​This week the House Healthcare committee voted out to important bills on prescription drugs that if implemented will ultimately lower some prescription drug prices and heard testimony on the recently announced plan by the UVMMC network to expand mental health care.
 
 S.175, An act relating to the wholesale importation of prescription drugs into Vermont, shall have the Agency of Human Services, in consultation with interested stakeholders and appropriate federal officials to design a wholesale prescription drug importation program, including requirements of safety and cost. The program would designate a state agency to become or contract with a licensed drug wholesaler to import prescription drugs at a significant cost savings to Vermonters.  AHS shall submit the proposed design for the program by Jan. 1, 2019.    The bill directs the state to seek the appropriate federal waivers and if obtained, the state will begin operating the program within six months of the approval.  Our committee took testimony from our federal delegation who are all in full support of our efforts and are willing to help. 
 
S. 92, An act relating to interchangeable biological products, allows VT to substitute biosimilars, a generic type of biological products, which would ultimately reduce the price of these drugs to consumers.  A biological product means such things as a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component derivative applicable to the prevention, treatment or cure of a disease or condition in human beings.  When a pharmacist receives a prescription for a biological product, the pharmacist shall select the lowest priced interchangeable biological product. A health insurance or benefit plan shall apply the same cost-sharing requirements to interchangeable biological products as apply to generic drugs.
 
The bill also has a section on Prescription Drug Cost Transparency, which strengthens a 2016 statute. The bill would require the Department of Health Access to identify annually up to 10 prescription drugs on which the state spends significant health care dollars.  Commercial insurers shall also create a list annually of prescription drugs on which its insurance plans spend significant amounts of their premium dollars, net of rebates and price concessions. The lists will be given to the state Attorney General’s office, which will require the manufacturer to provide a justification for each drug’s increase. The lists will be posted on the Green Mountain Care Board and AG’s website. 
 
The bill will also gauge the impact of drug costs on health insurance premiums by requiring insurers with more than 1,000 covered lives to report to the Green Mountain Care Board the 25 most frequently prescribed drugs and the average wholesale price for each; the 25 most costly drugs by total plan spending and the average wholesale cost of each; and the 25 drugs with the highest year-over-year price increases and average wholesale price for each. 
 
S.92 also eliminates the so-called “Gag Rule” that prohibits or penalizes a pharmacist for disclosing to a patient the cash price for a prescription drug or selling a lower cost drug to the patient if one is available. The pharmacist would be allowed to provide information to a patient regarding the cost-sharing amount for the drug.  Remember when ordering a prescription drug you may ask your pharmacists if there is a lower price available for the drug. 
                                                
The Health Care Committee joined the Institutions and Corrections committee to listen to an early proposal by UVMMC to add secure residential beds for mental illness at the Central Vermont Hospital, which is part of UVMMC network. The proposal would allow additional inpatient beds that would help address the problem with patients being held for long times in hospital emergency departments around the state. This proposal would also free the beds at the VT Psychiatric Hospital that would be used to as a secure residential facility, thereby eliminating the problem of relocating or adding beds in Middlesex.  This proposal is in it’s infancy and will take 3-4 years to implement so will not address our immediate problems.  However, it is an exciting opportunity when looking long term and with our state’s desire to bring parity to mental health and health care in that it locates the beds for mental health in a hospital setting. 
 
S175 and S92 will be on the House floor this week for a vote.  Should they pass both would go back to the Senate.
 
Any questions on these bills or anything else, please reach out. 
 
Thank you,
Lori
 
 

​Over the last few weeks the focus has been on gun violence prevention legislation.  However, in conversations many ask “what else are we doing about school safety and about mental health”.
School Safety - The House unanimously approved H923.  This annual bill appropriates funds to infrastructure improvement projects across the state.  This year the bill provides $4m for School Safety and Security Grants with an additional $1m in federal funds.  Schools may apply for grants to implement safety measures such as intercom systems, window coverings, door looks, etc. The Governor convened a group to perform security assessments of all schools. Once that report is delivered and the Capital Budget is signed into law, schools will be able to apply for a grant.

Mental Health - The general fund budget passed by the House allocated funds to provide community outreach counselors to assist people seeking emergency services in communities (including Essex); provide additional funds to make the Pathways peer warm line available 24/7; and provide funding for additional housing and associated supported services in the Rutland County area.  All programs have shown a significant ability to divert people from emergency services to provide the right care within the community.  The Capital Budget invests in additional beds for those needing a therapeutic setting but don’t require a hospital level of care.  These actions will have the combined effects of keeping individuals out of the ERs and improve the flow of patients between different types of facilities due to more available beds.  These investments continue our commitment to increase resources to provide the right care at the right time for all those suffering a mental health illness.

I want to be clear though,  I firmly believe gun violence and mental health are two distinct issues.  Less than 4% of gun violence is connected to a mental health illness.  There is a difference between someone suffering an illness such as bi-polar, schizophrenia, or severe and persistent depression and someone who is socially isolated, angry or resentful and chooses to act out with violence.  As a society, we need to appropriately discuss, provide resources and craft effective policy for each population – as the needs and resources for one are most likely not the same in the other.  

Recently Representative Giambatista, Dunn and I held a discussion on early childhood trauma and the long lasting effects toxic stress (i.e. poverty, abuse or neglect, exposure to violence, parental substance abuse) can have on an individual.   EWSD held a school safety community conversation.  I hope these types of conversations continue.  We need to continue learning together.

Please feel free to reach out lhoughton@leg.state.vt.us or www.lorihoughton.com.  Thank you for the opportunity to serve Essex Junction.

​Democracy was in action this week with 3 significant bills passing the House and 1 given preliminary approval with a final vote on Tuesday. 
 
As I’m sure most have heard, the House gave preliminary approval Friday to a suite of gun safety measures (S55) including; 1) a ban on bump stocks, 2) a ban on magazine that has a capacity of more than 10 rounds of ammunition, 3) age restriction on purchasing a gun to 21 unless a hunter safety course was taken, 4) expanded background checks, and 5) the sale of seized and abandoned firearms.  We expect amendments on Tuesday prior to a final vote.  I voted yes for S55.  I feel strongly that this law is not taking guns away from law abiding citizens, but may just save a life.  Once we move through final passage of the bill, I will provide a detailed explanation of my vote for each section.
 
As we talk about gun safety legislation, there is a sentiment by many that we aren’t doing anything else to make our schools and communities safer.  That is not accurate, it’s just that the gun safety legislation is at this time getting the attention.  Through the budget we have provided additional resources to programs helping those having a mental health crisis.  The Capital Budget, that we are voting on this week, as it’s written now has $5m allocated for school safety grants.  A group appointed by Governor Scott has been assessing, since March, all of our schools to determine what operational and structural changes may be needed to ensure the schools are safe communities.  We expect a report in late April.  I don’t expect our efforts to stop with these actions.  In next weeks blog I will provide more information on these initiatives. 
 
The House passed a balanced budget of $5.8 billion.  The all state funds grew only 1.2%; a rate that is one third of the F2018 forecasted gross state product and almost half the Governor’s growth rate target of 2.36%. Reserves are filled to their statutory levels. Commitments to sound financial planning were kept—one-time money was not spent for on-going needs, avoiding holes in future budgets. This budget addresses the needs of Vermonters and provides for the core services of State Government. It is a budget that helps families and communities thrive with investments in economic development, higher education, in preventing substance use disorders, and in reducing the ravages of mental illness.  It fully funds development disability services and protects attendant care services for severely disabled individuals.  House bill 924.
 
The House unanimously passed a bill (H897) fundamentally changing the way we pay for and provide special education services.  The legislation changes the funding model from a reimbursement model to a census-based model, which provides more flexibility in how funding can be used, is aligned with the State’s policy priorities of serving students who require additional support across the general and special education service-delivery system, and simplifies administration.
 
The House also passed H911.   The bill collapses the top two income tax brackets and lowers all personal income tax rates by 0.2%.  It creates a Vermont standard deduction, personal exemption, expands the Vermont earned income tax credit and 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.  The bill also creates a School Income Tax Surcharge which will be used to reduce average residential homestead rates.   There was a lot of good in this bill – changing our income tax structure to move away from the federal system so as things change at the federal level we aren’t tied so closely, as well as, the exemption of taxing social security benefits.  However, I didn’t agree with the changes to the education financing portion.  Specifically I felt that we were merely shifting pots of money while creating a school income tax surcharge.  Although with this particular bill we would  reduce property taxes approximately 10% (while adding an income surcharge), going forward our legislative body would now have two available tax sources to raise to fund schools.  I also didn’t feel there was cost containment in the bill.  This bill still as a long way to go, through the Senate, to conference committee then to the Governor’s desk.  He has indicated he will veto the bill as is due to this income tax surcharge.  I’m hopeful we will find a path forward to ensure at least the income tax and social security benefit changes can be implemented, but hopefully also with changes to the education financing system I can support.
 
We are doing a lot of work and providing all the details is difficult in one blog posting.  I’m always happy to answer any questions, so please reach out lhoughton@leg.state.vt.us or 373-0599.  Thank you for the continued opportunity to serve Essex Junction.

I was honored to be asked to speak at the Essex High School student led walk out.  A powerful morning seeing hundreds of students filling the bleachers and hearing 7 others speak from their heart.  Our students are making change happen!  

Below are my remarks,

Thank you to each of you out here today.  Because of each of you and your actions I know my 9 year old son will have a brighter, safer future. Thank you!

I was asked to speak to how youth not of voting age can make change?

I say you can do a lot and you already are:  today you are showing our leaders that not only are you willing to stand up for what you think is right – you can make change happen.    You are moving us forward!

What else can you do if you can’t yet vote? Reach out to those who can.  I may have been elected by residents of Essex Junction that are able to vote, but I represent all residents of Essex Junction – all ages.  Same goes for Representative Giambatista, your six Chittenden County Senators and your federal delegation – Senator Leahy, Senator Sanders and Representative Welch.  I know some of you don’t live in Essex Junction – find out who your representative is and contact them.  Our job is to listen to the wants and needs of our constituents than craft policy.  I haven’t heard from a single one of you on what you want and what you feel will make you  safer in your schools and community.  You need to reach out – call, email, text, write, knock on my door – do it!

In Vermont 17-year olds can vote in the primary election provided they turn 18 before the general election.  This year that means if you will be 18 on or before the General Election on Nov 6th you can vote in the primary election Tuesday Aug 14.  So some of you 17 year olds can vote this year.  I have two challenges for everyone that votes:

1. Vote in every election you can.  For president, governor, federal delegation, local representatives and senators, for your town leadership, for your school board representative.  They all matter – these are people who will be shaping your communities.  We just had a vote to fill a Town Selectboard seat – the seat was won by 18 votes – 18.  Every vote does count.
2. My second challenge – research the candidates – it doesn’t take long.  Know their issues, their values - do they align with yours.  Contact them, have a conversation.  Please don’t vote blindly.

So your thinking – well I can’t yet vote, so what can I do? 

Educate yourself – how does government work? What is the process for a bill to become a law? Democracy is messy and it’s definitely not easy but it’s our system and one can be more effective navigating the system when they understood the system.  Come to the statehouse (Dylan and I would be happy to help make that happen), take a government class, talk to elected members of our community.

Understand the issue - Spend time reading and listening to reputable publications. Seek out differing opinions.  You may learn something that strikes a chord with you, a viewpoint you never thought of.  Find the experts.  Follow legislation.  Right now there are several gun safety bills moving through the statehouse – find out what they are, read them and let your representative know how you feel about them.  But safety is not just a gun issue – what else as a community do we need to address – is it more counselors, reform of school discipline, anti-bullying, something no one else has thought of?   You all have grown up in the digital age – you know you can find anything online – be careful of what you believe as fact, but use it to understand all you can.

Learn the art of conversation – put down your phone, look the person in the eyes - ask questions, listen and respond respectfully and honestly.   I read recently, “Conversations, as they tend to play out in person, are messy—full of pauses and interruptions and topic changes and assorted awkwardness. But the messiness is what allows for true exchange.”  This is so true – don’t shy away from it.  Yesterday I read an article about kids from Chicago being invited to meet with kids from Parkland, FL.  Two groups that couldn’t be more different – one that deals with gun violence daily and one that was one of the safest places to live.  Economically, racially diverse kids – but they talked. I’m sure their conversations were messing and full of awkwardness – but they talked.  You can do it here - Engage someone who has a different opinion than yours, engage someone you’ve never talked with, engage the new person in school, engage the one sitting by themselves at lunch.  Policy change by itself doesn’t often achieve the long lasting outcome we seek for complex problems.  A cultural shift is needed for change to truly take hold and it all starts with conversation.

Lead by action – Anyone can talk or complain, action shows you are committed to a cause.  For instance, April 2nd the school district is holding a safety forum – if this is an issue important to you – come - engage.  Write or call your representative, create a petition for an issue that is really important to you.  Become active in local organizations that have a mission that speaks to you.  Have an idea but don’t know where to begin?  Ask around – you can always reach out to me.  Action leads to progress and change.
And one of the most important - Know yourself - Self-discovery continues throughout our lives but you are all in the thick of it now.  Pay attention to your heart, to what is important to you, to what values you hold dear. They might be different than what is important to your friends or even your parents.  That’s okay.  Be true to yourself and commit to those actions and issues that are important to you. 

Remember the future is yours – INSIST ON IT!
​
NEVERAGAIN. 

Thank you

In last week’s legislative update I provided the House healthcare committee’s recommendation to Appropriations on the Governor’s Healthcare FY2019 budget.  This week we came back to the discussion on the Governor’s FY2019 Department of Mental Health Budget. 

The department was advised to level fund their budget.  Specific to our jurisdiction are any recommendations specific to the mental health system - only two items were included this year.
 
One, the department recommended a general fund increase of $400,000 to place outreach workers as an extension of crisis services at designated agencies in the following communities: 4 towns in Chittenden County (including Essex), Rutland, Barre/Montpelier and Brattleboro.  These communities were targeted for these resources due to the high use of emergency departments for homelessness and general use assistance with mental health concerns.   According to testimony, the Chittenden County communities met together over the summer to create a strategic plan on how to best serve the needs of those in their communities.  They advocated with the Department of Mental Health for the addition of outreach workers.  The other communities were approached by the Department with the idea to hire additional outreach works; however, at this time the non-Chittenden County communities haven't created a plan for their use.

Two, the department recommended $1.5m for three months of operating costs for a yet to be built 12 bed forensics unit.  This unit would provide hospital level of care for those being referred for a competency and/or sanity evaluation that requires inpatient care; those who have been found incompetent to stand trial or not-guilty by reason of insanity; and inmates/detainees whose psychiatric needs reach inpatient level of care.  Providing these 12 beds for this cohort of people the Department of Mental Health, and other stake holders, believe the overall bed capacity for mental health patients will increase ensuring a higher level of care for all.  The capital budget for building this facility is under review by the House Institutions and Corrections committee.  At this time we do not believe the facility would be ready for use until 2020.

On the same day our committee is debating these two items, Governor Scott releases a letter to the legislative body outlining his list of recommendations for “maintaining the safest, healthiest and strongest communities and schools.”  This was in direct response to the horrific event in Florida and the arrest of the young man in Fairhaven, VT.    I applaud the Governor for releasing these recommendations and for his courage to change is stance on gun violence prevention.  However, I am also really discouraged by the wide chasm between his statement in his letter and the mental health system budget recommendations.  In this letter he advocates to “restore the foundation of the mental health system”.  Specifically he says “we do not currently have the capacity to meet the needs of those requiring inpatient mental health services.  To help meet this need, the Legislature should support our funding request for additional mental health outreach workers as well as funding for mental health treatment facilities”. 

I want to be clear – we have a mental health crisis separate and distinct from gun safety issues. 

Unfortunately, it is not just the capacity to meet the needs of those requiring inpatient mental health services that is causing a persistent crisis in our mental health system.  We need to attract qualified therapists, fill over 400 open positions within the designated agencies, pay employees of the designated agencies to reduce turnover, increase funding to complete the 24/7 peer support line, increase community  and school services, increase housing with supportive services and much more.  We need to ensure we are diverting a crisis going to an emergency department so the person in need is receiving the care they need, when they need it and in the best place to receive it.  At the same time we need a support system in place upon discharge from an inpatient stay.

Last year we passed Act 82 requiring the Secretary of Human Services to work in collaboration with the Commissioner of Mental Health, the Green Mountain Care Board, providers and persons affected by current services to produce an analysis and action plan for the General Assembly by December 15th, 2017.  Some of the areas of focus were to include:

• Specify steps to develop a common, long-term vision of how integrated, recovery and resiliency oriented services shall become part of a comprehensive and holistic health care system
• Identify causes underlying increased referrals and self-referrals for emergency services
• Identify gaps in services that affect the ability of individuals to access emergency psychiatric care
• Determine whether appropriate types of care are being made available as services in Vermont, including intensive and other outpatient services and services for transition age youths
• Identify the resources necessary to attract and retain qualified staff to meet identified outcomes required by designated and specialized service agencies

The agency and others worked diligently over the summer to analyze our system and provided reports on almost all the sections in the Act.  We need all parties to dig into these reports and suggest meaningful budget and legislative changes to our mental health system that will provide high quality care for all Vermonters, finally integrate mental and physical health and “restore the foundation of our mental health system”.  We need the administration and legislative body to step up to this challenge, now.

This was a busy week on the house floor with many thoughtful debates on important legislation. Below are a few of the bills and you can find all bills passed HERE.

H.294 - Prevents employers from asking about an applicant’s salary history while still allowing an employer to inquire about a prospective employee’s salary expectations and providing information about the wages, benefits, compensation or salary offered in relation to the position.  This is an important way to help close the pay gap in Vermont. Women in Vermont are paid 84 cents for every dollar paid to men, amounting to an annual wage gap of $7,787. The practice of having to disclose ones current salary only reinforces the pay gap by gender or race in our state. By eliminating this step, we can help level the playing field. The bill passed 137-0. I of course voted yes.

H.624 - Prohibits a public agency from knowingly disclosing any information pertaining to a registered voter that is maintained in the statewide voter checklist. When President Trump announced a Commission on Voter Fraud and asked for voters personal information Vermonters were outraged and wanted to protect their personal data. The outpouring of contacts to the Secretary of State’s Office from Vermonters was by far the greatest for any issue seen since Secretary Condos has taken office. Virtually every contact was asking that their individual data not to be shared, or that VT not comply with the Presidential Commission on Election Integrity’s request for the voter checklist data. It's important we
have protections in place for Vermonters’ sensitive and personal data contained in the statewide voter checklist and this bill provides that protection. The bill passed 94-37. I voted yes.

H.673- An Act Relating to miscellaneous amendments to the Reach Up Program restores consistency between overlapping state and federal rules with the overarching theme being to invigorate workforce development efforts and improve efficiency and effectiveness of our state agencies.  Reach Up helps eligible parents to gain job skills and find work so they can support their minor, dependent children. Besides the alignment of
rules our changes create more flexibility. For example, right now a single parent household can only have one vehicle and doesn't take into account an older child that can drive. It also adds completion of a literacy program as a qualifier for benefits. This bill passed with a voice vote and I voted yes.

H.764-An Act Relating to data brokers and consumer protection seeks to protect Vermont consumers through requiring companies trading in their personal information to register in Vermont and comply with data security standards. The highlights of the bill includes removing the fees for consumers to place AND lift security freezes with credit reporting agencies. Currently those fees are set in statute at $10 to place a security freeze and $5 to lift one. The bill also prohibits the unlawful acquisition of personally identifiable information and prohibits the use of personally identifiable information to commit unlawful acts; requires “data brokers” who buy and license or sell consumer data to register with the
Secretary of State as to whether or not they have an opt out process or a “credentialing” process on their customers; requires “data brokers” to report annually on the breaches of personal information they experienced, and the number of Vermonters exposed; and requires “data brokers” to institute and follow minimum data security processes, borrowed largely from Massachusetts statute. The bill passed 92-46. I did not vote on
this bill as I work for LexisNexis which is defined as a data broker under this legislation.

While not on the floor our House Healthcare Committee continued hearing testimony on the Governor’s proposed budget and made our final recommendation to the Appropriations committee. We could not support proposed cuts that would reduce access to affordable health care services for vulnerable Vermonters. At this time of uncertainty and change in the State and federal health care systems, it is critically important to support affordability, access to primary care services, the Office of the Health Care Advocate, and the core functions of the Green Mountain Care Board. We also recommended that $170,000 of State funds be appropriated to the Vermont Coalition of Clinics for the Uninsured. This money leveraged with federal dollars will enable these nine clinics to continue providing essential health care to uninsured and underinsured Vermonters without imposing charges or fees. The number of patients they serve annually has more than doubled over 10 years, but they have not received any increases to their annual funding allotments during that time. Our full budget recommendation can be found Here.

The next step in the budget process is for the Appropriations committee to review all policy committee recommendations to create a final budget to be presented to the full House for a vote.

Questions about the budget or any legislation, please join Representative Giambatista and I at our community conversation on Monday February 19th from 6:30 pm to 8:00pm at the Essex Senior Center, 2 Lincoln St. Can’t make it, feel free to reach out directly 802-373-0599.

It’s an honor to serve our community!

​It was an interesting week in the legislature:  from the Governor’s Budget Address, to the Health Care Access public meeting, to the passage of the House Transportation Committee’s Highway Safety Bill and finally to the “Brain. Science. Addiction. Lets Talk!” community conversation.  
 
The Highway Safety Transportation bill passed by a voice vote of 133-7.  Highlights of the bill include: creates civil violations for license suspensions that may be imposed prior to any criminal proceedings for persons under 21 including establishing minimum penalties for using portable electronic devices; enhances penalties for driving under the influence with minors in the car; and establishes primary seat belt legislation.   Primary seat belt legislation means police may pull someone over for not wearing their seat belt, even if that is their only violation.  In the last four years Vermont highway fatalities have risen steadily from 44 to 69.  Last year 52% of fatalities were unbelted.  Current Vermont seatbelt use hovers around 85%.  With this legislation we expect the percentage to increase by at least 5% based on other states data.  Based on Vermont statistics this could save 3 to 4 additional lives and 15 serious injuries each year moving forward.  Millions of dollars in medical costs, life insurance premiums, disability payments and lost wages could be avoided, not to mention the physical and mental stress placed on those injured and the family and friends around them.  We do know that racial profiling occurs with traffic stops and this caused many legislators to pause on their vote.  In Vermont we have Fair and Impartial Policing policies - police must track the race of everyone stopped.  That information is made public and reviewed by several committees of jurisdiction.  We need to ensure state and local police are eliminating racial profiling while protecting the lives of all Vermonters.
 
The House and Senate Health Care committees heard testimony from 51 witnesses Tuesday night at a joint public hearing on access to health care. The call from more than 400 people who attended, primarily from the Vermont Workers Center, was for implementing Act 48 with universal health care, with some witnesses urging universal primary care as a next step. Witnesses shared stories of healthcare hardships from being underinsured or not being able to afford premiums. Many people put off going to doctors until there is an emergency.  This hearing was a reminder that what we do is not theoretical- Vermonters lives are at stake.
 
The Governor’s budget address Tuesday proposed total spending for next year at $3.86m which is an increase of $82m reached without raising any new taxes or fees.  Just a few of his proposals include:  phased in elimination of income tax on social security benefits for low and moderate income seniors, $3.2m to attract people to Vermont by targeting those most likely to live here, $400k to a ThinkVT innovation fund to help small business expand and  $625k in incentives to help renovate and upgrade existing housing stock.  What is not discussed in the budget address is what programs are proposed to be reduced or eliminated to afford these new or expanded programs.  For instance Agency of Human Services has proposed $16m in reduced spending. We need to understand what programs are impacted and whether Vermonters will be better off.  All committees of jurisdiction have begun diving into the details with an expected final budget by mid-March.
 
Lastly, a highlight of my week was the conversation Brain. Science. Addiction. Let’s Talk!  Parents and community members came together to discuss substance use disease.  We learned how science in the brain both impact and are impacted by substances.   I had two big takeaways – youth will seek out risky behavior whether it’s rock climbing or substances.  We need to keep our youth engaged in activities that fulfill that need.  Also studies show the later you start using substances the less likely one will develop a substance use disease.  This correlates directly with the development of the brain.   We also heard about the 8th grade curriculum on substances, Howard Center’s First Step and statistics of use in our schools and prevention tips.   I look forward to finding a way to continue this important conversation.
 
Please don’t hesitate to reach out with questions or comments: lhoughton@leg.state.vt.us or 373-0599.  Thank you for the opportunity to serve Essex Junction!
 

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.

This piece was printed in the Essex Reporter as part of a Q&A to all 4 Essex Town/Village legislators.

1. Is there a piece of legislation Essex residents, in particular, should keep their eye on? Why?
 
Unfortunately we have a lot of priority issues that I recommend Essex residents pay attention to.  In healthcare our first priority is to understand and mitigate the effects of President Trump’s decision to eliminate the subsidy reimbursements to insurance companies.  By law insurance companies must continue to provide the subsidies, so insurance companies will be seeking a method to recoup the costs – most likely insurance hikes in the future.  We need to lessen these effects to all Vermonters.
 
We have also begun reviewing the many studies that are now coming due from our large mental health bill last year.  It is imperative that we eliminate wait times for treatment, ensure our children’s needs are being met, provide treatment to those in our prison system, and implement policy that moves our culture to treat mental health and physical health as one.
 
Two issues where we are watching federal action is funding for Children’s Health Insurance Program (CHIP) and our Federally Qualified Health Centers, like Community Health Center of Burlington.  Congress has not yet reauthorized these programs, although they have extended funding for CHIP through March.  Both of these are critical programs for the health of our children and for access to primary care.
 
Outside of our committee, the body is working on education funding, minimum wage, child care programs, tax reform, water clean-up, data privacy and our drug crisis, just to name a few.  We do not have a shortage of critical issues that affect Essex and all residents of the state.  We need residents to stay engaged and reach out with their comments and suggestions.
 
2. Several major bills have already been introduced this session, topics including recreational marijuana, water quality and minimum wage. What issue are you most passionate about and why?
 
I am most passionate about ensuring that we are spending your tax dollars effectively and equitably with outcomes that help Vermonters who need our assistance while providing economic conditions that help all Vermonters prosper and attract non-Vermonters to our beautiful state.  This will be the frame I use when voting on all bills this session.
 
3. Do you plan to introduce or sponsor any legislation this session? Tell us about it.
 
As I meet with residents we determine together if a policy change is needed to solve their concern.  Mostly, so far, all efforts have focused on bills that are already proposed to determine how to make them stronger and more effective.  I am currently researching one issue around child support.  Now that children can stay on a parent’s healthcare policy until age 26, should we require child support be paid to the parent providing the healthcare until age 21 or higher (assuming income criteria).  I welcome all thoughts on this, and any other, issue.
 
Thank you for the opportunity to serve Essex Junction and for your continued support. I can be reached at:  Lhoughton@leg.state.vt.us or cell 802-373-0599 or via my website at www.lorihoughton.com.