The last two weeks the House has been working hard on crafting a budget as well as continuing to hear testimony on a vast array of issues. The Governor's proposed budget, although laudable in recommending additional funding for many important issues such as higher and early education, was not balanced ($50m out of balance) and would have raised property taxes. Therefore, House Appropriations is creating a budget with recommendations from all the policy committees. They also held seven public hearings around the state with more than 150 people attending. They heard strong support for trying to address the urgent needs for mental health treatment and for funding for higher education and early education, as well as support for programs like the working lands initiative. By working together we will produce a balanced budget that meets the needs of Vermonters.
Also over the past two weeks I voted in support of a package of legislation to protect victims of sexual assault. Despite significant progress in strengthening Vermont's laws against sexual assault, too many victims of sexual violence are not ensured access to justice, health care and social services. The package of legislation reinforces the State's sexual assault laws by setting forth procedures and notifications related to medical forensic examinations of sexual assault victims. The legislation also ensures victims know their rights and resources available to them by receiving a copy of these rights and resources in writing. Most importantly, it ensures that victims will receive a medical forensic examination, including any related toxicology testing, at no cost, regardless of where the crime occurred and whether they have health insurance. The legislation now moves to the Senate for consideration.
My committee, Health Care, has heard testimony on many proposed bills including H.145 an act relating to establishing a Mental Health Crisis Response Commission. The bill evolved from the Grenon Group, an ad hoc group that former Senator Jim Leddy formed following the police shooting in Burlington of his friend, Phil Grenon, a 76-year-old man undergoing a psychiatric crisis. This bill proposes to establish a commission to review fatalities and serious bodily injuries that occur during interactions between law enforcement and persons demonstrating symptoms of mental illness. This bill has broad support from the police and mental health communities.
We also continue to hear testimony from Department of Vermont Health Access and One Care regarding the Next Generation Medicaid pilot. This is the 1-year pilot testing the All-Payer model for Medicaid patients. Our committee intends to remain very close to this pilot to fully understand the successes and the challenges and how Vermont's healthcare landscape will be altered. There has been quite a bit of news about this pilot, so feel free to reach out if you have specific questions.
Week 6 of the session was active with 44 bill introductions while 2 bills passed the house. Those two bills were H.143 an act relating to automobile insurance requirements and transportation network companies and H.14 an act relating to automated external defibrillators. Many resolutions were introduced and passed including H.C.R 36 congratulating the 2016 Eagle class of Green Mountain Council Boy Scouts of which the Essex community had several young man reaching this lofty status. Congratulations to all! All bill information for both the House and Senate can be found at www.legislature.vermont.gov under bills and resolutions.
Quite a number of notable items occurred during week 6 including Governor Scott’s press conference on immigration, the agreement with One Care to test the all payer model and two public hearings regarding mental health and minimum wage.
Governor Scott had tri-partisan support during his press conference announcing legislation that would require the governor’s approval prior to state or local police conducting federal immigration enforcement work as well as prohibiting the collection of personal information for purposes of establishing a mandatory federal registry or database. Bills H228 and S79 have been introduced to address the latter. I will keep you posted on the status on all.
Later in the week Governor Scott announced a one year agreement with OneCare that will pilot the all-payer system. This pilot will pay a network of healthcare provides a lump sum to care for approximately 30,000 patients within 4 geographic areas. The goal is to pay providers based on quality of care rather than quantity of services. The house healthcare committee will begin taking testimony on this pilot during week 7.
On Tuesday, the house healthcare committee held a joint hearing with the Senate Health and Welfare Committee and heard testimony from frontline workers within Vermont’s public health system. Serious concerns were expressed about unreasonable waiting times in hospital emergency departments for patients in mental health crisis, high turnover in staff, stressful workload, and insufficient funding for salaries. Our two committees will continue hearing testimony and working on these issues throughout the biennium.
The House General, Housing & Military Affairs committee is currently hearing testimony on two minimum wage bills. Both increase minimum wage to $15, one by 2020 and the other by 2022. While I’ve been following the testimony I’m still undecided on this issue and am awaiting the fiscal report. As always, if you have comments, thoughts or concerns, I would like to hear them.
Unfortunately this week I attended funerals in Washington DC that kept me out of the Statehouse for 3 days. While I was in attendance on Tuesday, I voted yes to House Resolution 9 supporting a woman’s right to decide her own reproductive choices, commemorating the 44th anniversary of the U.S. Supreme Court’s decision in Roe v. Wade, and the 52nd anniversary of Planned Parenthood of Northern New England. Full information on the resolution and vote can be found here.
Tuesday was also Mental Health Advocacy Day at the Statehouse. We heard testimony from one family regarding their struggles for finding quality and appropriate care for their grandson. It was heart wrenching testimony and I so appreciate them coming forward to tell their story. It is just one example of the importance of the decision to move mental health under the purview of the house healthcare committee. I firmly believe one's healthcare must be viewed in totality not in individual segments.
The House voted Friday to not move school budget votes to May 23rd as suggested during Governor Scott's budget proposal. Although this effectively kills Governor Scott's education budget plans, I do believe we will continue the important conversation on how to best pay for quality education moving forward.
I was honored to be appointed by the Speaker of the House to the Vermont Information Technology Leaders board. From their website: Vermont Information Technology Leaders, Inc. is a nonprofit organization that advances health care reform efforts in Vermont through the use of health information technology, and is the legislatively designated operator of the Vermont Health Information Exchange (VHIE). The VHIE is a secure, statewide data network which gives health care providers in Vermont the ability to electronically exchange and access patient data.
As the legislative representative to the board, I will work to ensure VITL continues to improve the quality and efficiency of Vermont's healthcare system while using our state dollars judiciously and appropriately.
Week 4 of the Legislative session saw Governor Scott’s budget address and the unanimous passage (141-0) of the budget adjustment bill in the House.
The budget is crafted for each fiscal year many months in advance using projected revenues and expenses. During the fiscal year the actual revenues and expenses are tracked to determine how they are performing against projections. Since revenues fluctuate and unanticipated expenses occur, we use this mid-year system to re-align the budget with the underlying goal to always have a balanced budget at year’s end.
Separate from this budget adjustment was Governor Scott’s budget address for the next fiscal year. Much of his address focused on Education, Healthcare/Human Services and Housing/Workforce Development. In the latter he proposed a $35m housing bond to increase our housing stock while increasing funding for economic development at both the state and municipal levels. In healthcare/human services he emphasized continued focus on our opioid crisis by increasing funding to the St Albans treatment center by $1m, increasing the number of treatment providers and providing additional funding to the guardian ad litem program. Funding would come from a reduction in payments to hospitals, changes to how the state plays on Vermont Health Connect and unclear savings in the Agency of Human Services. His education proposal has since gotten the most press and included additional funding for pre-k, higher education and VT National Guard continued education. Savings to pay for this additional funding and other changes to the education fund would come by mandating school boards level fund their budget and teachers pay 20% of their healthcare benefits. He recommended a move to statewide school budget voting on May 23th to allow time from school boards to make changes to their budgets. Committees are hearing testimony on his proposals with more information to come.
In the House Healthcare Committee we continue to learn about our physical and mental health systems. With 6 new members to the committee, the addition of mental health to our jurisdiction and the complexity of these two systems, the learning curve is steep. Several healthcare related bills have been assigned to our committee. As a new member I’m interested in seeing the full process of a bill’s trajectory first hand. We also continue to watch what is happening in DC around the Affordable Care Act and the potential effects to Vermonters.