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For the week ending May 7, 2004
The big political news this week relates to the Lieutenant Governor’s race. Rep. Steve Hingtgen, a Progressive from Burlington, threw his hat into an already crowded ring. This will likely set the stage for a three way race among Republican Lieutenant Governor Brian Dubie, one of two former state senators vying for the Democratic nomination, Jan Backus and Cheryl Rivers, and Hingtgen, as the Progressive candidate. This same dynamic worked well for Lieutenant Governor Dubie during the last election when the Democratic and Progressive Candidates split the more liberal leaning votes and handed him the office. More than one State House observer commented that Lieutenant Governor Dubie, who works as a professional pilot outside the State House, was likely “flying high” with the news, even if he didn’t step foot in a plane.
Fee Bill – Hospital & Nursing Home Provider Tax/Hospital Licensing Fees (H.772)
This week the Senate Finance Committee advanced H.772, the miscellaneous fee bill. At the request of John Michael Hall, Commissioner of PATH, the committee made significant changes to the nursing home bed tax. Apparently, the idea of licensing Wake Robbin, the Arbors and Merten’s House as assisted living facilities didn’t work. So they decided to cut in half the amount of bed tax these non-Medicaid facilities pay by imposing a variable per bed rate for different sized facilities ($1,900 per bed for facilities with 30 beds or fewer, $4,000 per bed for facilities with more than 30 beds). Commissioner Hall told the committee that PATH believes it is entitled to an automatic waiver to charge these variable rates. However, Hall agreed to include a provision in the fee bill that would lower the bed tax to $3,676.06 (the House-passed rate) for all beds if they failed to get the waiver. The committee also increased the hospital provider tax for the Retreat Healthcare, contingent upon obtaining a federal waiver. The committee declined to include an annual fee of $100 per x-ray tube (with a $1,500 per facility cap) to fund an x-ray radiation safety program as requested by the Department of Health. Here is a link to the Senate Calendar for Monday, May 10, 2004, with the text of the bill as amended by the Senate Finance Committee.
Whistleblower (S.154)
The House unanimously passed S.154, the whistleblower bill, this week. The
preliminary vote was a roll call vote of 134-0, while final approval was by
voice vote. The bill was then referred to the Senate, which can either accept
the House’s changes to the bill or ask for a conference committee. Here
is a link
to the text of S.154 as it passed the House.
Medical Marijuana (S.76)
This week the House Health and Welfare Committee voted 8-3 in favor of a bill that would allow individuals with certain incurable terminal illnesses to cultivate, possess and use small quantities of marijuana for relief from debilitating symptoms of their diseases. The measure would insure that those individuals would not be prosecuted by the state and local police. However, since the substance is considered illegal by the federal government, the bill cannot protect those same individuals from federal prosecution. Governor Douglas is concerned this bill will send Vermont’s youth a “mixed message” that this drug is not always illegal or bad. The bill then also approved by the House Ways and Means Committee and is currently pending in the House Appropriations Committee. Here is a link to the House Calendar for May 6, 2004, with the text of the bill as it was advanced by the House Health and Welfare Committee.
Prescription Drugs (S.288)/Opiate Treatment (S.279)
The House Health and Welfare Committee voted 8-3 to advance S.288, a prescription drug bill this week. The committee incorporated the provisions of S.279, related to expanding opportunities for opiate treatment in Vermont beyond hospitals, into the bill. The bill was then referred to the House Appropriations Committee. Here is a link to the House Calendar for Friday, May 7, 2004, with the text of the bill as advanced by the House Health and Welfare Committee.
Licensing Respiratory Therapists (H.609)
This bill to license respiratory therapists was released by the Senate Rules Committee and then was unanimously approved by both the Senate Health and Welfare Committee and the Senate Finance Committee. The bill will likely go to the Senate Appropriations Committee before it will be up for action on the Senate floor.
Pain Management/Advance Directives (H.752)
H.752, a bill related to pain management and advance directives, was referred to the Senate Appropriations Committee this week. The bill amends sections of Vermont’s law related to advance directives, including living wills and durable powers of attorney for health care. Significantly for hospitals and nursing homes, the bill requires that every health care provider develop systems to ensure that a patient’s advance directive is promptly available when the patient is to receive services from the provider, including that the existence of an advance directive is prominently noted on the file jacket or folder, if any, and that a note is entered into the provider’s electronic database, if any. The bill also amends the Nursing Home Bill of Rights to require that nursing homes provide patients with professional assessment of pain and its management. The bill contains a provision that would require a study of whether or not medical marijuana should be included as part of the curriculum in medical and nursing schools in Vermont. Here is a link to the Senate Calendar for Tuesday, May 4th, with the text of H.752 as approved by the Senate Health and Welfare Committee.
Workers’ Compensation (H.632)
This week the Senate passed H.632, a bill making changes to Vermont's Workers'
Compensation law. The Senate-passed bill directs that the cost control mechanisms
for all medical services be "designed to lower overall costs of those
services and supplies by at least four percent." The services included
in this requirement are "medical, surgical, hospital, nursing services
and supplies, prescription drugs, and durable medical equipment." There
was an attempt to strike this requirement on the Senate floor but it failed.
A conference committee was then appointed to work out the differences between
the House and Senate versions of the bill. Here is a link
to the bill as
it passed the Senate.
Long Term Care 1115 Waiver (H.735)
This week the House accepted the Senate changes to H.735, the bill that relates
to the federal Medicaid 1115 waiver application that the Department of Aging
and Disabilities submitted to the federal government to enable home and community-based
services to be an entitlement the same way that nursing home care is today.
The bill will now go to the Governor who is expected to sign it. Here is a
link
to the bill as it passed the House and Senate.
FY05 Budget Bill (H.768)
This week the conference committee appointed to work out the differences in the House and Senate-passed versions of H.768, the FY05 budget bill, met a number of times. They agreed to a bottom line of $955 million general fund dollars. Working out the differences in the bill doesn’t appear that it will be as difficult this year as it has been in the recent past.
Long Term Care Insurance/Vermont Partnership for Long Term Care (H.737)
A conference committee of three House members and three Senators met numerous times this week to work out the differences in the House and Senate-passed versions of H.737. The bill proposes to bring Vermont law in line with the National Association of Insurance Commissioners (NAIC) model law on long term care insurance. This bill also proposes to establish the Vermont partnership for long-term care services that would require the state to seek another waiver from the federal government to provide an incentive to Vermonters with assets to purchase long term care insurance to cover a portion of long term care services.
Naturopathic Physicians (S.184)
By a vote of 6-3-1-1 (one absent and one abstention) the House Health and Welfare Committee decided not to take any additional testimony on S.184 at this time. This bill requires insurance companies to cover naturopathic physician services.
Other bills of interest to VAHHS members that are still in play this session but did not see action this week include:
Civil Monetary Penalties (H.566) – in a Conference Committee
Health Insurance Market Reform (H.759) – in the Senate Rules Committee
Abuse of Vulnerable Adults (S.17) – in the House Judiciary Committee
Mental Health (H.558) – in the House Appropriations Committee (also in
budget bill)
Phosphorus Ban (S.284) – in the House Natural Resources Committee
Capital Construction Bill (H.767) (dialysis/VSH funding) – in a Conference
Committee