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Journal of the House

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FRIDAY, MAY 14, 2004

At nine o'clock and thirty minutes in the forenoon the Speaker called the House to order.

Devotional Exercises

Devotional exercises were conducted by Speaker Walter Freed of Dorset.

Pages Honored

In appreciation of their many services to the members of the General Assembly, the Speaker recognized the following named Pages who are completing their service today and presented them with commemorative pins:

Taylor Bates of Williston

Garrett Bauman of Castleton

Henry Cesari of Chelsea

Andrea Fagnant of Morrisville

Azalea Frank of Montpelier

Kendra LaBounty of Richmond

Hannah McMeekin of Randolph

Lukas Petersen of Burlington

Molly Taylor of Bethel

Genna Williams of Shaftsbury

House Resolutions Placed on Calendar

The Speaker placed before the House the following resolutions which were read and in the Speaker’s discretion, placed on the Calendar for action tomorrow under Rule 52.

H.R. 37

House resolution urging the province of Quebec to complete construction of highway 35 between the Vermont-Quebec border and Iberville, Quebec

Offered by: Representatives LaVoie of Swanton, Winters of Swanton, Allard of St. Albans Town, Bolduc of Barton, Branagan of Georgia, Dunsmore of Georgia, Howrigan of Fairfield, Keenan of St. Albans City, Parent of St. Albans City, Perry of Richford, Starr of Troy, Trombley of Grand Isle and Waite of Pawlet

Whereas, it is important for the purposes of regional economic development that a safe, fast, and completed highway link exist between the cities of Boston and Montreal, and

Whereas, it is in the common economic interest of both the state of Vermont and the province of Quebec that, in the event of a terrorist attack, there exist a border crossing for the passage of goods and individuals other than the crossing at Lacolle, Quebec, and

Whereas, the highway link between Boston and Montreal is primarily a limited access highway, and

Whereas, the Vermont segment of the highway, designated as Interstate 89, is complete, and the state of Vermont has assumed the responsibility for maintaining this road, and

Whereas, the segment of the Boston to Montreal highway located between the international border at Swanton, Vermont and Iberville, Quebec is a dangerous three‑lane road designated as R-133, and

Whereas, R-133 has been the site of many automobile accidents involving Americans and some of these have involved fatalities, and

Whereas, from Iberville north to the city of Montreal there exists a limited access highway designated as highway 35 that is safe and fast, and

Whereas, it is imperative for reasons of economic development and motorists’ personal safety that highway 35 be completed from the international border at Swanton to Iberville, and

Whereas, the province of Quebec must recognize the urgency of completing highway 35, now therefore be it

Resolved by the House of Representatives:

That this legislative body urges Jean Rioux, a member of the Quebec National Assembly representing Iberville riding to continue his effort to secure the necessary funding for the completion of highway 35, and be it further

Resolved: That the Clerk of the House be directed to send a copy of this resolution to Quebec Premier Jean Charest in Quebec City.

H.R. 38

House resolution congratulating Representative Doran Metzger of Milton on the occasion of his engagement to U.S. Army Captain Elaine Young

Offered by: Representatives Peaslee of Guildhall, DePoy of Rutland City, Rogers of Castleton, Endres of Milton, Wright of Burlington, Adams of Hartland, Allaire of Rutland City, Allard of St. Albans Town, Amidon of Charlotte, Anderson of Woodstock, Aswad of Burlington, Atkins of Winooski, Audette of South Burlington, Bailey of Hyde Park, Baker of West Rutland, Bartlett of Dover, Bohi of Hartford, Bolduc of Barton, Bostic of St. Johnsbury, Botzow of Pownal, Branagan of Georgia, Brennan of Colchester, Brooks of Montpelier, Brown of Walden, Carey of Chester, Chen of Mendon, Clark of St. Johnsbury, Clark of Vergennes, Connell of Warren, Corcoran of Bennington, Crawford of Burke, Cross of Winooski, Crowley of West Rutland, Dakin of Colchester, Darrow of Dummerston, Deen of Westminster, Donaghy of Poultney, Donahue of Northfield, Donovan of Burlington, Dostis of Waterbury, Duffy of Rutland City, Dunsmore of Georgia, Edwards of Brattleboro, Emmons of Springfield, Errecart of Shelburne, Fallar of Tinmouth, Fisher of Lincoln, Flory of Pittsford, Freed of Dorset, French of Randolph, Haas of Rutland City, Hall of Newport City, Head of South Burlington, Heath of Westford, Helm of Castleton, Hingtgen of Burlington, Houston of Ferrisburgh, Howrigan of Fairfield, Hube of Londonderry, Hummel of Underhill, Jewett of Ripton, Johnson of South Hero, Johnson of Canaan, Kainen of Hartford, Keenan of St. Albans City, Kennedy of Chelsea, Kenyon of Bradford, Keogh of Burlington, Ketchum of Bethel, Kilmartin of Newport City, Kirker of Essex, Kiss of Burlington, Kitzmiller of Montpelier, Klein of East Montpelier, Koch of Barre Town, Krawczyk, A. of Bennington, Krawczyk, J. of Bennington, Larocque of Barnet, Larrabee of Danville, Larson of Burlington, LaVoie of Swanton, Lippert of Hinesburg, Livingston of Manchester, Maier of Middlebury, Marek of Newfane, Marron of Stowe, Martin of Springfield, Masland of Thetford, Mazur of South Burlington, McAllister of Highgate, McCullough of Williston, McLaughlin of Royalton, Milkey of Brattleboro, Miller of Shaftsbury, Miller of Elmore, Molloy of Arlington, Monti of Barre City, Morrissey of Bennington, Myers of Essex, Nease of Johnson, Nitka of Ludlow, Nuovo of Middlebury, Obuchowski of Rockingham, O’Donnell of Vernon, Otterman of Topsham, Parent of St. Albans City, Partridge of Windham, Perry of Richford, Peterson of Williston, Pillsbury of Brattleboro, Pugh of South Burlington, Robinson of Richmond, Rodgers of Glover, Rusten of Halifax, Schiavone of Shelburne, Seibert of Norwich, Shand of Weathersfield, Sharpe of Bristol, Shaw of Derby, Sheltra of Derby, Shouldice of Calais, Smith of New Haven, Smith of Morristown, Starr of Troy, Sunderland of Rutland Town, Sweaney of Windsor, Sweeney of Colchester, Sweetser of Essex, Symington of Jericho, Towne of Berlin, Tracy of Burlington, Trombley of Grand Isle, Valliere of Barre City, Vincent of Waterbury, Waite of Pawlet, Westman of Cambridge, Winters of Swanton, Winters of Williamstown, Wood of Brandon, Young of Orwell and Zuckerman of Burlington

Whereas, marriage is the most significant journey that a man and woman in love can embark on during their lives, and

Whereas, when one partner proposes to the other that they become engaged, it is frequently the most private of events, and

Whereas, despite this tradition, on occasion, a proposal of marriage may occur at a public gathering, and

Whereas, while no historian can verify the following for certain, it is extremely unlikely that while the House of Representatives was sitting, that the well of the House has previously served as the setting for a proposal of marriage, and

Whereas, the romantic passion of the member from Milton, and Vermont Army National Guard helicopter pilot and lieutenant, Representative Doran Metzger, established a probable historic precedent when, during the announcement period preceding the Orders of the Day on May 7, 2004, he stood before his colleagues, and introduced his girlfriend, U.S. Army Captain Elaine Young of Owensboro, KY, the deputy chief of the pharmacy at Ft. Knox, KY, and

Whereas, relating his promise not to refer to her as “captain or doctor during announcements,” he declared in the alternative, “So Mr. Speaker, I am going to ask her to let me refer to her as my fiancée,” and

Whereas, the member from Milton then proceeded to the Senate seats where he bent down on one knee formally to seek Elaine Young’s hand in matrimony presenting a diamond ring to seal their engagement, and

Whereas, Captain Young, who Representative Metzger met while they were both in military training in Texas, consented to be his wife, to his relief and the cheering approval of his legislative colleagues, and

Whereas, in answer to the pending question before the House: Can an airborne helicopter pilot find true happiness with a pharmacist whose two feet are firmly planted on the ground, the ayes appear to have it, the ayes do have it, and the House unanimously votes in the affirmative, now therefore be it

Resolved by the House of Representatives:

That the members of this legislative body congratulate their colleague Representative Doran Metzger of Milton on the occasion of his engagement to U.S. Army Captain Elaine Young, and be it further

Resolved: That the Clerk of the House be directed to send a copy of this resolution to Representative Doran Metzger of Milton.

Joint Resolution Adopted in Concurrence

J.R.S. 66

Joint resolution, entitled

Joint resolution relating to weekend adjournment;

By Senator Welch,

Resolved by the Senate and House of Representatives:

That when the two Houses adjourn on Friday, May 14, 2004, it be to meet again no later than Tuesday, May 18, 2004.

Was taken up read and adopted in concurrence.

Committee of Conference Appointed

S. 311

Pursuant to the request of the Senate for a Committee of Conference on the disagreeing votes of the two Houses on Senate bill, entitled

An act relating to making miscellaneous changes in Statutes affecting the Vermont agency of transportation;

The Speaker appointed as members of the Committee of Conference on the part of the House:

Rep. Peaslee of Guildhall

Rep. Emmons of Springfield

Rep. Winters of Swanton

Committee Not Relieved of Consideration

S. 164

Rep. Nease of Johnson moved that the Committee on Natural Resources and Energy be relieved of further consideration of Senate bill entitled

An act relating to liability for genetic engineering;

Pending the question, Shall the committee on Natural Resources and Energy be relieved of the bill? Rep. Partridge of Windham demanded the Yeas and Nays, which demand was sustained by the Constitutional number. The Clerk proceeded to call the roll and the question, Shall the committee on Natural Resources and Energy be relieved of the bill? was decided in the negative. Yeas, 60. Nays, 68.

Those who voted in the affirmative are:

Rep. Allard of St. Albans Town explained his vote as follows:

“Mr. Speaker:

For years we fought with the Agency of Natural Resources over the 10 acre exemption. When we finally agreed on closing the 10 acre loophole in exchange for new affordable alternative systems, I thought it was over.

The agency has not lived up to the agreement, so it is time to return to what we had.”

Thereupon, third reading was ordered.

Message from the Senate No. 67

A message was received from the Senate by Mr. Marshall, its Assistant Secretary, as follows:

Mr. Speaker:

I am directed to inform the House that the Senate has considered joint resolutions originating in the House of the following titles:

J.R.H. 53. Joint resolution authorizing the Legislative Council to codify educational charters and agreements as Title 16 Appendix of the Vermont Statutes Annotated.

J.R.H. 71. Joint resolution in support of community-controlled preadjudication programs such as court diversion.

And has adopted the same in concurrence.

The Senate has considered the report of the Committee of Conference upon the disagreeing votes of the two Houses upon House bill of the following title:

H. 79. An act relating to establishing an evidentiary privilege to prohibit the disclosure of communications made to interpreters by hearing impaired persons.

And has accepted and adopted the same on its part.

The Senate has on its part adopted Senate concurrent resolutions of the following titles:

S.C.R. 61. Senate concurrent resolution commemorating the 100th graduating class of Bellows Free Academy-Fairfax (BFA-Fairfax).

S.C.R. 62. Senate concurrent resolution commemorating the 100th football game between Lyndon Institute and St. Johnsbury Academy.

S.C.R. 63. Senate concurrent resolution congratulating Bonnie Gainer on her retirement as executive director of the Rutland County Women’s Network and Shelter.

S.C.R. 64. Senate concurrent resolution Senate concurrent resolution congratulating Malcolm S. “Kim” Rode for his leadership of the Vermont Municipal Bone Bank and the Vermont Educational and Health Building Financing Agency

The Senate has on its part adopted concurrent resolutions originating in the House of the following titles:

H.C.R. 299. House concurrent resolution congratulating the Orleans Country Club on the occasion of the club’s 75th anniversary.

H.C.R. 300. House concurrent resolution congratulating the Morristown Community Playground Improvement Project (MCPIP).

H.C.R. 301. House concurrent resolution congratulating the Edmundite Fathers o the centennial anniversary of their management of the St. Anne’s Shrine on Isle La Motte.

H.C.R. 302. House concurrent resolution congratulating the Stratton Foundation for its outstanding contributions to southern Vermont’s community live and nonprofit organizations.

H.C.R. 303. House concurrent resolution congratulating David Estes on the 25th anniversary of his outstanding service as an educator in the Catholic school system.

H.C.R. 304. House concurrent resolution honoring the cinematic accomplishments of Luis Guzman of Sutton.

H.C.R. 305. House concurrent resolution congratulating Michael Zahner of Marshfield on winning the 2004 National Masters pole vaulting championship.

H.C.R. 306. House concurrent resolution congratulating Gregory Kendal Holtorf upon earning the rank of Eagle Scout.

H.C.R. 307. House concurrent resolution congratulating the Benevolent and Protective Order of Elks, Burlington Lodge #916, on its centennial anniversary.

H.C.R. 308. House concurrent resolution congratulating the 2004 Black river High School Presidents state championship girls’ snowboarding team.

H.C.R. 309. House concurrent resolution congratulating Pat Bethel on winning his fourth consecutive giant slalom title at the state high school snowboarding championship.

H.C.R. 310. House concurrent resolution in memory of the American military personnel who have died i the service o their nation in Iraq since March 16, 2004.

H.C.R. 311. House concurrent resolution honoring Kathy Francis of Georgia on her designation as the National Social Worker of the Year.

H.C.R. 312. House concurrent resolution expressing support for the members of the U.S. Army Reserve’s 443rd Transportation Company, 89th Regional Readiness Command during its Middle East deployment.

H.C.R. 313. House concurrent resolution congratulating Taylor Wunsch of Swanton on his superb alpine shi racing accomplishments.

H.C.R. 314. House concurrent resolution congratulating Ed Webster of Hyde Park on the completion of his term as president of the New England Association of Fire Chiefs, Inc.

H.C.R. 315. House concurrent resolution congratulating the students of the 3rd and 4th grades at the Bridport Central School on their reenactment of Ethan Allen’s capture of fort Ticonderoga.

H.C.R. 316. House concurrent resolution congratulating David Ely II of Troop #648 in Burlington upon earning the rank of Eagle Scout.

H.C.R. 317. House concurrent resolution congratulating Matt Edmonds of Trop #324 in Pawlet upon earning the rank of Eagle Scout.

H.C.R. 318. House concurrent resolution honoring Bruce Chesney on his retirement from the North Country Career Center.

Senate Proposal of Amendment Concurred in

with a further amendment thereto

H. 752

The Senate proposes to the House to amend House bill, entitled

An act relating to advance directive for health care;

By striking out all after the enacting clause and substituting in lieu thereof the following:

Sec. 1. LEGISLATIVE PARTICIPATION IN THE DECISION-MAKING COMMITTEE OF THE ATTORNEY GENERAL’S END-OF-LIFE INITIATIVE

Recognizing that the attorney general has commenced an initiative on end‑of‑life care, including the creation of a committee to consider the legal barriers to appropriate decision-making on health care, that the attorney general has invited public participation in this initiative, and that the decision‑making committee has already provided valuable services to the legislature in identifying and making specific proposals of how to improve Vermont laws with regard to decision-making on health care, the speaker of the house and the senate committee on committees shall appoint one member each from the house and senate committees on health and welfare and judiciary to participate in the decision-making committee of the attorney general’s end‑of‑life initiative. The general assembly anticipates that the committee will consider and recommend legislative action to improve and encourage the use of advance directives, the appropriate use of a default surrogate system and do‑not‑resuscitate orders, the role of the probate court in health care decision‑making, and the appropriate enforcement for failure to follow an advance directive. The general assembly requests the attorney general’s report by November 15, 2004. Legislative members appointed pursuant to this section shall be entitled to per diem compensation and reimbursement of expenses pursuant to section 406 of Title 2.

Sec. 2. ADVANCE DIRECTIVE ACCESSIBILITY STUDY

(a) The department of health shall conduct a study and develop a plan to create and maintain a registry identifying individuals who have executed an advance directive.

(b) The study shall include consideration that:

(1) the registry should be maintained in a secure database that provides authorized health care providers, health care facilities, residential care facilities, funeral directors, and crematory operators immediate access to the registry at all times;

(2) the registry could be consolidated with the anatomical gift registry authorized by section 5248 of Title 18; and

(3) all individuals entered in the registry would have the right to revoke or amend the advance directive as provided in chapter 111 of Title 18.

(c) The study should consider whether a copy of an individual’s advance directive or other means of determining the contents of an individual’s advance directive should be filed in and accessible through the registry.

(d) The commissioner of health is authorized to secure grants from public and private sources to conduct the study, to fund the registry, and to receive and disburse funds which are assigned, donated, or bequeathed to the department to cover the costs of the registry.

(e) The department of health in consultation with the department of motor vehicles shall determine a method of indicating on an individual’s motor vehicle license or identity card that the individual has an advance directive.

(f) The commissioner shall submit a report to the general assembly on or before January 15, 2005.

Sec. 3. 14 V.S.A. § 3453(a) is amended to read:

§ 3453. SCOPE AND DURATION OF AUTHORITY

(a) Subject to the provisions of this chapter and any express limitations set forth by the principal in the ~~durable power of attorney for health care~~ advance directive, the agent shall have the authority to make any and all health care decisions on the principal’s behalf that the principal could make. An agent may also have authority to direct the manner of disposition of the principal’s remains, including the making, limiting, or refusing to make an anatomical gift pursuant to chapter 109 of Title 18, and the funeral goods and services to be provided if the agent is appointed to do so in the advance directive; the authority of an agent appointed for these purposes shall continue beyond the death of the principal only for so long as may be needed for the agent to perform these duties.

Sec. 4. 14 V.S.A. § 3454 is amended to read:

§ 3454. ~~USE OF STATUTORY FORMS~~ HEALTH CARE INSTRUCTIONS; TERMINAL CARE DOCUMENT; DISPOSITION OF REMAINS, FUNERAL GOODS AND SERVICES; PRE-NEED FUNERAL CONTRACTS

(a) Every ~~person~~ individual wishing to execute a durable power of attorney for health care shall be provided with a disclosure statement substantially in the form set forth in section 3465 of this title prior to execution. The principal shall be required to sign a statement acknowledging ~~that he or she has received~~ receipt of the disclosure statement and has read and understands its contents.

(b) A durable power of attorney for health care ~~executed on or after July 1, 1988~~ ~~shall be substantially~~ may be in the form set forth in section 3466 of this title and may include the appointment of an agent and alternate agent for health care, health care instructions, a terminal care document, an agent and an alternative agent for disposition of remains or anatomical gifts, or instructions regarding the disposition of remains or for funeral goods and services.

(c) An advance directive may make reference to an irrevocable pre-need contract entered into with a funeral director, crematory, or cemetery. To the extent possible, the advance directive should be consistent with the pre-need contract.

Sec. 5. 14 V.S.A. § 3455 is amended to read:

§ 3455. RESTRICTIONS ON WHO CAN ACT AS AGENT; HEALTH CARE DECISIONS; DISPOSITION OF REMAINS, ANATOMICAL GIFTS, OR FUNERAL GOODS AND SERVICES

(a) Health care decisions. A person may not exercise the authority of agent for health care decisions while serving in one of the following capacities:

* * *

(b) Disposition of remains, anatomical gifts, or funeral goods and services. A person may not exercise the authority of agent for disposition of the principal’s remains, anatomical gifts, or funeral goods and services while serving in one of the following capacities, unless said person is a relative of the principal:

(1) a funeral director;

(2) an employee of the funeral director;

(3) a crematory operator;

(4) an employee of the crematory operator;

(5) a cemetery official; or

(6) an employee of a cemetery.

Sec. 6. 14 V.S.A. § 3456 is amended to read:

§ 3456. EXECUTION AND WITNESSES

The ~~durable power of attorney for health care~~ advance directive shall be signed by the principal in the presence of at least two or more subscribing witnesses, neither of whom shall, at the time of execution, be the agent, the principal’s health or residential care provider or the provider’s employee, the principal’s funeral director, crematory operator, cemetery official, or an employee thereof, the principal’s spouse, heir, or reciprocal beneficiary, a person entitled to any part of the estate of the principal upon the death of the principal under a will or deed in existence or by operation of law or any other person who has, at the time of execution, any claims against the estate of the principal. The witnesses shall affirm that the principal appeared to be of sound mind and free from duress at the time the ~~durable power of attorney for health care~~ advance directive was signed and that the principal affirmed that he or she was aware of the nature of the documents and signed it freely and voluntarily. If the principal is physically unable to sign, the ~~durable power of attorney for health care~~ advance directive may be signed by the principal’s name written by some other person in the principal’s presence and at the principal’s express direction.

Sec. 7. 14 V.S.A. § 3459 is amended to read:

§ 3459. ACTION BY PROVIDER

(a) A principal’s health or residential care provider, and employees thereof, having knowledge of the principal’s durable power of attorney for health care, shall be bound to follow the directives of the principal’s designated agent to the extent they are consistent with this chapter and the durable power of attorney for health care.

(b) If because of a moral or other conflict with a specific directive given by the agent, a principal’s health or residential care provider finds it impossible to follow that directive, ~~he or she~~ the provider shall forthwith have the duty to inform the agent and if possible the principal, and actively assist in selecting another health care provider or physician who is willing to honor the agent’s directive.

(c) Every health care provider, residential care provider, funeral director, crematory operator, and cemetery official shall develop systems to ensure that a principal’s advance directive is promptly available when services are to be provided, 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, funeral director’s, crematory operator’s, or cemetery official’s electronic database, if any.

(d)(1) A principal’s funeral director, crematory operator, or cemetery official and employees thereof having knowledge of the principal’s advance directive shall follow the instructions in the advance directive and the directives of the principal’s agent to the extent that they are consistent with this chapter, the advance directive, and applicable law.

(2) If the principal directs a disposition and the principal’s estate is without sufficient funds, the direction shall be void and the disposition shall occur in a manner approximating the principal’s wishes to the extent it is financially possible.

(e) In the event the principal’s instructions in an advance directive regarding the disposition of remains or for funeral goods and services is in apparent conflict with a contract for the disposition of remains, funeral goods, or services entered into by the principal, the most recent document created by the principal shall be followed to the extent of the conflict. Nothing in this subsection shall be construed as limiting any other available remedies.

Sec. 8. 14 V.S.A. § 3462 is amended to read:

§ 3462. IMMUNITY

(a) No person acting as agent pursuant to ~~a durable power of attorney for health care~~ an advance directive shall be subjected to criminal or civil liability for making a ~~health care~~ decision in good faith pursuant to the terms of the ~~durable power of attorney for health care~~ advance directive and the provisions of this chapter.

(b) No health or residential care provider, funeral director, crematory operator, or cemetery official, nor any other person acting for ~~the provider~~ or under ~~the provider’s~~ such person’s control, shall be subjected to civil or criminal liability, nor be deemed to have engaged in unprofessional conduct, for any act or intentional failure to act done in good faith if the act or intentional failure to act is done pursuant to the dictates of the ~~durable power of attorney for health care~~ advance directive, the directives of the ~~patient’s~~ principal’s agent and the provisions of this chapter. Nothing herein shall be construed to establish immunity for the failure to exercise due care in the provision of services.

Sec. 9. 14 V.S.A. § 3464 is amended to read:

§ 3464. LIABILITY FOR ~~HEALTH CARE~~ COSTS

Liability for the cost of health care, disposition of remains, anatomical gifts, or funeral goods and services provided pursuant to the agent’s decision made in accordance with an advance directive shall be the same as if the ~~health care~~ services were provided pursuant to the principal’s decision.

Sec. 10. 14 V.S.A. § 3466 is amended to read:

§ 3466. DURABLE POWER OF ATTORNEY FOR HEALTH CARE; OPTIONAL FORM

The durable power of attorney ~~shall be in substantially~~ for health care may be in the following form and may include any of the following provisions:

* * *

Sec. 11. 18 V.S.A. § 5252 is amended to read as follows:

§ 5252. DEFINITIONS

The following definitions shall be applicable in the construction of this chapter:

(1) “Advance directive” means a durable power of attorney for health care or a terminal care document, or both. A durable power of attorney for health care may include instructions regarding terminal care. No separate document need be executed.

~~(1)~~(2) “Attending physician” means the physician selected by, or assigned to the patient, who has primary responsibility for the treatment and care of the patient.

~~(2)~~(3) “Extraordinary measures” means any medical procedure or intervention which utilizes mechanical or other artificial means to sustain, restore, or supplant a vital function which, in the judgment of the attending physician, when applied to the patient, would serve only to artificially postpone the moment of death and where, in the judgment of the attending physician, the patient is in a terminal state.

~~(3)~~(4) “Terminal care document” means a document which, when duly executed, contains the express direction that no extraordinary measures be taken when the person executing said document is in a terminal state, without hope of recovery from such state and is unable to actively participate in the decision-making process.

~~(4)~~(5) “Physician” means a medical doctor licensed to practice ~~in the state of~~ ~~Vermont~~, an osteopathic physician licensed pursuant to subdivision 1750(9) of Title 26, an advance practice registered nurse licensed pursuant to subdivision 1572(4) of Title 26, and a physician’s assistant certified pursuant to section 1733 of Title 26.

~~(5)~~(6) “Terminal state” means an incurable condition caused by injury, disease or illness which regardless of the application of life-saving procedures would, within reasonable medical judgment, produce death and where application of life-sustaining procedures would only postpone the moment of death.

Sec. 12. 18 V.S.A. § 5256 is amended to read:

§ 5256. ACTION BY PHYSICIAN

(a) An attending physician and any other physician under ~~his~~ the physician’s direction or control, having in ~~his~~ the physician’s possession ~~his~~ the patient’s terminal care document, or having knowledge that such a duly executed document is part of the patient’s record in the institution in which he the patient is receiving care, shall be bound to follow as closely as possible the dictates of said document. However, if because of moral conflict with the spirit of this act, a physician finds it impossible to follow ~~his~~ the patient’s directions, he the physician shall forthwith have a duty to so inform ~~his~~ the patient or of those facts and actively assist in selecting another physician who is willing to honor the patient’s directions, or both.

(b) Every health care provider and residential care provider shall 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.

Sec. 13. STUDY ON PAIN MANAGEMENT

The department of health, in collaboration with interested parties, including the commissioner of aging and disabilities, the office of professional regulation, the pain/symptom management committee of the Attorney General’s end of life care initiative, the Vermont Program for Quality in Health Care, Inc., health care providers, health care facilities, nursing homes, residential care facilities, as well as individuals who have experienced or currently experience symptoms of pain or the families of those individuals, shall investigate and evaluate methods for improving pain management. Such methods shall include: improving standards of practice for medical professionals with respect to pain assessment and treatment; incorporating pain management into the hospital credentialing process for physicians; requiring continuing education in pain management for health care providers; developing uniform recordkeeping requirements for assessing a patient’s pain; establishing, by administrative rule, legally enforceable standards for assessing and treating pain; providing and enhancing rights to pain assessment and management for individuals in health care facilities; establishing educational partnerships on pain management among communities, health professionals, and health training programs; and developing enhanced training in pain management, including the use of medical marijuana, in the medical school, residency training programs, and nursing schools in Vermont. The commissioner also shall inventory existing studies on pain management and shall attempt to establish a baseline measure of current pain management methods against which the effects of improvement initiatives may be measured. With respect to the requirements of this section, the commissioner shall report the findings and recommendations to the general assembly by January 15, 2005.

Sec. 14. 33 V.S.A. § 7301 is amended to read:

§ 7301. NURSING HOME RESIDENTS’ BILL OF RIGHTS

The general assembly hereby adopts the Nursing Home Residents’ Bill of Rights as follows:

(1) The governing body of the facility shall establish written policies regarding the rights and responsibilities of residents and, through the administrator, is responsible for development of, and adherence to, procedures implementing such policies. These policies and procedures shall be made available to residents, to any guardians, next of kin, reciprocal beneficiaries, sponsoring agency, or representative payees selected pursuant to ~~section~~ subsection 205(j) of the Social Security Act, and Subpart Q of 20 CFR Part 404, and to the public.

(2) The staff of the facility shall ensure that, at least, each ~~person~~ individual admitted to the facility:

~~(1)~~(A) is fully informed, as evidenced by the resident’s written acknowledgment, prior to or at the time of admission and during the stay, of these rights and of all rules and regulations governing resident conduct and responsibilities. Reasonable accommodation shall be made to communicate the resident’s bill of rights to residents with communication impairments and residents who speak a language other than English;

~~(2)~~(B) is fully informed, prior to or at the time of admission and during stay, of services available in the facility, and of related charges including any charges for services not covered under Titles XVIII or XIX of the Social Security Act, or not covered by the facility’s basic per diem rate, including the facility’s policy on providing toiletries, adult briefs, wheelchairs, and all personal care and medical items. The facility shall inform residents in writing about Medicaid and Medicare eligibility and what is covered under those programs including information on resource limits and allowable uses of the resident’s income for items and services not covered by Medicaid and Medicare. The facility shall inform residents or their guardians or agents in writing about eligibility for hospice services and the circumstances under which hospice services may be available;

~~(3)~~(C) is fully informed, by a physician, of ~~his or her~~ the medical condition, and is afforded the opportunity to participate in the planning of ~~his or her~~ the medical treatment and to refuse to participate in experimental research;

~~(4)~~(D) is transferred or discharged only for medical reasons, or for ~~his or her~~ the resident’s welfare or that of other residents, or for nonpayment of ~~his or her~~ the resident’s stay (except as prohibited by Titles XVIII or XIX of the Social Security Act), and is given reasonable advance notice to ensure orderly transfer or discharge, and such actions are documented in ~~his or her~~ the resident’s medical record. Residents shall be notified in writing of the proposed transfer or discharge and reasons for it at least 72 hours before a transfer within the facility and 30 days before a discharge from the facility. In cases where the health or safety of individuals would be endangered, or an immediate transfer or discharge is required by the resident’s urgent medical needs, notice shall be made as soon as practicable before transfer or discharge. Notice shall explain the resident’s right to appeal the proposed action, under the facility’s grievance procedure and shall include the address and phone number of the area ombudsman. The resident informed of this right may choose to relocate before the notice period ends. The facility shall make reasonable efforts to accommodate new residents without disrupting room assignments;

~~(5)~~(E) is encouraged and assisted, throughout ~~his or her~~ the resident’s period of stay, to exercise ~~his or her~~ the individual’s rights as a resident and as a citizen, and to this end may voice grievances and recommend changes in policies and services to facility staff or to outside representatives of ~~his or her~~ the resident’s choice, free from restraint, interference, coercion, discrimination, or reprisal;

~~(6)~~(F) may manage ~~his or her~~ the resident’s personal financial affairs, or is given at least a quarterly accounting of financial transactions made on ~~his or her~~ the resident’s behalf should the facility accept ~~his or her~~ the resident’s written delegation of this responsibility to the facility for any period of time in conformance with state law;

~~(7)~~(G) is free from mental and physical abuse, and free from chemical and (except in emergencies) physical restraints except as authorized in writing by a physician for a specified and limited period of time, or when necessary to protect the resident from ~~injury to himself or herself or~~ self‑injury or injury to others. The facility shall inform residents of its restraint policy and appeal rights under the facility’s grievance procedure. The policy must include the release of the restraints no less than every two hours for ten minutes for exercise or repositioning. The resident has the right to be free from any physical restraints imposed or psychoactive drugs administered for purposes of discipline or convenience;

~~(8)~~(H) is assured confidential treatment of ~~his or her~~ the resident’s personal and medical records, and may approve or refuse their release to any individual outside the facility, except, in case of ~~his or her~~ the resident’s transfer to another health care institution, or as required by law or third-party payment contract;

~~(9)~~(I) is treated with consideration, respect, and full recognition of ~~his or her~~ the resident’s dignity and individuality, including privacy in treatment and in care for ~~his or her~~ the resident’s personal needs;

~~(10)~~(J) is not required to perform services for the facility that are not included for therapeutic purposes in ~~his or her~~ the resident’s plan of care;

~~(11)~~(K) may associate and communicate privately with persons of ~~his or her~~ the resident’s choice, and send and receive ~~his or her~~ the resident’s personal mail unopened;

~~(12)~~(L) may meet with, and participate in activities of social, religious, and community groups at ~~his or her~~ the resident’s discretion;

~~(13)~~(M) may retain and use ~~his or her~~ the resident’s personal clothing and possessions as space permits, unless to do so would infringe upon rights of other residents;

~~(14)~~(N) if married or in a reciprocal beneficiaries relationship, is assured privacy for visits by ~~his or her~~ the resident’s spouse or reciprocal beneficiary; if both are residents of the facility, they are permitted to share a room;

~~(15)~~(O) ~~residents~~ shall have the right to choose ~~their~~ the resident’s own personal physician, and the right to request a second opinion from a physician of the resident’s choice where significant alternatives for care or treatment exist, or when the resident requests information concerning care or treatment alternatives, the resident has the right to receive such information from ~~his or her~~ the resident’s doctor or the administrators as appropriate;

~~(16)~~(P) to the extent permitted by law, ~~the resident~~ has the right to refuse care or treatment, including the right to discharge himself or herself from the facility, and to be informed of the consequences of that action and the nursing home shall be relieved of any further responsibility for that refusal;

~~(17)~~(Q) is assured reasonable access to a telephone located in a quiet area where the resident can conduct a private conversation;

~~(18)~~(R) has the right to return to the first available bed in the nursing home ~~he or she~~ the resident came from, after hospitalization if the patient has not retained ~~his or her~~ the resident’s bed under subdivision ~~(19)~~(S) of this ~~section~~ subdivision (2), provided the facility is able to meet the resident’s medical needs and that the resident’s welfare or that of other residents will not be adversely affected;

~~(19)~~(S) has the right upon payment of ~~his or her~~ the resident’s usual rate or, in the case of Medicaid residents, ~~his or her~~ the resident’s certified per diem compensation, to retain ~~his or her~~ the resident’s bed in the nursing home while absent from the facility due to hospitalization provided such absence does not exceed ten successive days; and

(T) is provided with professional assessment of pain and its management.

(20) residents and their families, including a reciprocal beneficiary, shall have the right to organize, maintain, and participate in either resident or family councils or both. The facility shall provide space and, if requested, assistance for meetings. Council meetings shall be afforded privacy, with staff or visitors attending only at the council’s invitation. The facility shall respond in writing to written requests from council meetings. Resident councils and family councils shall be encouraged to make recommendations regarding facility policies;

(21) residents and their families, including a reciprocal beneficiary, shall have the right to review current and past state and federal survey and inspection reports of the facility, and upon request, to receive from the facility a copy of any report. Copies of reports shall be available for review at any time at one station in the facility. The facility may charge a reasonable amount for more than one copy per resident.

(3) The staff of the facility shall ensure that the residents and their families, including a reciprocal beneficiary:

(A) shall have the right to organize, maintain, and participate in either resident or family councils, or both. The facility shall provide space and, if requested, assistance for meetings. Council meetings shall be afforded privacy, with staff or visitors attending only at the council’s invitation. The facility shall respond in writing to written requests from council meetings. Resident councils and family councils shall be encouraged to make recommendations regarding facility policies;

(B) shall have the right to review current and past state and federal survey and inspection reports of the facility, and upon request, to receive a copy of any report from the facility. Copies of reports shall be available for review at any time at one station in the facility. The facility may charge a reasonable amount for more than one copy per resident.

Sec. 15. RESIDENTIAL CARE HOME BILL OF RIGHTS

Notwithstanding the provisions of chapter 25 of Title 3, the department of aging and disabilities shall amend section VI of the residential care home regulations to include the right of each resident to professional assessment of pain and its management without the requirement that the department go through the formal rulemaking process. The amended rule shall have the same force and effect as if adopted pursuant to chapter 25 of Title 3.

Sec. 16. STATUTORY REVISION

Sections 5251 through 5262 of Title 18 shall be recodified as subchapter 1 of chapter 111 of Title 18. Chapter 121 of Title 14 shall be recodified as subchapter 2 of chapter 111 of Title 18 and the sections renumbered as necessary. Section 5252 (Definitions) of Title 18 and section 3452 (Definitions) of Title 14 shall be combined into a new definitions section which shall apply to chapter 111 of Title 18. Any duplicative definitions shall be removed and if there are minor differences, the definition in section 5252 of Title 18 shall be used. Chapter 111 of Title 18 shall be redesignated “Advance Directives for Health Care and End of Life.”

Sec. 16a. 18 V.S.A. chapter 86 is amended to read:

CHAPTER 86. THERAPEUTIC USE OF CANNABIS

Subchapter 1. Research Program

§ 4471. Cannabis therapeutic research program; establishment; participation

* * *

Subchapter 2. Marijuana Use by Persons with Severe Illness

§ 4472. DEFINITIONS

For the purposes of this subchapter:

(1) “Bona fide physician-patient relationship” means a treating or consulting relationship, in the course of which a physician has completed a full assessment of the registered patient’s medical history and current medical condition, including a personal physical examination.

(2) “Debilitating medical condition” means cancer, multiple sclerosis, acquired immune deficiency syndrome, positive status for human immunodeficiency virus, or a life threatening, progressive, and debilitating disease or medical condition, if:

(A) the disease or medical condition or its treatment produces severe, persistent, and intractable symptoms such as cachexia or wasting syndrome; severe nausea; severe pain; or seizures; and

(B) in the context of the specific condition, reasonable efforts have been made over a reasonable amount of time without success in relieving the symptoms.

(3) “Marijuana” shall have the same meaning as provided in subdivision 4201(15) of this title.

(4) “Possession limit” means the amount of marijuana collectively possessed between the registered patient and the patient’s registered caregiver which is no more than two mature marijuana plant, three immature plants, and two ounces of usable marijuana.

(5) “Physician” means a person who is licensed under chapter 23 or chapter 33 of Title 26, and is licensed with authority to prescribe drugs under Title 26.

(6) “Registered caregiver” means a person who is at least 21 years old who has never been convicted of a drug-related crime and who has agreed to undertake responsibility for managing the well-being of a registered patient with respect to the use of marijuana for symptom relief.

(7) “Registered patient” means a person who has been issued a registration card by the department of public safety identifying the person as having a debilitating medical condition pursuant to the provisions of this subchapter.

(8) “Secure indoor facility” means a building or room equipped with locks or other security devices that permit access only by a registered caregiver or registered patient.

(9) “Usable marijuana” means the dried leaves and flowers of marijuana, and any mixture or preparation thereof, and does not include the seeds, stalks, and roots of the plant.

(10) “Use for symptom relief” means the acquisition, possession, cultivation, use, transfer, or transportation of marijuana or paraphernalia relating to the administration of marijuana to alleviate the symptoms or effects of a registered patient’s debilitating medical condition which is in compliance with all the limitations and restrictions of this subchapter. For the purposes of this definition, “transfer” is limited to the transfer of marijuana and paraphernalia between a registered caregiver and a registered patient.

§ 4473. ADMINISTRATION

The department of public safety shall establish a distinct, dedicated phone line to provide Vermonters with information about the registration process and requirements. Any information received from individuals shall be confidential and shall comply with the “Standards for Privacy of Individually Identifiable Health Information” contained in Parts 160 and 164 of Title 45 of the Code of Federal Regulations, 45 C.F.R. §§ 160.101 et seq. and 45 C.F.R. §§ 164.102 et seq.

§ 4474. REGISTERED PATIENTS; QUALIFICATION STANDARDS AND PROCEDURES

(a) To become a registered patient, a person must be diagnosed with a debilitating medical condition by a physician in the course of a bona fide physician-patient relationship.

(b) The department of public safety shall review applications to become a registered patient using the following procedures:

(1) A patient with a debilitating medical condition shall submit, under oath, a signed application for registration to the department. If the patient is under the age of 18 the application must be signed by both the patient and a parent or guardian. The application shall require identification and contact information for the patient and the patient’s registered caregiver applying for authorization under section 4475 of this title, if any. The applicant shall attach to the application a copy of relevant portions of the patient’s medical record sufficient to establish that the patient has a debilitating medical condition.

(2) The department shall contact the physician for purposes of verifying the existence of a bona fide physician-patient relationship and the accuracy of the medical record.

(3) The department shall approve or deny the application for registration in writing within 30 days from receipt of a completed registration application. If the application is approved, the department shall issue the applicant a registration card which shall include the registered patient’s name and photograph, as well as a unique identifier for law enforcement verification purposes under section 4479 of this title.

(4)(A) A review board is established. The medical practice board shall appoint three physicians licensed in Vermont to constitute the review board. If an application under subdivision (1) of this subsection is denied, within seven days the patient may appeal the denial to the board. Review shall be limited to information submitted by the patient under subdivision (1) of this subsection, and consultation with the patient’s treating physician. All records relating to the appeal shall be kept confidential. An appeal shall be decided by majority vote of the members of the board.

(B) The board shall meet periodically to review studies, data, and any other information relevant to the use of marijuana for symptom relief. The board may make recommendations to the general assembly for adjustments and changes to chapter 86 of this title.

(C) Members of the board shall serve for three-year terms, beginning February 1 of the year in which the appointment is made, except that the first members appointed shall serve as follows: one for a term of two years, one for a term of three years, and one for a term of four years. Members shall be entitled to per diem compensation authorized under section 1010 of Title 32. Vacancies shall be filled in the same manner as the original appointment for the unexpired portion of the term vacated.

§ 4475. REGISTERED CAREGIVERS; QUALIFICATION STANDARDS AND PROCEDURES

(a) A person may submit a signed application to the department of public safety to become a registered patient’s registered caregiver. The department shall approve or deny the application in writing within 30 days. The department shall approve a registered caregiver’s application and issue the person an authorization card, including the caregiver’s name, photograph, and a unique identifier, after verifying:

(1) the person will serve as the registered caregiver for one registered patient only; and

(2) the person has never been convicted of a drug‑related crime.

(b) Prior to acting on an application, the department shall obtain from the Vermont criminal information center a Vermont criminal record, an

out-of-state criminal record, and a criminal record from the Federal Bureau of Investigation for the applicant. For purposes of this subdivision, “criminal record” means a record of whether the person has ever been convicted of a drug-related crime. Each applicant shall consent to release of criminal records to the department on forms substantially similar to the release forms developed by the center pursuant to section 2056c of Title 20. The department shall comply with all laws regulating the release of criminal history records and the protection of individual privacy. The Vermont criminal information center shall send to the requester any record received pursuant to this section or inform the department that no record exists. If the department disapproves an application, the department shall promptly provide a copy of any record of convictions and pending criminal charges to the applicant and shall inform the applicant of the right to appeal the accuracy and completeness of the record pursuant to rules adopted by the Vermont criminal information center. No person shall confirm the existence or nonexistence of criminal record information to any person who would not be eligible to receive the information pursuant to this subchapter.

(c) A registered caregiver may serve only one registered patient at a time, and a registered patient may have only one registered caregiver at a time.

§ 4476. REGISTRATION; FEES

(a) The department shall establish a fee for the application authorized by sections 4474 and 4475 of this title not to exceed $100.00. The fees received by the department shall be deposited into a registration fee fund and used to offset the costs of processing applications under this subchapter.

(b) A registration card shall expire one year after the date of issue, with the option of renewal, provided the patient submits a new application which is approved by the department, pursuant to section 4474 or 4475 of this title, and pays the fee required under subsection (a) of this section.

§ 4477. EXEMPTION FROM CRIMINAL AND CIVIL PENALTIES; SEIZURE OF PROPERTY

(a) A person who has in his or her possession a valid registration card issued pursuant to this subchapter and who is in compliance with the requirements of this subchapter, including the possession limits in subdivision 4472(4) of this title, shall be exempt from arrest or prosecution under subsection 4230(a) of this title.

(b) A physician who has participated in a patient’s application process under subdivision 4474(b)(2) of this title shall not be subject to arrest, prosecution, or disciplinary action under chapter 23 of Title 26, penalized in any manner, or denied any right or privilege under state law, except for giving false information, pursuant to subsection 4478(f) of this title.

(c) No person shall be subject to arrest or prosecution for constructive possession, conspiracy, or any other offense for simply being in the presence or vicinity of a registered patient or registered caregiver engaged in use of marijuana for symptom relief.

(d) A law enforcement officer shall not be required to return marijuana or paraphernalia relating to its use seized from a registered patient or registered caregiver.

§ 4478. PROHIBITIONS, RESTRICTIONS, AND LIMITATIONS REGARDING THE USE OF MARIJUANA FOR SYMPTOM RELIEF

(a) This subchapter shall not exempt any person from arrest or prosecution for:

(1) Being under the influence of marijuana while:

(A) operating a motor vehicle, boat, or vessel, or any other vehicle propelled or drawn by power other than muscular power;

(B) in a workplace or place of employment; or

(2) The use or possession of marijuana by a registered patient or a registered caregiver:

(A) for purposes other than symptom relief as permitted by this subchapter; or

(B) in a manner that endangers the health or well-being of another person.

(3) The smoking of marijuana in any public place, including:

(A) a school bus, public bus, or other public vehicle;

(B) a workplace or place of employment;

(D) any correctional facility; or

(E) any public park, public beach, public recreation center, or youth center.

(b) This chapter shall not be construed to require that coverage or reimbursement for the use of marijuana for symptom relief be provided by:

(1) a health insurer as defined by subdivision 9402(7) of this title, or any insurance company regulated under Title 8;

(2) an employer; or

(3) for purposes of worker’s compensation, an employer as defined in subdivision 601(3) of Title 21.

(c) A registered patient or registered caregiver who elects to grow marijuana to be used for symptom relief by the patient may do so only if the marijuana is cultivated in a single, secure indoor facility.

(d) A registered patient or registered caregiver may not transport marijuana in public unless it is secured in a locked container.

(e) Within 72 hours after the death of a registered patient, the patient’s registered caregiver shall return to the department of public safety for disposal any marijuana or marijuana plants in the possession of the patient or registered caregiver at the time of the patient’s death. If the patient did not have a registered caregiver, the patient’s next of kin shall contact the department within 72 hours after the patient’s death and shall ask the department of public safety to retrieve such marijuana and marijuana plants for disposal.

(f) Notwithstanding any law to the contrary, a person who knowingly gives to any law enforcement officer false information to avoid arrest or prosecution, or to assist another in avoiding arrest or prosecution, shall be imprisoned for not more than one year or fined not more than $1,000.00, or both. This penalty shall be in addition to any other penalties that may apply for the possession or use of marijuana.

§ 4479. LAW ENFORCEMENT VERIFICATION OF INFORMATION; RULEMAKING

(a) The department of public safety shall maintain and keep confidential, except as provided in subsection (b) of this section and except for purposes of a prosecution for false swearing under section 2904 of Title 13, the records of all persons registered under this subchapter or registered caregivers in a secure database accessible by authorized department of health employees only.

(b) In response to a person-specific or property-specific inquiry by a law enforcement officer or agency made in the course of a bona fide investigation or prosecution, the department may verify the identities and registered property addresses of the registered patient and the patient’s registered caregiver.

(c) The department shall maintain a separate secure electronic database accessible to law enforcement personnel 24 hours a day that uses a unique identifier system to allow law enforcement to verify that a person is a registered patient or registered caregiver.

(d) The department of public safety shall implement the requirements of this act within 120 days of its effective date. The department may adopt rules under chapter 25 of Title 3 and shall develop forms to implement this act.

Sec. 16b. REPORT

The department of public safety, with input from the review board and the department of health, shall report to the house and senate committees on health and welfare and judiciary on the use of marijuana for symptom relief by January 1, 2006. The report shall include:

(1) statistics regarding the number of people using marijuana for symptom relief, the number of applications received by the department for persons to become registered patients or registered caregivers, and the types of debilitating medical conditions presented in the applications;

(2) a summary of the current research, including the conclusions of the Institute of Medicine, regarding whether there are legitimate medical uses of marijuana;

(3) an evaluation of the costs of permitting the use of marijuana for symptom relief, including any costs to law enforcement officers and costs of any litigation;

(4) an analysis of whether permitting the use of marijuana for symptom relief has made it more difficult to enforce criminal laws relating to substance abuse;

(5) an analysis of whether permitting the use of marijuana for symptom relief has increased illegal marijuana use by creating a public perception that arrests for possession and use of marijuana have become less likely to occur, and criminal charges have become more difficult to prosecute;

(6) statistics regarding the number of prosecutions brought against doctors and other persons for violations of this act; and

(7) whether the United States Food and Drug Administration has altered its position regarding the use of marijuana for medical purposes or has approved alternative delivery systems for marijuana.

Sec. 17. EFFECTIVE DATE; TRANSITIONAL PROVISIONS

(a) This section and Secs. 1 and 10 of this act shall take effect upon passage.

(b) Secs. 3-9 and 11-12 of this act shall apply to any advance directive entered into on and after July 1, 2004. This act shall not apply to powers of attorney executed before July 1, 1988 or to durable powers of attorney for health care and terminal care documents executed prior to July 1, 2004.

(c) Notwithstanding any provision of law to the contrary, any irrevocable pre-need contract in effect prior to July 1, 2004 shall be considered an advance directive, may not be amended except by the principal, and shall be enforced as if entered into on or after July 1, 2004 and pursuant to the provisions of Secs. 3 through 12 of this act.

and by amending the title to read: “AN ACT RELATING TO ADVANCE DIRECTIVES FOR HEALTH CARE, PAIN MANAGEMENT, AND LONG‑TERM CARE”

Rep. Maier of Middlebury moved to concur in the Senate proposal of amendment with a further amendment thereto:

First: In Sec. 13, in the second sentence, before the words “and developing enhanced training in pain management,” by inserting the words: “developing a program, subject to subsequent legislative authorization, for monitoring all prescription drug use in Vermont and tracking the prescribing patterns of providers of federally controlled substances;”

Second: By striking Secs. 15, 16a, and 16b in their entirety and renumbering Sec. 17 to be Sec. 15

Which was agreed to.

Joint Resolution Adopted

J.R.H. 76

Joint resolution, entitled

Joint resolution urging the federal government not to reduce funding for federal housing support programs nor convert the Section 8 housing voucher program into a block grant;

Was taken up and adopted on the part of the House.

Rules Suspended; Senate Proposal of Amendment Not Concurred in;

Committee of Conference Requested and Appointed

H. 272

On motion of Rep. Symington of Jericho, the rules were suspended and House bill, entitled

An act relating to nutrition policy in Vermont schools;

Appearing on the Calendar for notice, was taken up for immediate consideration.

The Senate proposes to the House to amend the bill by striking out all after the enacting clause and inserting in lieu thereof the following:

Sec. 1. STATEMENT OF PURPOSE

It is the purpose of this act to encourage wellness programs in Vermont public schools and in Vermont communities. Wellness programs will be designed to encourage life-long patterns of healthy eating and regular physical exercise among Vermont citizens.

Sec. 2. 16 V.S.A. § 216 is added to read:

§ 216. WELLNESS PROGRAM

(a) In this section:

(1) “Physical activity program” means a program which includes, in addition to regular physical education classes, minimum daily physical activity for each student provided through activities such as recess and other recreation periods, and participation in athletics either during or after regular school hours. “Physical activity” means moderate and vigorous physical activities.

(2) “Physical education program” means a program which is a sequential, developmentally appropriate program that is an enjoyable experience for students and designed to help students develop the knowledge, skill, self-management skill, attitudes, and confidence needed to adopt and maintain physical fitness throughout their lives.

(3) “Fitness program” means a program which includes a physical education program and a physical activity program.

(4) “Nutrition” includes all food and beverages sold or served in the food service program, vending machines, snack bars, and school stores.

(5) “Wellness program” means a program which includes fitness and nutrition.

(b) The commissioner with the approval of the state board shall establish an advisory council on wellness which shall include at least three members associated with the health services field. The members shall serve without compensation but shall receive their actual expenses incurred in the pursuit of their duties relating to wellness programs. The council shall assist the department of education in planning, coordinating, and encouraging wellness programs in the public schools.

(1) Supervise the preparation of appropriate nutrition and fitness curricula for use in the public schools, promote programs for the preparation of teachers to teach these curricula, and assist in the development of wellness programs.

(2) Prepare and continually update a list of school and community programs which have the potential to improve childhood wellness. The commissioner shall make the list available to all school districts and to any community groups that request it.

(3) Establish and maintain a website which displays data from a youth risk behavior survey in a way that enables the public to aggregate and disaggregate the information.

(4) Research funding opportunities for schools and communities that wish to build wellness programs and make the information available to the public.

(d) The department shall offer assistance to school districts and supervisory unions to provide teacher instruction in wellness programs.

(e) Any school district board or supervisory union board may establish a wellness community advisory council to inventory community programs and assets and to assist the school board and community in developing and implementing wellness programs. The school board shall provide public notice to the community to allow all interested parties to apply for appointment. The school board shall endeavor to appoint members that represent various points of view and expertise within the community regarding wellness programs. Members may include representatives from coordinated school health teams, teachers, school administrators, students, community members, health care providers, parents, and others.

Sec. 3. COMMISSIONER OF EDUCATION; SECRETARY OF HUMAN SERVICES; CHILDHOOD FITNESS AND NUTRITION MODEL POLICIES; COMMUNITY GRANTS PROGRAM

(a) The commissioner of education shall collaborate with the secretary of human services and the secretary of agriculture, foods and markets to write a model school fitness and nutrition policy. The policy shall be available to school districts on or before January 1, 2005. The model policy shall include:

(1) A definition of nutritious foods, nutritional guidelines, and policies regarding purchasing of locally grown foods for food and beverages sold or served in the food service program, vending machines, snack bars, and school stores.

(2) A model physical education curriculum which is a sequential, developmentally appropriate program that is an enjoyable experience for students and designed to help students develop the knowledge, skill, self‑management skill, attitudes, and confidence needed to adopt and maintain physical fitness throughout their lives. The model program shall include an annual report to parents which describes their child’s performance on fitness and other wellness indicators.

(3) Model physical activity policies which include, in addition to regular physical education classes, minimum daily physical activity for each student provided through programs such as recess and other recreation periods, and participation in athletics either during or after regular school hours. In this subsection, “physical activity” means moderate and vigorous physical activities.

(4) A process for implementing and enforcing nutrition and physical fitness policies.

(5) A process for gathering data on the health status of students reporting aggregate data to the community.

(b) The commissioner of education shall develop and implement a wellness grant program which awards funds to help school communities establish a wellness program pursuant to section 216 of Title 16. The funds may be used to establish a wellness community advisory council, inventory community programs and assets, gather data about the health status of children in the community, adopt a fitness and nutrition policy based on the model policy developed under subsection (a) of this section, begin to implement and coordinate wellness programs in the community based on the adopted policy, and seek funding for further implementation of the policy from other sources such as the department of health.

(c) On or before January 15, 2006, the commissioner of education shall report to the senate and house committees on education on the implementation of this act.

Sec. 4. POSITION CREATED

One position - educational consultant II - is created in the department of education, safe and healthy schools division, for the purpose of implementing this act.

Pending the question, Will the House concur in the Senate proposal of amendment? Rep. McLaughlin of Royalton moved that the House refuse to concur and ask for a Committee of Conference, which was agreed to, and the Speaker appointed as members of the Committee of Conference on the part of the House:

Rep. Branagan of Georgia

Rep. Chen of Mendon

Rep. McLaughlin of Royalton

Bills Messaged to Senate Forthwith

On motion of Rep. Symington of Jericho, the rules were suspended and the bills were ordered messaged to the Senate forthwith.

H. 272

House bill, entitled

An act relating to nutrition policy in Vermont schools;

H. 752

House bill, entitled

An act relating to advance directive for health care;

Bill Not Messaged to Senate Forthwith

S. 76

Senate bill, entitled

An act relating to the medical use of marijuana;

Rep. Zuckerman of Burlington moved to suspend the rules and message the bill to the Senate forthwith.

Pending the question, Shall the House suspend the rules and message the bill to the Senate forthwith? Rep. Connell of Warren demanded the Yeas and Nays, which demand was sustained by the Constitutional number. The Clerk proceeded to call the roll and the question, Shall the House suspend the rules and message the bill to the Senate forthwith? was decided in the negative. Yeas, 58. Nays, 51. a 3/4 vote of 82 needed.

Those who voted in the affirmative are: