stay for 10 minutes, stay for the whole time. Hope to see you there!

As the session winds down the only must pass bill is the budget.  The budget always begins in the House, then is sent to the Senate.  The Senate passed their budget out of Appropriations Friday with floor action expected this week.  Once they pass, the House Appropriations committee will review and either concur with their amendments or recommend that the two bodies meet in a conference committee to hash out the details. 

Two of the bills we passed last week (there were 6 total) include:

S. 40 an act relating to testing and remediation of lead in the drinking water of schools and child care facilities which requires all school and childcare facilities to test for lead in the water.   As passed the bill attempts to cover the full costs of any needed remediation and replacement of fixtures with an appropriation of $3.2 million. 

S.43 an act relating to prohibiting prior authorization requirements for medication-assisted treatment which prohibits a health insurer from requiring prior authorization for a patient receiving MAT and for any counseling and behavioral therapies associated with that treatment.

The House Government Operations Committee passed out their version of the bill to tax and regulate marijuana which is quite different from the Senate passed bill.  The bill can be found at  www.legislature.vermont.gov under House Calendar dated Friday May 3rd.  Some of the changes the House made – towns will need to opt in to allow a retail establishment, 30% of tax revenue will be routed to a specific fund for prevention and concentration levels are capped.    The bill is now going to House Appropriations and House Ways and Means.  No timeline yet on when the bill will make it to the floor.

A big thank you to all who helped on GreenUp Day and to all those residents I see picking up trash as they take their walks – without it having to be GreenUp Day.  It does take a Village!

Please reach out with questions, comments or concerns.

Thank you for the continued opportunity to serve Essex Junction. 

Lori Houghton

With the end of the session just a few weeks away, I will focus our attention on three bills working their way through committees to reach the floor for a vote.  I appreciate constituent feedback and can be reached at lhoughton@leg.state.vt.us.

S169 an act relating to firearms procedures, otherwise known as the waiting period bill, currently in House Judiciary would require a 24 hour waiting period on hand gun transfers after the completion of the background check.  It would not apply to hand gun transfers that do not require a background check. The bill also makes changes to various pieces of the 2018 gun legislation related to large capacity ammunition feeding devices, shooting competitions, reporting on extreme risk protection orders and allows for, does not require, healthcare provider notification options.

S23 an act relating to increasing the minimum wage passed out of House General and will now go through the money committees.  The bill would raise the minimum wage gradually until it reaches $15 in 2024.  Thereafter, the minimum wage would increase each year by the percentage increase in the Consumer Price Index.  Unfortunately, no language was added to raise the wages for Medicaid-funded health care workers.  Over the past two years we’ve worked on this issue in the health care committee increasing funding for mental health workers, but workers at home health agencies, nursing homes and others have not seen an increase in wages.  This is an issue we need to focus on in the near term.

S54 an act relating to the regulation of cannabis.  Although a vote in the committee has not yet occurred and language is not final, the committee has added language regarding a Substance Misuse Prevention Fund.  Thirty percent of the revenues raised by the cannabis excise tax, not to exceed $6 million per fiscal year, would go to the fund for prevention education.   No decisions, as of this writing, have been made to roadside testing requirements.

Other areas of importance from last week – the House Energy and Technology committee held a public hearing on proposed bills that would ban or limit new fossil-fuel infrastructure (H.51, H.175 and H.214)  The hearing was well attended and the committee will continue to work on this issue.

The House passed S.86 which will increase the legal age for buying and using cigarettes, electronic cigarettes and other tobacco products from 18 to 21 years of age.  Passed originally in the Senate the House concurred with their language except to change the effective date to September 1, 2019.  This was the third leg of our strategy to reduce youth tobacco usage.

Please reach out with questions and comments! Thank you for the privilege to serve Essex Junction.
​
Lori Houghton
 

Please join us for our next community conversation June 1st from 8:30am to 10:00 am at The Nest located at 17 Main St in the Village.  We will provide a wrap up of the session (hopefully!) and answer questions.  Come early, come late – stay for 10 minutes, stay for the whole time. Hope to see you there!

A few of the bills we passed last week (there were 6 total) include:

H207 an act relating to approving an amendment to the charter of the City of Montpelier regarding non-citizen voting in City elections.  This approval, if passed by the Senate, will allow legal non-citizens to vote in city elections. 

S.49 a bill that regulates PFAS in drinking water and surface waters in Vermont on a vote of 135-1.  This bill establishes regulatory monitoring of drinking waters to ensure that Vermonters remain safe and manufacturers are held accountable for their waste.   On or before December 1, 2019 all public water systems in Vermont will be required to conduct monitoring for PFAS. 

S.68 which changes the name of the legal holiday from Columbus Day to Indigenous People’s Day.

This week:
We will take up on the House floor S.86 which proposes to raise the legal age for buying and using cigarettes, electronic cigarettes and other tobacco products from 18 to 21 years of age.  The goal of S.86 is to reduce tobacco use by youth and protect developing brains, uniquely vulnerable to the effects of nicotine and nicotine addiction.  The Surgeon General predicts that 10,000 Vermont youth alive today will die prematurely of tobacco-related illnesses if we fail to change course. 

In the House Health Care Committee we will continue our discussion on a bill to license ambulatory surgical centers in Vermont and hear testimony on electronic medical records.
 
As I’m sure all have heard the Senate passed out a bill to tax and regulate marijuana which is now working its way through the appropriate committees in the House.  I welcome feedback on this measure – should it pass? With certain restrictions? With specific prevention or safety measures?   Please email me at lhoughton@leg.state.vt.us.

Thank you for the continued opportunity to serve Essex Junction. 
Lori Houghton
 

Please join us for our next community conversation April 13th from 8:30am to 10:00 am at Sweet Alchemy located at 45 Upper Main St.  This is a time to talk with your Essex area representatives about issues of importance to you.  Come early, come late – stay for 10 minutes, stay for the whole time. Hope to see you there!

Last week the House passed out H107 Paid Family and Medical Leave bill on a vote of 92 – 52.  As many may know the United States is one of only two countries that does not offer a paid family medical leave insurance program that is universal.  Currently only 15% of Vermonters have access to any kind of family and medical leave insurance and some of those aren’t offered a plan that is substantial enough to take any meaningful time off.  This legislation seeks to keep Vermonters here and attract new workers, provides a level playing field for small businesses and protects our most vulnerable Vermonter. 

In its current form, H107, provides eligible employees up to 12 weeks per year for parental and bonding leave and up to 8 weeks for personal medical and family caregiving leave.  Total leave in one year cannot exceed 12 weeks.  An eligible employee is one who has earned at least $11,200 in at least 6 months of the last 4 calendar quarters.  If someone works multiple jobs, the earnings would be calculated across all employment.  The program is paid by employee contributions - employers can cover some or all of the cost.  There are many more details I can provide for anyone interested.  H107 now moves to the Senate.

The Health Care Committee, on which I serve, continues its deep dive into understanding Vermont's ACO system. For those who are not familiar with this system, ACO stands for Accountable Care Organization.  In its simplest form, ACO's are organizations of providers, usually centered around a hospital and the surrounding care practices, that agree to be collectively held accountable for the quality of care that patients ("attributed lives") receive. The intention of having ACOs is to give medical providers greater flexibility in providing treatment, and incentivize coordination of care. For example, in this model, primary care physicians are financially rewarded when their patients do not need to use the emergency room.

Vermont has a single statewide ACO, called OneCare Vermont. Whereas many ACOs in other states are linked only to Medicare, Vermont's ACO uses the "All Payer Model." This means that all the payers - Medicare, Medicaid, Blue Cross / Blue Shield, MVP - are connected to OneCare.   The idea of having an ACO is to gradually switch to a "Per Member Per Month" payment model, where provider networks are given a lump sum of money to keep their patients healthy each month, instead of having to bill for every individual service, which is the current "fee for service" system.  

The testimony we've received surrounding ACO's has raised a number of questions for our committee to continue to work through, including what oversight the state should have over OneCare Vermont, whether having an ACO will really change the quality of care received, and how the savings from the ACO compares with the administrative cost of the ACO.

Thanks for your time in reading the legislative updates.  Please don't hesitate to reach out with questions or comments.

Thank you for the continued opportunity to serve Essex Junction. 

Lori Houghton
 

The daily schedule has definitely changed.  We spent much of our week on the house floor voting on bills that passed out of committee prior to crossover.  In the healthcare committee we had two bills pass over to the Senate:  H83 Act relating to female genital cutting (FGC) and H528 The Rural Health Services Task Force.
 
Regarding H83, In 1996 Congress passed legislation prohibiting female genital cutting (FGC).  This past fall, a federal judge in the Eastern District of Michigan dismissed a case against two doctors and others who were charged with violating the statute.   The judge found that Congress overstepped its bounds by legislating to prohibit FGC because under our federal system of government, local criminal activity is for the states to regulate, not Congress.   The case is on appeal, but the District Court ruling is likely to reduce or eliminate the chances of it being used by federal prosecutors around the country, and signals that the states need to regulate FGC if they want to prohibit the act.  This is an important piece of legislation.
 
Regarding H528, rural health care systems are facing challenges all throughout the country.  More than 100 rural hospitals have closed in the US since 2010, and here in Vermont at least one critical-access hospital is facing financial crisis.  While we are concerned about the future of Vermont’s rural hospitals, we also recognize that the rural health care continuum consists of many more service providers than just hospitals.  These service providers are often interwoven into networks of care.  So H528 creates a Task Force to bring together representatives from the different components of the rural health care continuum, and would ask the members of the Task Force to think boldly about the future of this system.

A bill of importance to many in our community and the broader state is H531 - an act relating to Vermont’s child care and early learning system.  The House Human Services committee voted unanimously out of committee and is headed to the house floor this week.  The Human Services Committee views this legislation as a first step in addressing the current child care crisis in Vermont. If it becomes law, it will be part of a multi-year strategy to improve and strengthen child care laws and regulations, a priority of both the Legislature and the Administration. H. 531, does the following:

•  Invests $10.5 million in VT’s child care and learning system;
  
• Expands income eligibility for child care for low and middle-income families;
  
• Increases reimbursement rates to child care providers from 2008 levels to 2015 levels for pre-school and school age children;
• Includes a student loan repayment program and funds scholarships for early educators to further professional development;
  
• Invests in infrastructure and technology redesign of the Child Care Financial Assistance Program (CCFAP); and
•  Creates an exemption from certain educational requirements for child care  business owners and teachers who have worked in the field 10 or more years.

The goal is to create more favorable conditions for Vermont families to access affordable, high-quality child care, so parents who want or need to work can which will also provide a continuing, robust supply of experienced workers for Vermont businesses.
 
I’m excited to share two upcoming events:

Please join the Essex Democrats Open House, Saturday March 30th 6-7:30 at Brownell Library, Kolvoord Room, 6 Lincoln St Essex Junction.  Local residents are invited to learn more about the Essex Democrats, consider joining the committee, meet current members, and get up to speed on issues.  This event is free and open to the public.  Light refreshments will be served.  See the facebook event link here for more details:  https://www.facebook.com/events/2196573720606128/.

Our next community conversation will be April 13th from 8:00am to 9:30am at Sweet Alchemy located at 45 Upper Main St.  This is a time to talk with your Essex area representatives about issues of importance to you.

I look forward to hearing from residents, so please reach out with comments or questions! Thank you for the continued opportunity to serve Essex Junction!

We are now in the middle of our Town Meeting week break. Thank you to all who come out to the Town of Essex meeting on Monday night to vote on the budget – which passed. Thanks also to all who voted yesterday for Selectboard. Patrick Murray and Annie Cooper were elected to the Essex Selectboard. Congratulations to both. Thank you to Irene Wrenner for her many years of service.

The Village of Essex Junction will hold our annual meeting April 3rd at Essex High School. This is the time we vote on the municipal budget. A free community dinner begins at 6pm with the meeting beginning at 7pm.

Essex Westford School District will hold their annual meeting Monday April 8th at 7pm at the Essex High School Auditorium. Voting on the budget occurs April 9th from 7am to 7pm.

Back to the Statehouse. The House is currently working on the FY2020 budget. The House is on target to advance this budget proposal shortly after our break. The budget will be balanced – to meet the needs of Vermonters while keeping ongoing spending in check. While building the budget, the House Appropriations Committee goes deep into the numbers, hearing testimony from all state-related entities. They look at old and new initiatives to ensure they are accountable and provide value for the residents of Vermont. They question proposed reductions, as well increases, position changes, perceived program delivery hurdles, use of "one-time" money, and "vacancy savings." They seek the input from all policy committees and testimony from advocates. I'll be reporting more on the budget in coming weeks.

Two bills relating to tobacco and E-Cigarettes passed their respective chambers. In December 2018, the Surgeon General declared an epidemic regarding e-cigarette use among teens. This action was prompted by new data showing a 78-percent increase in e-cigarette use among high school students in just one year's time (2017-2018). In that same timeframe, middle school use increased by 48 percent. Teens who use e-cigarettes are four times more likely to become regular tobacco users. The Vermont House voted to pass H47, which places an excise tax on the liquids and delivery devices of e-cigarettes to discourage use among youth who are the most price-sensitive consumers. Just as we tax other tobacco products, 92 percent of the wholesale value of the e-cigarettes will be collected at the licensed distributor level and used for prevention purposes. The Senate passed S86 which increases the legal age for buying and using cigarettes, e-cigarettes and other tobacco products from 18 to 21 years of age. Both of these bills have crossed over to the other chamber for testimony and action.

Our next community conversation will be March 17th at 2:00pm at The Nest Café on Main St in the Village. This is a time to talk with your Essex area representatives about issues of importance to you.

I look forward to hearing from residents, so please reach out with comments or questions anytime through the contact section on the website or lhoughton@leg.state.VT.us.

Thank you for the continued opportunity to serve Essex Junction. 
​
Lori Houghton