Representative View
S.88 is a Senate bill to hire a consultant to develop and recommend among three options for comprehensive Vermont health care coverage. The project is to be completed in eight months.
The Senate bill has been merged with a House committee bill.
Much of the House segment addresses expansion of the “Blueprint for Health” health care delivery model, aimed for statewide implementation for all hospitals by July of 2012 and in full by the fall of 2013.
It has some glitches.
The Blueprint is a promising model, but not one that has actually been shown to save money yet. We’re going to jump-start it without waiting to see how it will fully interact with the segments of new federal law coming on line... or even with the options that will be developed by the consultant under S 88.
It costs money to implement the community health teams that work to make sure that an individual’s care is coordinated between primary care and all other care (including services someone might be getting from the state agency of human services).
Insurance companies will be mandated to pay for their patient cost share, but there is no reimbursement from Medicare for the extra costs. The state would be seeking a federal Medicare waiver, but the program will not wait to see if, or whether, it will be approved.
Who will pay for that share? Stay tuned.
Challenges for Change
- I was the sole attendee of a “mock session” last Monday. Such sessions are held to move the calendar ahead by a day to gain time, not to take any action.
There was one action this time: introduction of the “Challenges for Change” bill.
I went to get a copy, only to be told it “didn’t exist” as a bill yet. Various sections were still being consolidated, along with final editing. Part of the extra staff work was because the Appropriations Committee had voted the bill out last Friday without waiting for a “clean copy” with its final edits.
So a bill that wasn’t complete yet was introduced! This goes beyond sloppy work; it makes a mockery of the process. I shared the facts – and my feelings about them – on the floor the next morning.
- Later in the week, various amendments to correct errors had to be made by the committee. One removed administration members that were added to a legislative standing committee. It would have been unconstitutional (violating the separation of powers between branches of government.)
“Challenges for Change” is a government reorganization and revised budgeting process that we are experimenting with this year.
It tackled a few specific targeted areas for $38 million in saved money, which was removed from the budget in advance. It is being rushed through to help the budget crunch, but is approving major changes that will change state services, with very little review.
The governor and the Senate and House leaders had decided on this course before the session began, and representatives were all expected to toe the line for major changes in state functions as a way to address part of the state’s $150 million revenue shortfall.
- The initiatives proposed were thin on detail, and even thinner on how the savings were going to actually be achieved. Any that are not, will revert into direct budget cuts after the legislature is gone.
The bill we passed on to the Senate accepted, at the most generous calculations, about $20 million of the $30 that the governor had identified, both figures short of the $38 necessary.
The Republican caucus did achieve the one success of backing Democrats into a corner to agree that if the $38 million is not identified when we close down in two weeks, we will come back in July after the first of the administration’s quarterly reports.
That will never happen, because candidates can’t raise money from lobbyists until the session is over, and there are three leading Senators running for governor. But at least it becomes a way to push for a final balanced budget before we leave.
- I voted against passing the bill, with a vote explanation:
“A budget is a budget is a budget. We can pass this today, and pretend it isn’t part of the whole, but that does not change the facts – nor does it change the fact of our abdication of responsibility to be accountable to our constituents for a complete budget.”
At least this time, the vote to pass was 98-43, instead of the nearly unanimous support for the bill that started the process in February.
I voted against most of the many various amendments; I wanted nothing to do with this bill, which is so widely, though quietly, acknowledged as an act of fiction.
- But I rose in support of one of the parts of the plan to reduce the prison population. I wish it had been an independent bill. It would create alternatives to bail (such as home detention) to ensure that persons return for trial.
I am a fierce advocate of our constitutional commitment to innocence until proven guilty. As a small state, we mix together inmates who have been convicted of crimes with those who are waiting for trial, something which has always horrified me.
Often, a person pleading guilty is sentenced to “time served” – the time spent in prison while waiting to be convicted or acquitted. So the innocent person released at the same point in time has served the same sentence as the guilty one!
- Lastly, I won a small but important amendment of my own. For $90,000 in savings, “Challenges” planned elimination of public notices in the newspapers about proposed agency rules and convert to the internet, leaving those who are not tech-savvy behind.
The Government Operations Committee had created a phase-in, which would maintain small newspaper notices with a referral to a state agency contact, until next January 1. My proposal to change the date to January 30 was accepted; this will give an opportunity for the legislature to actually think through this public policy change before it becomes permanent.
Human Services Committee
My committee has agreed to focus on completing two of the bills sent over by the Senate this year: one updating the Uniform Anatomical Gift Act legislation to maintain interstate protocols (a high priority for me); the other to ban plastic containers that contains the compound bisphenol A.
Additional odds and ends in a busy time period:
- I was very pleased to support a well crafted bill to help ensure that there is adequate funding reserved by Vermont Yankee to meet its obligation to return the site to greenfield status when the plant closes, whether that is next year or in 20 years.
- I was equally delighted with the great work of the same Natural Resources Committee with the continued expansion of its work on renewable energy; that bill passed 129-3.
- A trade-in program for voluntarily getting rid of old, polluting outdoor wood fired boilers passed 77-17 (That totals 94 of 150 representatives; where was everyone...just because it was a Friday afternoon?)
I voted no because involuntary removals are required in a small number of situations, and the funding is not a sure thing. We could well be telling some struggling families, whose boilers were legal when first installed: put in a new heating system you can’t afford, or freeze.
- A bill requiring town listers to check the number of housing units on a property for a state rental registry was amended to allow towns to request a waiver; this made me comfortable to shift to support.
- We passed the long awaited federally funded jobs bill. It was a long and complicated bill sent over by the Senate, with no notice time on the calendar.
My questions on the floor to clarify what I was voting on were dragging on and making others restless, so I gave up, and became the sole “no” vote on the roll call, explaining, “I believe I support every part of this bill. Unfortunately, I ran out of time to read and fully review the Senate changes.”
- My bill to expand the small estates process to include sole survivors who are parents has now been signed into law by the governor. This was the “Ben Carr bill”, introduced after I learned about the gap in the law after the drowning death of my cousin’s 23-yearold son.
Ben, known to many in Northfield for his editorship of the News and Transcript, naturally had no will, and his “estate” – a car, a few hundred dollars in the bank – had to go through full probate.
- I tried to attach an amendment to a miscellaneous motor vehicles bill to create a midlevel licensing category for small size, automatic scooters that are currently classified as motorcycles. This had been a bill Maxine Grad and I had introduced when we learned of a problem from a Northfield constituent who couldn’t possibly take the driver’s exam on a full size cycle.
The Transportation Committee Chair obtained verification that under a new Commissioner, applicants can take the test on their own cycle, so I withdrew the amendment.
- I was voted down on another amendment to the same bill. We’re dropping an inspection requirement on small trailers. I acknowledge, it’s probably not a vital law – but is this the time to abandon the $40,000 to $50,000 revenue it was bringing in each year?
A lot will be happening in the final time left during this session. Feel free to email me (counterp@tds.net) or leave a message for me either at home (485-6431) or at the state house (828-2228) if you have any questions or issues to discuss. I want to help keep you as connected as possible.
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