Paid Sick Leave Bill Appears on Track for Passage
The Senate Economic Development, Housing and General Affairs Committee on Thursday approved its version of a House-passed bill, H.187, that would require many Vermont employers to provide paid sick leave to employees. The bill passed the committee on a unanimous, 5-0 vote. If enacted, the bill will require most employers to provide three days of paid time off that can be used as sick time until 2019, when the requirement moves to five days. Paid vacation and combined time off would qualify.
The Senate's version of the bill adds exemptions to satisfy some concerns within the business community. For example, it exempts workers under the age of 18 and seasonal employees whose jobs are expected to last less than 20 weeks. It also allows employers to impose a waiting period. If passed by the full Senate, the bill will likely go to a conference committee with the House.
First Senate Committee Moves on Legalization of Marijuana
Inspired by a press conference boost early in the week from Gov. Peter Shumlin, the Senate Judiciary Committee voted 4-1 Friday morning to advance a bill, S.241, that would legalize the sale and recreational use of marijuana. In a key concession to nervous critics, the bill would provide more than two years for the Vermont Department of Public Safety, which would oversee enforcement, to develop the regulatory framework to control the market.
Public Safety Commissioner Keith Flynn told another Senate committee, concurrently, that it is heroin and opioid addiction that keeps him awake at night and not marijuana use. He said the Department of Public Safety is well suited to enforce a legalized environment.
Flynn said he has been to Colorado where marijuana has been legalized and has taken some lessons from that visit. He said Colorado made the mistake of not regulating its medical marijuana industry effectively, but that the Vermont DPS has been very effective at regulating medical marijuana. If marijuana is legalized, he said, "we are uniquely situated (to regulate it) because it is a situation we have made to work."
Commerce Considers Regulation of Litigation Loans
A relatively new industry has arisen in which businesses loan money to plaintiffs to help finance the cost of litigation. The loans are often made at extraordinarily high interest rates and are only repaid out of the proceeds of lawsuits.
Legislation passed last year banned the practice in Vermont for one year, pending a report and recommended legislation by the Department of Financial Regulation and the Office of Attorney General. The House Commerce Committee received a preview of the proposed legislation this week.
The most contentious issue facing the committee will be whether to cap interest charges. The draft bill does not include an interest cap, but insurers and the Vermont Chamber of Commerce will seek one. Lawsuit lenders claim their products are not loans because repayment is contingent upon recovery through litigation, and several committee members appear to agree with that reasoning.
Natural Resources Board Wants Jurisdictional Opinions Appealed to Environmental Court
The chairman of the Natural Resources Board would like the legislature to reverse a decision it made three years ago that has the board review appeals of jurisdictional opinions before they go to the Environmental Court. Jon Groveman suggested that the Senate Natural Resources and Energy Committee could add the provision to its agency permit bill, S.123. A jurisdictional opinion is issued by an Act 250 regional coordinator when asked if a certain proposed development would need a new or altered permit under Act 250.
Groveman said the appeals used to go directly to the board, and while the recent change was intended to improve efficiency, the opposite has happened. He said the board's legal staff routinely gives legal advice to the coordinator in preparing the initial opinion, then gives redundant advice to its own commissioners on the appeal.
In his appearance before the committee, Groveman noted that Act 250 will soon be 50 years old and much has changed. He said it was time for a comprehensive review of the law. "I have some ideas and have been talking to some people about it," he said, "but that is a big discussion."
What Does it Cost to Offer an 'Adequate' Education?
Independent education analyst Lawrence Picus told several committees of the House this week that the state could spend $164 million less than the $1.72 billion it currently spends on K-12 education and still provide adequate results. Picus’s firm, Picus, Odden & Associates, was the winning bidder for a state contract to study the system in 2015. He presented his report “The Cost of an Adequate Education in Vermont” to several House committees this week.
On Thursday, Picus told the House Ways and Means Committee that much of the “overspending” is in the area of special education. Vermont identifies 16 percent of its students as eligible for special education services, but Picus’s model, based on a 2014 snapshot, estimates that only 12 percent of the student population requires these additional services. The model also reduces the number of paraprofessionals used in the classroom, and instead utilizes coaches, tutors, and other support staff.
Picus told the committee that Vermont is a high spending state, partially due to the “bottom up” budget building approach that school boards use, as well as its designation as an equity state. He noted that Vermont seems to have the equity down, and now it’s time to focus on adequacy.
Picus will be instructing Agency of Education staff and others on how to use his model to explore different ways to provide adequate education to Vermont’s students.
House Panel Begins Work To Clarify Independent Contractor Designation
Annie Noonan, Commissioner of the Department of Labor, and Stephen Monahan, Director of the Worker’s Compensation and Safety Division, appeared before the House Committee on Commerce and Economic Development on Thursday to propose new legislation, H.773, that would amend the definition of “independent contractors.”
Noonan said the department doesn’t like to operate on a “gotcha” basis, and that the bill is yet another attempt to clarify when individuals are considered employees or independent contractors for the purpose of unemployment insurance and workers compensation coverage. The bill creates a presumption that when a person is hired, he or she is an employee. Committee members tested the clarity of the language with many different scenarios, with Rep. Steve Carr, D-Brandon, expressing concern that it would be difficult to “defeat uncertainty.”
Rep. William Botzow, D-PownaL, a sponsor of the legislation, reminded committee members that the “real challenge is to understand the larger picture” and that they can’t attempt to address every little thing that needs to be fixed. The committee is likely to spend the next several weeks attempting to craft a bill. Committee member Rep. Heidi Scheuerman, R-Stowe, has also introduced legislation addressing the issue, H.378, which the committee will be reviewing.
Regional Development Corps Provide Vital State Function, Panel Agrees
The 12 regional development corporations that promote economic development out in the field are a vital function of state government, according to the House Commerce and Economic Development Committee. The committee placed the RDCs in the "Most Critical" category after presentations on Tuesday by Commissioner of Economic Development Joan Goldstein and Bob Flint, president of the Regional Development Corporations of Vermont and executive director of the Springfield Regional Economic Development Corporation.
The Commerce Committee has been among the most diligent in meeting a request by Speaker Shap Smith, D-Morristown, to review the programs conducted by agencies under its jurisdiction and rank their importance relative to one another. Other programs considered critical include the work of the regional planning commissions and the Vermont Economic Progress Council and the captive insurance industry. An earlier look at the committee's draft matrix is shown here.
Lawmakers Pursuing Limits on Opioid Prescribing
Vermont Department of Health Commissioner Harry Chen and several health care providers appeared before the Senate Health and Welfare Committee this week on two bills, S.201 and S.243, that would limit the prescribing of opioids for acute and chronic conditions and increase the frequency with which health care providers must query the Vermont Prescription Monitoring System. S.243 establishes a statewide prescription drug disposal program and requires health insurers to reimburse pharmacists for conducting opioid pill counts that are ordered by the prescribing physician.
Chen said many provisions in the bill would challenge the system and create a hardship for consumers and providers. The legislation would limit opioid prescriptions for acute pain to no more than a 72-hour supply and prohibit physicians from prescribing more than a 30-day supply for patients with chronic pain.
Chen said he is working on a separate omnibus prescription drug bill that will address the prescribing of opioids. He plans to engage the Unified Pain Management System Advisory Council to help develop guidance on opioid prescribing based on evidence-based practice. His presentation can be found here.
Physicians testifying said they support the use of the VPMS to screen for aberrant behavior and potentially decrease doctor shopping. The VPMS helps track the prescribing and dispensing of controlled substances that are most likely to lead to abuse, addiction or patient harm if they are not used properly. The physicians testified that they oppose the requirement that health care providers query the VPMS each time the provider issues a new or renewal prescription for an opioid Schedule II, III, or IV controlled substance to a patient. They also oppose limiting the number of pills that can be prescribed, stating the state should not legislate standard of care. University of Vermont Medical Center Director of Pain Medicine Dr. Carlos Pino said there are technologies available today that allow for abuse deterrent formulations – formulations that resist or deter common forms of misuse. Pino said these products work, but are not fool-proof.
Independent Doctors Oppose Governor’s Tax Proposal
The governor’s proposal to impose a 2.35 percent provider tax on independent physicians and dentists received a frosty reception in the Senate Finance Committee this week. The proposal would raise $37 million in state and federal funds and would be used to reduce the deficit in the Medicaid program, restore cuts in reimbursement rates to Medicaid primary care providers, and increase Medicaid reimbursement rates for providers for preventive dental services.
Providers said the tax would undermine the state’s primary care infrastructure and compromise their ability to attract practitioners. All providers testifying noted that Vermont is already seeing a provider shortage. The provider tax would make Vermont a less attractive place for providers to locate and increase the health care access problem.
HealthFirst and Evergreen Family Health Chief Medical Officer Dr. Paul Reiss testified that low Medicaid rates have created a crisis for small physician practices. He said they were already very low, and recently have been reduced even further. According to Reiss, “The financial burden of the 2.35 percent tax is greater than the potential income from improved Medicaid reimbursement for nearly all independent physicians who currently care for Medicaid patients.”
Department of Vermont Health Access Commissioner Steven Costantino and Agency of Administration Director of Health Care Reform Robin Lunge said the Medicaid deficit is driven by increased enrollment due to the Affordable Care Act and Medicaid expansion. Lunge said the state has two options to close the Medicaid deficit: cut services or raise revenue. Committee Chairman Tim Ashe, D-Chittenden, offered a third option: manage Medicaid utilization better.
Lunge told the committee that when the state imposes provider taxes it must follow federal law. The law requires that the tax be broad-based and uniformly imposed across a provider class (i.e. all physicians), and cannot be used to make providers whole. The presentation by Lunge and Costantino can be found Lunge Presentation.
Smoke-Free Policies Challenge Treatment Facilities
The Vermont Department of Health has issued a tobacco-free policy for state-funded addiction treatment centers that began on July 1. Treatment centers initially supported the idea, but the implementation of the policy has been difficult. In light of concerns from providers, VDH has worked with the residential facilities on a gradual rollout of the policy. While the implementation of the policy has been delayed, the department plans to bring treatment centers in line with the state’s tobacco-free policy this year.
Valley Vista Chief Executive Officer Jack Duffy said making the decision to go into addiction treatment is already stressful. Any client that seeks treatment must have a willingness to quit. Clients experience intense anxiety and fear while going through withdrawal. Patients who are told they can’t smoke experience more intense fear. Treatment facilities tend to allow patients to smoke because many providers believe that treating a person for smoking, in addition to other substance abuse, would be too difficult and likely to result in failure.
Brattleboro Retreat Senior Vice President Peter Albert said the Retreat has maintained a smoke-free campus since 2008. When the policy was adopted they did see a drop in people seeking treatment, but that is not the case today. Treatment plans for patients now include ways to quit smoking. The current struggle for the Retreat is with patients seeking daily suboxone treatment for opioid addiction who smoke cigarettes but can’t smoke on campus.
