The 2012 Legislative session ended on May 5th of this year. This was the second year of the biennium under the Shumlin administration with Democratic majorities in both the House and Senate. The major focus of the Legislature and administration was the task of rebuilding after Tropical Storm Irene, which involved everything from finding the funds to rebuild heavily damaged state and municipal infrastructure, to helping Vermonters who lost homes and livelihoods, deciding whether to rebuild or relocate the Waterbury State office complex, and resolving the long-standing issue of replacing the Vermont State Hospital and redesigning the State’s mental health system.
In the end, they addressed these complex issues, while also resolving the fifth budget deficit in a row and continuing down the path to comprehensive health care reform.
Legislative Wrap-Up article from May 9th:
VCDR members and organizations, along with other disability advocates, organization representatives, and private citizens testified on a variety of VCDR Platform Issues and other topics of interest to the Disability Community in numerous legislative committees, public hearings and state meetings in support of or in opposition.
In addition to Budget issues related to SSI, Reach Up benefits, Choices for Care and Developmental Disabilities, policy topics of interest included: The Mental Health System of Care, Vermont State Hospital, Respectful Language, Warrantless Access to Drug Monitoring, School Harassment and Bullying, Autism Insurance Coverage , Physician Assisted Suicide, Seclusion and Restraint Rule and School Resource Officers, Integrated Family Services, Sports Injuries, Mental Health Ombudsman, Health Care Reform, Duel Eligibles, Medicaid for Working Persons with Disabilities, Vermont State Hospital, Adult Protective Services, Vulnerable Adults, Peer Navigators, Fuel Assistance, and Disability Awareness, Emergency Management, among others.
As in past years, VCDR brought together disability advocates, consumers and families, providers, and policymakers from across the state to spend time at the statehouse, testify in committees and meet with legislators on Disability Awareness Day.
The theme this year was “We are ALL Vermont Strong”, and focused on the emergency preparedness, response and recovery during disasters from the unique perspective the civil rights of people with disabilities, bringing in a disability integration specialist from FEMA. The day included meetings with legislative committees, presentations, workshops, a social hour with legislators, and dinner with the keynote speaker.
H.781 – FY 2013 Appropriations Bill – Passed - Act 162
This act is the FY13 appropriations act, which provides appropriations for the support of state government during the upcoming fiscal year; it is referred to as the "Big Bill." In addition to providing appropriations, this act also amends and adds substantive provisions affecting state laws and programs.
For details and summaries of the amounts appropriated and other provisions, see the explanatory documents from the Joint Fiscal Office.
JFO Website: www.leg.state.vt.us/jfo
FY 2013 Budget Information: http://www.leg.state.vt.us/jfo/budget_fy2013.aspx
Summary of the FY 2013 Budget:
The Budget passed by the Legislature for Fiscal Year (FY) 2013 is the fifth year of state budget facing significant gaps. This year the Budget gap of $50 million was covered with fewer reductions than in previous years and does include increases in some needed program areas. The Budget reflects growth in spending of 5.8% with increased pressures in Federal Medicaid Match (FMAP) loss, increased retirement costs, pay act increases, and replacement of special funds which are no longer available. Half of the growth in spending has been attributed to tropical storm “Irene” and expenses and cost associated with other natural disasters Vermont faced this past year.
Most of the federal funds growth is in the transportation cost and disaster relief related funds. Those federal funds are reflected in the appropriations bill budget growth. Other federal increases are primarily in Medicaid for new Information Technology Systems and the Healthcare Exchange, as well as match for Mental Health Services formerly provided at the Vermont State Hospital. There are also caseload increases in Developmental Services and other Human Services paid for with federal funds.
The budget provides for $13.6-16.5 million in reserves above the stabilization fund to provide some capacity to address revenue shortfalls and continuing federal fund losses. With the budget proposal, the FY 2014 budget gap is projected at $0-$22m.
Any revenue surpluses in the House passed budget are designated to be automatically deposited; 50% to the education fund, 25% to offset federal cuts, and 25% to build the Rainy Day reserve fund, ending the practice of funding desired programs with “Waterfall” surplus revenues.
The Appropriations bill also adds language about the purpose of the state budget “… The state budget should be designed to address the needs of the people of Vermont in a way that advances human dignity and equity.” An additional provision in the bill requires a public process in the development of budget goals and public review of a current service budget and estimates. (See full language at the end of this report)
Revenue downgrade from VT Digger July, 24th, 2012:
Selected Highlights of Ups and Downs and Human Service Budget Funding:
DCF Reach-Up – SSI – The Governor proposed reducing the Reach-Up grant for families receiving an SSI benefit to align it with the policy for those receiving an SSDI benefit. The “savings” would have achieved reduced funding of $927,262. The Administration withdrew the SSI proposal after the legality of policy change was challenged. The $927,000 gap in the budget was made up using AHS caseload reserves.
DAIL Developmental Services - Hospitalization reimbursement Change – The Governor proposed eliminating all services for developmental disabilities Home and Community Based Care (HCBC) while individuals were hospitalized, reducing funding by $825.000. The Administration adjusted the reduction to $475,000 in “savings” continuing to cover payments to contracted home providers and service coordinators. The reduction in “savings” came out of the Developmental Services caseload increase.
DAIL Developmental Services – Caseload Increases
The DS budget is level funded with an additional $6.1 million: $4,163,857 in new caseload, which includes high school graduates and $1,976,292 for those who meet public safety criteria. The “savings” (reductions) in the hospitalization reimbursement changes came out of the high school graduates caseload increase. The “net” total is the same for DAIL.
DVHA - Choices for Care – Home and Community Based Care - Case Management – Governor proposed $827, 830 of reductions originally. The Administration withdrew their $339,837 reductions in HCBC changes in rates & caps, and the House restored $ $487,993 investments in enhanced residential care and HCBS reimbursement rate changes. Above restorations were possible due to lowering of current trend. The Legislature also made additional investments in choices for care using $1.1 million in carry forward funds, and added language that directs DAIL to meet with providers and stakeholders before implementing any significant changes in the choices for care program.
DMH – Funding for Metal Health Reforms added $15 Million dollars in for an enhanced investment in community based services (in separate legislation (H.639/Act79)
ADAP – Additional funding for Methadone treatment ($636,000). Hub and Spoke will receive $4.1 million in federal funds.
MEDICAID – Dental Cap – The Legislature lifted dental cap for 60 days for pregnant and postpartum women. Cost: $378,701
Vermont Oral Health Coalition Web-site: http://vtoralhealth4all.org/
AHS Central Office - Legal Aid – The Governor's proposed budget reduced VLA funding by $100,000: the Legislature restored the cut to Legal Aid ($50k General Fund and $50k in Federal Funds)
Homeowner Assistance - Legal Aid – The Legislature put in $200,000 of special funds for homeowner foreclosure assistance.
MENTAL HEALTH SYSTEM OF CARE - Passed
H.630 Mental Health System of Care as enacted into law Act 79:
This legislation is intended to strengthen Vermont’s existing mental health care system by offering a continuum of community and peer services, as well as a range of acute inpatient beds throughout the state. This system of care shall be designed to provide flexible and recovery-oriented treatment opportunities and to ensure that the mental health needs of Vermonters are served. It calls for the agency of human services to fully integrate all mental health services with all substance abuse, public health, and health care reform initiatives, consistent with the goals of parity. Multiple effective dates, beginning April 4, 2012
MEDICAID FOR WORKING PERSONS WITH DISABILITIES - Passed
S.89 Medicaid for Working Persons with Disabilities and Organ and Tissue Donation, as enacted into law- ACT 132:
This bill calls for the Cost and Saving analysis and implementation of initiatives that promote work incentives and increase the stability of health coverage for individuals receiving Medicaid for “Working Persons with Disabilities” and makes it easier for these individuals and eligible spouses to receive additional services. The bill also sets up the coordination of public and private efforts for the donation and transplantation of human organs and tissues in Vermont and to increase organ and tissue donation rates. Effective Date: May 11, 2012
AUTISM INSURANCE COVERAGE - Passed
S.223 An act related to coverage for diagnosis and treatment of early childhood developmental disorders including autism spectrum disorders as enacted into law ACT 158:
This health insurance legislation requires coverage for the evidence-based diagnosis and treatment of early childhood developmental disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, from birth to the age of 21. This coverage applies to Medicaid the Vermont health access plan, and any other public health care assistance program.
HEALTH CARE REFORM - Passed
H.559 An act related to Health; health care reform; health insurance; health benefit exchange and Green Mountain Care as enacted into law – ACT 171:
This legislation implements a number of changes to Vermont’s health insurance, health coverage, and health care provider regulatory frameworks, including: defining a small employer for the first three years of the Vermont health benefit exchange as an employer with 100 employees or fewer; merging the individual and small group insurance markets; expanding the duties and clarifying the role of the Green Mountain Care board; giving the Green Mountain Care board authority over the health insurer rate review, hospital budget review, and certificate of need processes; banning discretionary clauses in health insurance contracts; restricting the amount of an insured’s out-of-pocket expenditures for prescription drugs; authorizing the agency of human services to seek certain waivers from the Centers for Medicare and Medicaid Services; and repealing Catamount Health and the Vermont health access plan upon implementation of the Vermont health benefit exchange.
SPORTS INJURY - Additional Language in Act 171 on concussions and head injuries related to participation in sports activities
New language underlined – deleted language strikethrough
Sec. 39a. 16 V.S.A. § 1431(d) is amended to read:
(d) Participation in athletic activity.
(1) A coach shall not permit a youth athlete to continue to participate in
any training session or competition associated with a school athletic team if the coach has reason to believe that the athlete has sustained a concussion or other head injury during the training session or competition.
(2) A coach shall not permit a youth athlete who has been prohibited
from training or competing pursuant to subdivision (1) of this subsection to
train or compete with a school athletic team if the athlete has been removed or prohibited from participating in a training session or competition associated with the school athletic team due to symptoms of a concussion or other head injury until the athlete has been examined by and received written permission to participate in athletic activities from a health care provider licensed pursuant to Title 26 and trained in the evaluation and management of concussions and other head injuries.
PHYSICIAN ASSISTED SUICIDE – Did Not Pass
S.103 Physician Assisted Suicide - An act relating to patient choice and control at end of life. Did Not Pass
Legislation as introduced:
This bill proposed to allow, a mentally competent person diagnosed as having less than six months to live to request a prescription which, if taken, would hasten the dying process.
On Tuesday April 10th the Senate Health and Welfare committee voted 3-2 to attach the Physician Assisted Suicide legislation, S.103 as an amendment to a tanning bill (H.157) moving through the committee in order to forward it to the Senate floor. The Senate Judiciary Committee heard testimony on the issue and did not advance the legislation. The Senate debated whether or not to make this amendment germane to the bill and it was defeated 18 to 11 effectively stopping the legislation from advancing.
ADULT PROTECTIVE SERVICES – Passed – Vetoed by Governor
H.290 - An act related to Adult Protective Services as passed by House and Senate – The GOVERNOR VETOED this Bill on May 5th and the legislature did not challenge that action:
As passed by House and Senate:
This bill would have required the secretary of human services to adopt rules governing the implementation of the statutory responsibilities of the department of disabilities, aging, and independent living, division of licensing and protection, with respect to adult protective services.
VULNERABLE ADULTS - Passed
H. 413 An act relating to creating a civil action against those who abuse, neglect, or exploit a vulnerable adult as enacted into law
– ACT 141: http://www.leg.state.vt.us/docs/2012/Acts/ACT141.pdf
Act Summary: http://www.leg.state.vt.us/docs/2012/Acts/ACT141sum.htm
This act permits the attorney general to bring a civil action for damages on behalf of the state against a person or caregiver who, with reckless disregard or with knowledge, abuses, neglects, or exploits a vulnerable adult. The act establishes the amount of damages and the civil investigation procedure for a civil enforcement action. It also amends the statute on records of abuse, neglect, and exploitation to allow the investigating report to be disclosed to designated persons or entities for a civil enforcement action and a civil investigation. Effective Date: July 1, 2012
Harassment and Bullying in Educational Settings - Passed
H. 412 An act relating to harassment and bullying in educational settings as enacted into law – ACT 140
This act defines the legal standard under the Vermont Fair Housing and Public Accommodations Act necessary to prevail in an action alleging harassment in an educational setting.
Act 140 specifically sets forth that in order to prevail in an action alleging unlawful harassment; the plaintiff must prove both of the following:
(1) The student was subjected to unwelcome conduct based on the student's or the student's family member's actual or perceived membership in a category protected by law by 9 V.S.A. § 4502.
(2) The conduct was either:
(A) for multiple instances of conduct, so pervasive that when viewed from an objective standard of a similarly situated reasonable person, it substantially and adversely affected the targeted student's equal access to educational opportunities or benefits provided by the educational institution; or
(B) for a single instance of conduct, so severe that when viewed from an objective standard of a similarly situated reasonable person, it substantially and adversely affected the targeted student's equal access to educational opportunities or benefits provided by the educational institution.
Effective Date: May 15, 2012
From Robert Appel, Executive Director of the Human Rights Commission:
Excerpt from (attached) memo:
“The issue is whether a student who is the target of peer-to-peer harassment should have to prove that the harassment was not only severe but pervasive as opposed to either severe or pervasive – the standard used in the workplace, by the US Department of Education’s Office of Civil Rights and other states,”
SCHOOL RESOURCE OFFICERS - Passed
S.181 - An act relating to school resource officers as enacted into law – ACT 101: http://www.leg.state.vt.us/docs/2012/Acts/ACT101.pdf
This act confirms that neither the state board of education nor the department can regulate the use of restraint and seclusion by a fully sworn school resource officer and repeals any portion of board rule that purports to do so. In addition, it encourages school districts to enter into memorandum of understanding with school resource officers regarding the officer's possession and use of weapons on school property and the nature and scope of the officer's assistance to the school system. Effective Date: May 4, 2012.
The Education Committee expects that discussions will continue to take place with all interested parties on further defining the school resource officer’s role, the collection of data, and adherence to the seclusion and restraint rule in the education system.
PRESCRIPTION DRUG MONITORING – Did Not Pass
H.745 An act relating to the Vermont prescription monitoring system – Passed House – Passed in Senate - Committee of Conference assigned – The House and Senate could not agree on a compromise primarily related to access to records without a warrant section that the House stood firmly against. (Did not pass)
Senate Proposal of Amendment:
The stated purpose of this legislation was to maximize the effectiveness and appropriate utilization of the Vermont prescription monitoring system, which serves as an important tool in promoting public health by providing opportunities for treatment for and prevention of abuse of controlled substances without interfering with the legal medical use of those substances.
VT Digger Article:
Under an initial proposal from the Shumlin administration, a few specially trained officers would be allowed access to the database if they could demonstrate a bona fide investigation.
The administration’s proposal was watered down in the House, which only approved access to the information in the database when officers had a warrant. They would also need to get the information from the Department of Health rather than directly from the database.
With the compromise, police would be able to access the name, age and address of a patient who they believe may be diverting prescription drugs for illegal use. Police could also receive access to the name and address of the pharmacy and doctors where the patient accessed certain scheduled drugs — generally opiates.
MENTAL HEALTH IN CORRECTIONS - Passed
H.765 - An act relating to the mental health needs of the corrections population as enacted into law – ACT 87
This act requires the secretary of human services to establish a work group to assess and improve the delivery of services to individuals with a serious functional impairment incarcerated in a correctional facility, collect information regarding individuals with a mental illness or disorder, and evaluate correctional officers' training as it relates to working with individuals with disabilities. Effective Date: April, 2012
IMMUNIZATION - Passed
S.199 - An act relating to immunization exemptions and the immunization pilot program. Maintains the philosophical exemption with certain conditions as enacted into law – ACT 157
This bill proposed to extend the termination date of the immunization pilot program and remove the exemption from immunization on philosophical grounds.
The Senate removed the philosophical exemption but the House put it back in with certain conditions. The amended vaccine bill requires parents to sign the philosophical exemption each year and requires that parents review material provided by the Department of Health and acknowledge that their decision may have an adverse effect on their families and communities. Proponents of vaccines looked at the changes as a public safety issue and believe it endangered a small minority of children and adults unable to vaccinate due to health conditions. Opponents believed that vaccinations should be a parental choice.
SECURE RESIDENTIAL RECOVERY FACILITIES - Passed
H.759 An act relating to permitting the use of secure residential recovery facilities for continued involuntary treatment as enacted into law – ACT 160 (Removed offensive language)
Act Summary: http://www.leg.state.vt.us/docs/2012/Acts/ACT160sum.htm
This act authorizes the commissioner of mental health to oversee and have patients treated in a secure residential recovery facility, which is defined as a facility licensed as a therapeutic community residence for individuals no longer in need of acute inpatient care, but who remain in need of treatment in a secure setting for an extended period of time. The act requires a secure residential recovery facility to provide the same degree of legal protections that residents would receive at facilities providing acute inpatient care. If the commissioner intends that a patient receive further treatment at a secure residential recovery facility, such intent must be specified in the application for a court order authorizing continued treatment. The application must also contain the commissioner's reasons for determining that clinically appropriate treatment for the patient's condition can be provided safely only in a secure residential recovery facility. Effective Date: May 17, 2012
RESPECTFUL LANGUAGE – JOINT RESOLUTION - Passed
Joint Resolution was PASSED by both the House and Senate - JRH 58
No. R-456 - Joint resolution relating to respectful language in the Vermont Statutes Annotated.
This resolution request that the legislative council prepare a bill that will propose to amend the Vermont Statutes Annotated by replacing words and phrases as recommended by the study group created pursuant to the Study Committee recommendations (Act No. 24 of 2011).
Both the House Human Services Committee and the Senate Government Operations Committee reviewed the Respectful Language Report issued in December of 2011 and passed the above resolution.
Respectful Language Report:
CONCERN OVER PORTRAYAL OF MENTAL ILLNESS - Passed
No. R-504. Joint resolution expressing concern over the Reader’s Digest portrayal of mental illness (J.R.H.38)
INTEGRATED FAMILY SERVICES – Testimony Taken
The House Human Services Committee has taken testimony from the administration, providers, families and advocates on the progress of integrated family services.
From the agency of Human Services Web Site: “The Agency of Human Services (AHS), in partnership with other state departments, the provider network and families, continues to move Integrated Family Services (IFS) from concept to concrete changes. IFS is the overarching structure for all AHS provided or contracted direct services to a child and family.”
Integrated Family Services Inventory Report: http://humanservices.vermont.gov/integrated-family-services/final-ifs-inventory-report-1-16-12/view
The “Peoples Budget” Language in the Appropriation’s Bill:
Sec. E.100.1 32 V.S.A. § 306a is added to read:
§ 306a. PURPOSE OF THE STATE BUDGET
(a) Purpose of the state budget. The state budget, consistent with Chapter I, Article 7 of Vermont’s constitution, should “be instituted for the common
benefit, protection, and security of the people, nation, or community…” The
State budget should be designed to address the needs of the people of Vermont in a way that advances human dignity and equity.
(b) Spending and revenue policies will seek to promote economic
well-being among the people of Vermont, and foster a vibrant economy.
Integral to achieving the purpose of the state budget is continuous evaluation of the raising and spending of public funds by systems of outcome measurement based on indicators that measure success in accomplishing the purposes of the state budget.
(c) Spending and revenue policies will reflect the public policy goals
established in state law and recognize every person’s need for health, housing, dignified work, education, food, social security, and a healthy environment.
(d) As consistent with state law and in conjunction with the federal
government, the budget will reflect support for economic development, public safety, transportation, and other infrastructure needs.
(e) Revenue measures shall also be based on the principles of sustainability and stability. The administration shall develop budget and revenue proposals as part of a transparent and accountable process with direct and meaningful participation from Vermont residents.
Sec. E.100.2 PURPOSE OF THE STATE BUDGET
(a) Public participation. The administration will develop a process for
public participation in the development of budget goals, as well as general
prioritization and evaluation of spending and revenue initiatives. This process shall begin by October 1, 2012.
(b) Current services. The administration shall develop and publish
annually for public review as part of the budget submission process a current services budget, providing the public with an estimate of what the current level of services is projected to cost in the next fiscal year. The initial current services budget shall be submitted with the administration’s fiscal year 2014 budget proposal.
To view other legislation passed in the 2011-2012 Legislative Session:
Submitted by Karen Lafayette, VCDR Legislative Liaison email@example.com