This past Friday marked the departure of the first class of Legislative Pages. Through the session we have three groups of pages – each group staying 6 weeks. Pages are vital to our work. One of their most important roles is to deliver messages from our constituents in a timely and confidential manner.
Their departure also signals that we are about 1/3 of the way through the 2019 session. Crossover – the date policy bills must be voted out of their respective chamber to cross over to the other chamber – is March 15th with the budget following a week later on March 22nd.
The Health Care committee has been busy during the last two weeks taking testimony on several issues relating to the stability of the health insurance marketplace. We talk a lot about the need for a “stable risk pool,” which basically means that the more people who purchase health insurance in the same market, the lower and more stable each member’s rates will be. The President has removed the national financial penalty for not purchasing health insurance, and we are discussing whether if and how we should enforce the health insurance mandate at the state level. We have continued to discuss health insurance options for small businesses, as well as, mandating coverage for people with pre-existing conditions. This coverage is required by the Affordable Care Act but is not a state statute.
February 14th was suicide awareness day at the statehouse. Vermont suicide deaths are above the national average and are also increasing at a faster rate than the national average. One of the issues is that many doctors in Vermont do not have the training to provide adequate support for someone with suicidality. Regarding guns and suicide: access to guns does not increase the number of suicide attempts, but it does increase the deadliness of those attempts and therefore the number of deaths by suicide.
The General, Housing and Military Affairs committee voted out the paid family and medical leave bill. In its current form the bill proposes up to 12 weeks of paid family and medical leave financed through an insurance premium, shared equally by employers and employees. The committee made changes to expand the definition of family, expand the foster care age to 18 and to clarify language throughout. Further iterations on the financial modeling and tax income ramifications will be developed in the next two committees - Ways and Means and Appropriations. The administration has also proposed a paid family leave plan.
We had a lively group at our community conversation Sunday. Our next conversation is March 17th from 2:00 to 3:30pm 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. Hope to see you on the 17th.
Feel free to reach out at anytime with questions or comments!
Activity in committees and on the house floor picked up this week. House bills that passed out included:
Wednesday was Mental Health Advocacy Day and in the health care committee we had various organizations provide testimony on what is happening in our communities. Mental health will be a continued focus of our committee this year with an emphasis on community based programs. On Friday we watched the movie "Faces of ACEs". I came away with a new understanding of how the trauma we experience as a youngster effects our adult life. We must integrate this learning in all health care discussions.
In the health care committee we ended the week hearing testimony from the Individual Mandate Working Group. In 2018 Act 182 established an individual mandate for Vermont residents to maintain minimum essential health insurance coverage beginning January 1, 2020. The act created a working group to develop recommendations regarding the administration and enforcement of an individual mandate. We will continue hearing from the working group on their recommendations to determine how we move forward to ensure the stability of the Vermont health care market.
Public Hearing has been set for Wednesday Feb 6th on H57 an act relating to preserving the right to abortion. In Vermont we follow Roe vs Wade but that law is not codified in state law. H57 will codify Roe Vs Wade into state law. This hearing will take place at the Statehouse from 4:30 pm to 6:30 pm. If you wish to provide testimony sign ups will begin at 4:00pm. We are expecting a large crowd so please arrive early.
As always, please reach out with questions, comments or concerns.
We are two weeks into the session and the building is buzzing with a lot of new people. I'm sure you've heard that close to 50% of the members of the House have been representatives less than 2 years. That means week 2, for most committees, has been one of review. I'm happy to announce that I am again serving on the Health Care Committee. This year with the additional responsibility of Ranking Member. Although there is no formal job description, it means I will assist the Chair and Vice Chair with the planning and direction of the committee, chair the meeting if both are absent, and be unofficial mentor to new members. The Health Care Committee has 5 new members so our 2nd week included Health Care 101, the History of Health Care Reform in Vermont, Green Mountain Care Board overview and Agency of Human Services Overview. New to all members this week was the results review of the Vermont Household Health Insurance Survey. This survey is conducted via phone every few years (maybe you were included) and provides data that is valuable when drafting health care policy. We also had a presentation from Professor Jessica Holmes, Ph.D, Economics Professor, Middlebury College on Health Care Economics. The health care sector is unique - meaning it doesn't have the same features common of most economic markets - and therefore doesn't follow the same economic theories of most markets. This presentation highlighted those differences:
I will keep you posted with weekly blog updates, but please reach out anytime with questions or if I can be of assistance. 802-373-0599.
Thank you for your continued support!
Disclaimer - this was written last weekend for publication in this week's Essex Reporter. We know now that the House did not override the Governor's veto.
By the time you read this I’m hopeful that we will have overridden Governor Scott’s veto to pass a fiscally responsible budget – a budget supported by virtually every legislator including members of his own party, provides for appropriately $30m in income tax reductions and significant reductions in the taxation of social security income and levels the residential education tax rate. Therefore, I’d like to direct your attention to other good work your legislative body accomplished this session.
Act 196 aims to make it simpler for small businesses to interact with state government by expanding the information on the Secretary of State website and links to relevant parts of other state websites. The goal is to have a project scope, design, budget and timeline by December 2018 that will act as a roadmap for website enhancements and services for the next 10 years.
Act 189 moves us forward in meeting the current and anticipated needs of employers and employees. The bill does many things including, but not limited to, extending the use of Career Pathways in workforce development by engaging students as early as 7th grade, strengthening apprenticeship programs in the state, authorizing the use of Workforce Education Training funds to assist small businesses in recruiting, relocating and retaining workers, and develops metrics to measure the relative success of these different efforts to guide future decision making.
Act 173 allows schools to use their allocated state aid for special education dollars in more flexible ways with a goal of educating students who require additional support more effectively and efficiently. Schools will be unshackled from the intensive bookkeeping that goes along with today’s special education reimbursement system. The bill also emphasizes Vermont’s obligation to students on IEP’s and each student’s right to a public education.
Act 126 will start changing our wage gap by prohibiting the practice of allowing an employer to ask for a person’s salary history prior to offering them a job. When a woman is asked to reveal her salary during a job interview, which is likely lower than her male counterparts, she is asked to perpetuate an income gap job after job because her salary may be based on her already low pay. This adds up over time, and it is discriminatory.
These are just a few of our accomplishments. Mental health, stabilizing our healthcare market, prescription drug transparency, breast imaging without cost sharing, lead poisoning prevention, adverse childhood experiences, gun violence prevention, data brokers and consumer protection and so much more was accomplished. Please reach out with any questions. I can be reached at firstname.lastname@example.org or 802-373-0599. I look forward to seeing you around the Village this summer. Enjoy!
As we enter what is likely to be the last week of the session, the activity on the House and Senate chambers has picked up. Many bills passed out this week and you can find a full list HERE. I’ve summarized just a few below.
The Healthcare Committee continued their focus on prescription drug pricing by passing out S175 an act relating to the wholesale importation of prescription drugs into Vermont. The intent is to import the prescription drugs that would provide a substantial savings to Vermonters. This bill requires the Agency of Human Services to design a wholesale drug importation program that ensures the safety of our prescription drug market by continuing to follow the US FDA safety standards and the tracking and tracing of prescription drugs as laid out in federal regulation and will prohibit distribution outside Vermont. Once the agency designs the program they will submit a formal request to the Federal Health and Human Services agency for a waiver. There is a provision in federal law that allows for the issuance of this waiver, and we can’t move forward without it. The National Academy of State Health Policies, who is currently working with Utah on similar legislation, is making available the template and design process to Vermont at no cost. Congressman Welch, Senator Sanders and a representative for Senator Leahy all testified in our commitment and pledged their support for S175 and will provide their assistance at the federal level. This bill passed the House on a vote of 141-2.
The House gave preliminary approval to S260 the Clean Water Bill on a vote 94-48. S260 creates a Clean Water Fund Board to study and recommend long-term funding sources for water cleanup in our state. If a long term funding source is not found by 2020, this bill provides for two funding sources – a 0.25% increase in rooms and meals tax and moving uncollected beverage disposal deposits to the fund. As the House Speaker stated in her press release “There are currently over 350 water segments in Vermont that need water quality improvement. Our waters are a vital component of our communities, our industries and our traditions. Vermonters deserve a Vermont that works for all of us. That includes clean water, and this bill takes vital steps to ensure our lakes, rivers and streams remain healthy for future generations.”
The House also gave preliminary approval on a vote of 135-0 to S261 an act relating to mitigating trauma and toxic stress during childhood by strengthening child and family resilience. Although we don’t have a clear estimate of the monetary costs in Vermont (in 2012 a CDC study estimated the cost of child maltreatment at $128 billion), we do know that Vermont is not immune from the ravages of childhood adversity. The latest research shows 24% of our children have an adverse childhood experience (ACE) score of 2 or more, while the US national average is 22% of children. Generational poverty, addiction, homelessness and incarceration continue to plaque our children and families – and in too many cases the root cause is childhood trauma. It is the purpose of this act to ensure a consistent family support system by enhancing opportunities to build resilience among families throughout the State that are experiencing the causes or symptoms of childhood adversity. While significant efforts to provide preventative services are already under way in many parts of the state, better coordination is necessary to ensure that gaps in services are addressed and redundancies do not occur.
If you have questions on these bills or anything else, please attend our next community conversation Monday May 21st at the Essex Senior Center. Representative Giambatista and I have held these conversations throughout our two sessions and we look forward to the opportunity to talk with constituents. Can't attend but still have a question - reach out directly email@example.com or through the contact session on my website.
I’m grateful for the opportunity to serve Essex Junction. I look forward to being back in the community more once the session ends and hope to see you around the Village.
I believe this past week was the calm before the storm. We have only a few weeks left in the session and week 15 was a quiet one. We did pass S92 which puts in place strengthened prescription drug transparency rules, allows pharmacists to provide information on lower drug costs at the time a prescription is filled, and requires additional reporting by medicaid and commercial insurers on those drugs with the highest spend in Vermont and where the price increases greatly. Most importantly S92 puts in place a generic type law for speciality drugs – think Humira and Embril - as their generic versions become available. All of the above will result in lower prescription drug costs, over time, to both insurers and patients. S92 will now head to the Senate for final approval.
Also, Governor Scott signed an executive order establishing the Governor’s Community Violence Prevention Task Force. This task force, composed of 14 members from the administration and the public, will review existing research and current gaps in Vermont communities to report back on how to address the “root causes” of the risk of violence.
Finally, our community hosted Congressman Peter Welch on Friday as he toured local businesses, spoke with Village officials and held a community conversation at The Nest Café and Bakery. I personally took much away from the visit but the most impactful to me was Peter’s statement “don’t underestimate what you can do in your local community.” With that as the backdrop I want to let everyone know about a new community initiative in Vermont that is happening this year. It is called Neighbors Day and the entire State of Vermont will be celebrating it on June 2, 2018.
To give you a little background, Neighbors Day was created in 1999 in Paris by Atanase Périfan, the deputy mayor of the 17th arrondissement after the unnoticed passing of an elderly resident. Périfan created Neighbors Day to help create bonds between strangers and since its inception, it has spread to more than 30 countries on 5 continents.
Last year the Essex Junction was the first local municipality to celebrate Neighbors Day in Vermont. After the success of that event, we decided that Vermont would be the perfect state to be the first place in the US to celebrate Neighbors Day as a statewide event. Dylan Giambatista and I wrote a Resolution that was passed at the start of legislative session in January designating this event to be held statewide.
There are many reasons that this is an important event, especially as the political climate in the US creates a divide between many people in our communities. Ultimately, the best part of this event is its simplicity. It is not a party for an entire village or town, but rather it is a hyper-local event planned by the citizens themselves and involving only their own self-defined “neighborhood”. Last year, some residents invited only the houses to their left and right for cocktails, while others invited the entire floor of their apartment building for an ice cream social. My neighborhood invited 30+ households to a breakfast event held on the playground of our neighborhood school.
This Neighbors Day initiative is a reflection of the power of positivity that still exists in Essex Junction and Vermont. I hope that you will find a way to bring this event to your neighborhood. You can find out about the history of Neighbors Day as well as all of the details about planning and hosting an event on the website: http://neighborsdayvt.org.
As always, I appreciate the opportunity to serve Essex Junction. Please don’t hesitate to reach out with questions or concerns – firstname.lastname@example.org or 802-373-0599
The Essex community has the unfortunate recognition of having experienced a school shooting. 1 teacher was killed and 1 injured. Last year we experienced a lock-down. It wasn’t a drill. My husband works in the community and he said the sounds from all the sirens were deafening. Teens texted their parents goodbye. I was here that day unable to fully grasp what was happening in my community. Knowing the situation was at the high school, I couldn’t begin to imagine what those parents, teachers and students were going through. For a brief time all schools were locked down. What I did imagine was my sweet 8 year old boy, along with 19 other children, in a room with one teacher, unsure why the doors are locked and shades drawn. When I asked my son what happened he said “a man in our community was having a bad day so we had to stay inside and be quiet until someone helped him”. Thank goodness for our teachers. I was honored to be at our high school walk out last week. I saw the look in the eyes of our teens, I heard their voices – they should not be afraid.
The Essex community had a murder-suicide, an adult and teenager, by gun. Our community lost a youth to suicide, by gun. And those are the ones I can remember off the top of my head.
Our conversation and action on gun safety legislation shouldn’t be just about the mass shootings. One live lost is one too many.
I support common sense gun laws, just as I support common sense driving laws. Will these laws stop all violence and death, no. But if they stop some, they are worth it.
I support extreme risk measures, expanded background checks, changing the age to 21 to purchase guns with the carve outs, I support a ban on bump stocks and high capacity magazines, and I support a waiting period and safe storage.
I also know this committee will d0 their due diligence. What will come forth will be laws we can enforce and laws that don’t impinge on the true intent of the 2nd amendment. I thank you for what your doing.
We as a legislative body also need to look at the whole picture, not just gun safety legislation. What are the root causes of this violence, what supports and services do we need in our communities and in our families, what security measures do we need at our schools that don’t infringe on the freedom of our children. What else do we need to stop another senseless death.
Last night at a community conversation a gentleman indicated he was okay with kids and schools having to do drills – he did it growing up during the Cold War. I appreciate his perspective but I don’t agree with him. We as citizens really couldn’t control a nuclear threat. We as citizens should be able to control a threat of our own making.
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.
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 email@example.com 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 firstname.lastname@example.org or 373-0599. Thank you for the continued opportunity to serve Essex Junction.