Legislative Update - Week 3

It’s good to be back at the Statehouse. Many people have asked me if this year is different from last and I say a resounding yes! Last year with new leadership in the House, Senate and Executive Branch and 30+ new legislatures a lot of time was spent bringing everyone up to speed. This year all committees are diving right into the important work we must accomplish.

This week the house passed the following:
H.593: Unanimous approval of the consumer protection bill. This legislation addresses automatic contract renewals, retainage for construction materials, credit protection for vulnerable persons and use of credit information for personal insurance.
H.554: An act relating to the regulation of dams. Purpose is to protect public safety and provide for the public good through the inventory, inspection, and evaluation of dams in the state under the Dept of Environmental Conversation.
H.568: Amendments to the Charter of the Town of Barre.
H.633: Budget Adjustment Act

It was an interesting week in the Health Care Committee. All committee chairs juggle priority setting - time to address proposed bills and issues that are time sensitive versus time to hear, think and talk more broadly about topics that inform and affect decisions across the entire system, in our case the health care system. This week was more of the later and the focus was access and affordability.

We started the week with the Department of Health discussing Vermont’s health outcomes; specifically focusing on equity and outcomes for Vermonters by subpopulation. It is important for us to remember the systems that shape daily life and the -isms they create related to categories of race, gender, ethnicity, social position, sexual orientation and disability affect our health. Conditions in which people are born, grow, work, life and age are important determinants in the health of oneself and our population. A study from 2007 shows that access to health care contributes only 10% to health outcomes. We also discussed the concept of diseases of despair and disconnection - both becoming prevalent in our society. We have to look at the interplay of all these factors, and lived experiences, to truly affect change in our health care system and the health of all Vermonters. The Department of Health, through surveys, focus groups and data collection, have created a wealth of data on this topic. All is available to the public at www.healthvermont.gov and there is a very interesting presentation on our committee website.

We had a robust conversation with our Healthcare Advocate, Mike Fisher, on affordability of our health care system. We have requested a follow up conversation to better understand the benefits cliff issues in our health care system. Two organizations providing solutions for those unable to afford health care are Pathways Vermont and the Vermont Coalition of Clinics for the Uninsured.

Pathways Vermont provided updates on their five programs: Housing First, Veteran Family Re-housing program, Soteria House, a Community Center and a confidential nonjudgmental peer-to-peer support line (833-VTTALKS). An interesting fact from their testimony is the savings their Housing First program achieves. Based on their data the cost to incarcerate someone is $158/day (remember we have many people remaining in jail because they lack housing), the cost of residential treatment is $98/day, the cost of transitional housing is $58/day and the cost for Housing First - to provide permanent housing and support resources - is $43/day. I am a strong supporter of Pathways Vermont and encourage you to check out their website.

Vermont Coalition of Clinics for the Uninsured (VCCU) is a network of 9 clinics relying on volunteers to provide no charge health and referral services to our most vulnerable Vermonters. Their testimony was a harsh reminder that in our age of health care reform there are still many Vermonters who cannot afford or have barriers to accessing health care. They are also a strong example of a piece of the system that should no longer fly under the radar but must be viewed within the whole system.

Our update on the All Payer Model and the next generation Medicaid pilot further bolstered the point of VCCU needing to no longer fly under the radar. This health care reform effort works with “covered lives” from Medicaid, Medicare and Commercial Insurance. Those served by VCCU are not considered “covered lives”. A large hole in our system.

As we know, we are not immune to the decisions being made in our Federal government. With the removal of the ACA Individual Mandate starting Jan 1, 2019 we need to understand the effects this causes to the stability of our Vermont insurance market. We started that conversation this week and expect much more conversation in the coming weeks.

Our committee also heard testimony from the Secretary of the Agency of Human Services, on their proposal to build a 925 bed campus. This proposal has generated a lot of media attention; however, it is just a proposal that will be vetted thoroughly by several committees. In summary the proposal would not add new net beds to the system other than bringing all out of state prisoners back to Vermont, would result in the closure of the men’s facility in St Albans and the women’s facility in South Burlington, and would be staffed by Vermont state employees. Stayed tuned for more information.

The Speaker of the House, Mitzi Johnson, has asked all committees to view climate change in the context of their jurisdiction. To that end we heard from Vermont Climate and Health Alliance a fairly new organization intent to show the impact of climate change on humans and animals. One interesting fact they provided is that 87 degrees is the temperature where heat related illnesses rise. Currently we have about 7 days of 87 or higher degree temperatures, but in the future we will rise to 30+ days. This will have an impact on our health care system. We will be continuing our conversation on this topic next week with testimony from the Department of Health.

This is just what occurred in the House Health Care committee. So much more happened in your Statehouse last week. You can find all testimony at www.legislature.vermont.gov

I appreciate the opportunity to serve Essex Junction and am always open to feedback, comments and conversation. Feel free to reach out at lhoughton@leg.state.vt.us or 373-0599 or through this website.