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NO. 174.  AN ACT RELATING TO TECHNICAL AMENDMENTS TO THE VERMONT STATUTES ANNOTATED RELATED TO RESTRUCTURING THE AGENCY OF HUMAN SERVICES.

(H.853)

It is hereby enacted by the General Assembly of the State of Vermont:

* * * Executive Branch * * *

Sec. 1.  3 V.S.A. § 131(g) is amended to read:

(g)  Nothing in this section shall prohibit the disclosure of information regarding disciplinary complaints to state or federal law enforcement agencies, the department of disabilities, aging, and disabilities independent living, or the department of banking, insurance, securities, and health care administration in the course of their investigations, provided the agency or department agrees to maintain the confidentiality and privileged status of the information as provided in subsection (d) of this section.

Sec. 2.  3 V.S.A. § 212(20) is amended to read:

(20)  The department of prevention, assistance, transition, and health access for children and families.

Sec. 3.  3 V.S.A. § 309a(b) is amended to read:

(b)  Rules adopted by the commissioner shall allow flexibility with respect to hiring handicapped persons.  The commissioner may require certification by the commissioner of the department of disabilities, aging, and disabilities independent living to accompany the usual application for employment.  The commissioner of the department of disabilities, aging, and disabilities independent living shall indicate in its certification that:

Sec. 4.  3 V.S.A. § 816(a)(1) is amended to read:

(1)  Acts, decisions, findings, or determinations by the human services board or the commissioner of prevention, assistance, transition, and health access for children and families or his, it’s or their a duly authorized agents agent, and to procedures or hearings before and by him the board or commissioner or it or his or its agents, provided further that subdivisions 802(a)(3) and (4), and subsections 802(b) and 804(a) of this title shall not apply to information made confidential under federal or state law agent.

Sec. 5.  3 V.S.A. § 3085a is amended to read:

§ 3085a.  DEPARTMENT OF DISABILITIES, AGING, AND

                 INDEPENDENT LIVING

The department of disabilities, aging, and independent living is created within the agency of human services as the successor to and continuation of the department of aging and disabilities, the developmental services division of the department of developmental and mental health services, and the personal care and hi-tech programs in the former department of prevention, assistance, transition, and health access to manage programs and to protect the interests of older Vermonters and Vermonters with disabilities.  It shall serve as the state unit on aging, as provided by the Older Americans Act of 1965, as amended, and it shall serve as the administrative home within the agency of human services for the designated state agencies for federal vocational rehabilitation and independent living programs, as provided by the Rehabilitation Act of 1973, as amended.

Sec. 6.  3 V.S.A. § 3085b is amended to read:

§ 3085b.  Commission on Alzheimer’s disease and related

                disorders

* * *

(b)  The commission shall be composed of 16 members:  the commissioner of disabilities, aging, and disabilities independent living or a designee, one senator chosen by the committee on committees of the senate, one representative chosen by the speaker of the house, and 13 members appointed by the governor.  The members appointed by the governor shall represent the following groups:  physicians, social workers, nursing home managers, the clergy, adult day center providers, the business community, registered nurses, residential care home operators, family care providers, the home health agency, the legal profession, mental health service providers, and the Alzheimer’s association.  The members appointed by the governor shall represent, to the degree possible, the five regions of the state.

* * *

(d)  Legislative members shall be entitled to compensation and expenses as provided in 2 V.S.A. § 406 for no more than six meetings per year; the remaining members shall be entitled to compensation and expenses as provided in 32 V.S.A. § 1010 for no more than six meetings per year.  Payment to legislative members shall be from the appropriation to the legislature.  Payment to the remaining members shall be from the appropriation to the department of disabilities, aging, and disabilities independent living.

* * *

(g)  The department of disabilities, aging, and disabilities independent living shall provide the commission with administrative support.

* * *

Sec. 7.  3 V.S.A. § 3086(a) is amended to read:

(a)  The operations division of the agency is created.  It shall be administered by a director of administration and rate setting, who shall be in the classified service.  The director shall also be the head of the division of rate setting pursuant to 33 V.S.A. § 902(b).

Sec. 8.  3 V.S.A. § 3091(a) is amended to read:

(a)  An applicant for or a recipient of assistance, benefits or social services from the department of social and rehabilitation services, the department of prevention, assistance, transition, and health access for children and families, the office of Vermont health access, the office of economic opportunity, and the department of disabilities, aging, and disabilities independent living, the office of child support, the division of mental health of the department of health, or an applicant for a license from one of those departments or offices, or a licensee, may file a request for a fair hearing with the human services board.  An opportunity for a fair hearing will be granted to any individual requesting a hearing because his or her claim for assistance, benefits or services is denied, or is not acted upon with reasonable promptness; or because the individual is aggrieved by any other agency action affecting his or her receipt of assistance, benefits or services, or license or license application; or because the individual is aggrieved by agency policy as it affects his or her situation.

Sec. 9.  3 V.S.A. § 3094(a) is amended to read:

(a)  The office of child support is created within the agency of human services as the successor to and continuation of that part of the department of prevention, assistance, transition, and health access responsible for child support enforcement department for children and families and shall be designated the IV-D agency for purposes of Title IV-D of the federal Social Security Act.

* * * Judiciary * * *

Sec. 10.  4 V.S.A. § 953(b) is amended to read:

(b)  Notwithstanding any law to the contrary, the court administrator may obtain the names, addresses, and dates of birth of persons which are contained in the records of the department of motor vehicles, the department of employment and training, the department of taxes, the department of health, and the department for children and family services families.  The court administrator may also obtain the names of voters from the secretary of state. After the names have been obtained, the court administrator shall compile them and provide the names, addresses, and dates of birth to the jury commission in a form that will not reveal the source of the names.  The jury commission shall include the names provided by the court administrator in the list of potential jurors.

* * * Banking and Insurance * * *

Sec. 11.  8 V.S.A. § 4185(c)(2)(B) is amended to read:

(B)  the amounts provided by contract between a hospital provider and the department of prevention, assistance, transition, and office of Vermont health access for similar services to recipients of Medicaid; or

Sec. 12.  8 V.S.A. § 10204(25) is amended to read:

(25)  Reports or disclosure of information to the department of disabilities, aging, and disabilities independent living, pursuant to subsection 6903(b) and section 6904 of Title 33.

Sec. 13.  8 V.S.A. § 14212(e) is amended to read:

(e)  The fiduciary shall maintain accurate records to permit an accounting of the acts of the fiduciary, and shall provide such records and accounting if requested to do so by the owner, by a legal representative of the owner, by the attorney general, a state’s attorney, or the department of disabilities, aging, and disabilities independent living if any has reason to believe the fiduciary is in violation of this section, or by a court of competent jurisdiction.

* * * Commerce and Trade * * *

Sec. 14.  9 V.S.A. § 2470b(f) is amended to read:

(f) At least annually, the department of health shall notify day care facilities and family day child care homes licensed or registered under chapter 35 of Title 33 of the list of children’s products created and maintained under subsection (b) of this section.

Sec. 15.  9 V.S.A. § 2480h(l)(5) is amended to read:

(5)  The economic services division of the department for children and families or the office of Vermont health access or its agents or assignee acting to investigate welfare or Medicaid fraud.

* * * Conservation and Development * * *

Sec. 16.  10 V.S.A. § 531(d) is amended to read:

(d)  In issuing a grant or entering a contract for the conduct of training under this section, the secretary of commerce and community development shall first consult with: the commissioner of education regarding vocational-technical education; the commissioner of employment and training regarding apprenticeship programs, on-the-job training programs, and recruiting through Vermont Job Service and available federal training funds; the commissioner of prevention, assistance, transition, and health access for children and families regarding welfare to work priorities; and the University of Vermont and the Vermont state colleges.

* * * Court Procedure * * *

Sec. 17.  12 V.S.A. § 3169(a)(3) is amended to read:

(3)  whether the judgment debtor has been a recipient of assistance from the Vermont department of prevention, assistance, transition, and health access for children and families or the office of Vermont health access within the two months preceding the date of the hearing; and

Sec. 18.  12 V.S.A. § 3170(a) is amended to read:

(a)  No order approving the issuance of trustee process against earnings shall be entered against a judgment debtor who was, within the two-month period preceding the hearing provided in section 3169 of this title, a recipient of assistance from the Vermont department of prevention, assistance, transition, and health access for children and families or the office of Vermont health access.  The judgment debtor must establish this exemption at the time of hearing.

* * * Crimes and Criminal Procedure * * *

Sec. 19.  13 V.S.A. § 4814(a) is amended to read:

(a) Any court before which a criminal prosecution is pending may order the department of developmental and mental health services to have the defendant examined by a psychiatrist at any time before, during or after trial, and before final judgment in any of the following cases:

* * *

Sec. 20.  13 V.S.A. § 4815 is amended to read:

§ 4815.  Place of examination; temporary commitment

* * *

(b)  The order for examination may provide for an examination at any jail or correctional center, or at the state hospital, or at such other place as the court shall determine, after hearing a recommendation by the commissioner of developmental and mental health services.

* * *

(g)(1)  Inpatient examination at the state hospital or a designated hospital. The court shall not order an inpatient examination unless the designated mental health professional determines that the defendant is a person in need of treatment as defined in 18 V.S.A. § 7101(17).

* * *

(4)  If a return to court is not ordered and the defendant is not in the custody of the commissioner of corrections, the defendant shall be returned to the defendant’s residence or such other appropriate place within the state of Vermont by the department of developmental and mental health services at the expense of the court.

* * *

Sec. 21.  13 V.S.A. § 4820(4) is amended to read:

(4)  Upon trial by court or jury is acquitted by reason of insanity at the time of the alleged offense;

the court before which such person is tried or is to be tried for such offense, shall hold a hearing for the purpose of determining whether such person should be committed to the custody of the commissioner of developmental and mental health services.  Such person may be confined in jail or some other suitable place by order of the court pending hearing for a period not exceeding fifteen 15 days.

Sec. 22.  13 V.S.A. § 4821 is amended to read:

§ 4821.  Notice of hearing; procedures

The person who is the subject of the proceedings, his or her attorney, the legal guardian, if any, the commissioner of the department of developmental and mental health services or the commissioner of disabilities, aging, and independent living, and the state’s attorney or other prosecuting officer representing the state in the case, shall be given notice of the time and place of a hearing under the preceding section.  Procedures for hearings for persons who are mentally ill shall be as provided in chapter 181 of Title 18.  Procedures for hearings for persons who are mentally retarded shall be as provided in subchapter 3 of chapter 206 of Title 18.

Sec. 23.  13 V.S.A. § 4823(a) is amended to read:

(a)  If the court finds that such person is a person in need of custody, care and habilitation as defined in section 8839 of Title 18, the court shall issue an order of commitment directed to the commissioner of developmental and mental health services disabilities, aging, and independent living for care and habilitation of such person for an indefinite or limited period in a designated program.

* * * Decedent’s Estates and Fiduciary Relations * * *

Sec. 24.  14 V.S.A. § 3067(a) is amended to read:

(a)  When a petition is filed pursuant to section 3063 of this title, the court shall order an evaluation of the respondent.  Except as otherwise provided in this subsection, the cost of the evaluation shall be paid for out of the respondent’s estate.  If the respondent is unable to afford some or all of the cost of the evaluation without expending income or liquid resources necessary for living expenses, the court shall order that the department of developmental and mental health services or the department of disabilities, aging, and independent living provide the evaluation through community mental health agencies affiliated with the department departments.

Sec. 25.  14 V.S.A. § 3091 is amended to read:

§ 3091.  Office of public guardian established

(a)  An office of public guardian is established within the department of disabilities, aging, and disabilities independent living for the purpose of making guardianship services available to mentally disabled persons 60 years of age or older for whom the probate court is unable to appoint a guardian from the private sector.

(b)  The commissioner of the department of disabilities, aging, and disabilities independent living shall employ persons as public guardians to act as designees of the office and to carry out the duties of the office of public guardian.  Public guardians shall be available for appointment in each of the planning and service areas served by the area agencies on aging.

(c)  The commissioner of the department of disabilities, aging, and disabilities independent living may adopt rules necessary to accomplish the purposes of this subchapter including, but not limited to, standards relating to the maximum number of appointments that may be accepted by the office.

* * *

Sec. 26.  14 V.S.A. § 3510 is amended to read:

§ 3510.  Action for accounting; declaratory relief;

               termination of power of attorney

* * *

(b)  The commissioner of disabilities, aging, and disabilities independent living, or designee, acting pursuant to chapter 69 of Title 33, may also file a petition in superior court for the purposes listed in subsection (c) of this section.  If, upon motion of the principal, the court determines that the principal is capable of expressing his or her opinion and does not wish the commissioner, or designee, to pursue the petition, the court shall dismiss the petition unless the court finds the opinion is the product of duress or undue influence.

(c)  A petition may be filed for the following purposes:

* * *

(4)  To compel the agent to submit an accounting or to report his or her acts as agent to the commissioner of disabilities, aging, and disabilities independent living, acting pursuant to subsection (b) of this section, upon a showing that there is good cause to believe:

* * *

(d)(1)  In a proceeding under this section, commenced by the filing of a petition by a principal or the principal’s legal representative, the court may order an agent to pay reasonable attorney’s fees to the principal if the court determines that the agent has clearly violated the provisions of this chapter or the terms of the power of attorney, his or her fiduciary duties under the power of attorney, or has failed without any reasonable cause or justification to submit accountings or reports after written request.

(2)  In a proceeding under this section, commenced by the filing of a petition by the commissioner of disabilities, aging, and disabilities independent living, or designee, the court may order the commissioner to pay reasonable attorney’s fees to the agent if the court finds that the petition was filed without a substantial basis in law or fact.

* * *

* * * Domestic Relations * * *

Sec. 27.  15 V.S.A. § 209 is amended to read:

§ 209.  DISPOSITION, CARE, AND MAINTENANCE OF CHILDREN

When a parent is found guilty of nonsupport or desertion of his or her child, the court may enter such order or judgment relating to the disposition, care and maintenance of such child, either by committing the child to the department of prevention, assistance, transition, and health access for children and families or to some person or suitable institution, as shall be equitable in the premises.  The court may enforce the same by execution or by any proper proceedings.  The property of such parent shall not be exempt from levy and sale under execution.

Sec. 28.  15 V.S.A. § 293(a) is amended to read:

(a)  When parents of minor children, or parents and stepparents of minor children, whether said parents are married or unmarried, are living separately, on the complaint of either parent or stepparent or, if it is a party in interest, the department of prevention, assistance, transition, and health access for children and families, the family court may make such decree concerning parental rights and responsibilities and parent-child contact (as defined in section 664 of this title), and the support of the children, as in cases where either parent deserts or without just cause fails to support.  Thereafter on the motion of either of the parents, the stepparent or the department of prevention, assistance, transition, and health access for children and families, the court may annul, vary or modify the decrees.

Sec. 29.  15 V.S.A. § 294(a) is amended to read:

(a)  When the mother of minor children is residing within the same household as a man unrelated to her and not otherwise liable for the support of the mother and her children, on the complaint of the mother or, if she is receiving public assistance, the department of prevention, assistance, transition, and health access for children and families, the superior court shall make such decree concerning the support of the mother and the care, custody, maintenance and education of the children as in cases where the husband refuses without just cause to support his wife and children.  The decree shall by its terms continue in force for so long as the defendant resides within the household or until further order of the court.

Sec. 30.  15 V.S.A. § 603 is amended to read:

§ 603.  CONTEMPT

A person who disobeys a lawful order or decree of a court or judge, made under the provisions of this chapter, may be proceeded against for contempt as provided by section 122 of Title 12.  The department of prevention, assistance, transition, and health access for children and families may institute such proceedings in all cases in which a party or dependent children of the parties are the recipients of financial assistance from the department.  The court may order restitution to the department of prevention, assistance, transition, and health access, and that payments be made to the department of prevention, assistance, transition, and health access for distribution, or make such other orders or conditions as it deems proper.

Sec. 31.  15 V.S.A. § 606(a) is amended to read:

(a)  When a judgment or order for the payment of either temporary or permanent maintenance, child support, or suit money has been made by the family court, and personal jurisdiction of the person liable for the payment of money under the judgment or order has been obtained, the party entitled by the terms of the judgment or order to payment thereunder, or the office of child support in all cases in which the party or dependent children of the parties are the recipients of financial assistance from the department of prevention, assistance, transition, and health access for children and families, may file a motion in the family court asking for a determination of the amount due.  Upon notice to the other party and hearing thereon, the family court shall render judgment for the amount due under the judgment or order; the court may order restitution to the department of prevention, assistance, transition, and health access, order that payments be made to the office of child support for distribution, or make such other orders or conditions as it deems proper.  The judgment shall be as binding and as enforceable in all respects as though rendered in any other civil action.  Notice shall be given in such manner as the supreme court shall by rule provide.  An additional motion may be brought at any time for further unpaid balances.  The family court in which the cause was pending at the time the original judgment or order was made shall have jurisdiction of motions under the provisions of this section, irrespective of the amount in controversy or the residence of the parties.  The motions may be brought and judgment obtained on judgments, decrees and orders previously rendered and still in force.

Sec. 32.  15 V.S.A. § 653(7) is amended to read:

(7)  “Self-support reserve” means the needs standard established annually by the commissioner of prevention, assistance, transition, and health access for children and families which shall be an amount sufficient to provide a reasonable subsistence compatible with decency and health.  The needs standard shall take into account the available income of the parent responsible for payment of child support.

Sec. 33.  15 V.S.A. § 658(b) is amended to read:

(b) A request for support may be made by either parent, a guardian, or the department for children and families or the office of Vermont health access, if a party in interest.  A court may also raise the issue of support on its own motion.

* * * Education * * *

Sec. 34.  16 V.S.A. § 1592(3) is amended to read:

(3)  Coordinate such programs with other employment and training programs such as those offered by the department of employment and training, the department of labor and industry, the department of prevention, assistance, transition, and health access for children and families, the agency of commerce and community development, independent colleges, and the Vermont Student Assistance Corporation.

Sec. 34a.  18 V.S.A. § 1 is amended to read:

§ 1.  GENERAL POWERS OF DEPARTMENT OF HEALTH

As herein or elsewhere specified, the department of health shall have power to supervise and direct the execution of all laws relating to public health, mental health, and substance abuse.

* * * Health * * *

Sec. 35.  18 V.S.A. § 7101(2) is amended to read

(2)  “Commissioner” means the commissioner of developmental and mental health services;

Sec.  36.  18 V.S.A. § 7103(e) is amended to read:

(e)  Mandatory disclosure to home providers.

(1)  With the written consent of the individual, or his or her guardian, an agency designated by the department of disabilities, aging, and independent living or of health to provide developmental disability and mental health services shall disclose all relevant information, in writing, to a potential home care provider for that individual so that the provider has the opportunity to make a fully informed decision prior to the placement.

(2)  If the individual, or his or her guardian, does not consent to the disclosure, the placement will not occur unless the home care provider agrees, in writing, to the placement, absent disclosure.

(3)  A home care provider must furnish to any person providing respite care, the individual’s relevant information obtained from the agency designated by the department of disabilities, aging, and independent living or of health to provide developmental disability and mental health services, as provided in this subsection.  Where the home care provider has agreed to placement without disclosure, the home care provider shall inform the respite provider of that fact.

(4)  Home care and respite providers, whether or not they agree to a placement, shall be subject to the confidentiality and disclosure requirements of subsections (a), (b), and (c) of this section.

(5)  As used in this subsection:

(A)  “Home care provider” means a person or entity paid by an agency designated by the department of disabilities, aging, and independent living or of health to provide developmental disability and mental health services, to provide care in his or her home.

* * *

(7)  Where the individual has consented to disclosure, an agency designated by the department of disabilities, aging, and independent living or health to provide developmental disability and mental health services shall provide updated information regarding the individual to the home care provider.

Sec. 37.  18 V.S.A. § 7113 is amended to read:

§ 7113.  INDEPENDENT EXAMINATION: PAYMENT

Whenever a court orders an independent examination by a mental health professional or a qualified mental retardation professional pursuant to this title or 13 V.S.A. § 4822, the cost of the examination shall be paid by the department of developmental and mental health services of disabilities, aging, and independent living or of health.  The mental health professional or qualified mental retardation professional may be selected by the court but the commissioner of developmental and mental health services disabilities, aging, and independent living or the commissioner of health may adopt a reasonable fee schedule for examination, reports and testimony.

Sec. 38.  18 V.S.A. chapter 173 is amended to read:

Chapter 173.  THE DEPARTMENT OF

DEVELOPMENTAL AND MENTAL HEALTH SERVICES,

DIVISION OF MENTAL HEALTH

§ 7201.  ESTABLISHMENT OF DEPARTMENT MENTAL HEALTH

The department of health, as the successor to the division of mental health services of the former department of developmental and mental health services, is created to shall centralize and more efficiently establish the general policy and execute the programs and services of the state concerning mental health, and to integrate and coordinate those programs and services with the programs and services of other departments of the state, its political subdivisions, and private agencies, so as to provide a flexible comprehensive service to all citizens of the state in mental health and related problems.

§ 7202.  Coordination

The department of health shall be responsible for coordinating efforts of all agencies and services, government and private, directed towards the control, reduction and prevention of those problems involving mental retardation,  mental illness and, in coordination with the departments of social and rehabilitation services and education, severe emotional disturbance on a statewide basis in order to promote and improve the mental health of individuals through outreach, education, and other activities.  The department of disabilities, aging, and independent living shall be responsible for coordinating the efforts of all agencies and services, government and private, on a statewide basis in order to promote and improve the lives of individuals with developmental disabilities.

§ 7205.  SUPERVISION OF INSTITUTIONS

The department of health shall operate the Vermont State Hospital and the Training School and shall be responsible for state patients at the Retreat receiving involuntary treatment at a hospital designated by the department of health.

§ 7206.  RECOMMENDATIONS AND REPORTS

The department shall from time to time study comprehensively the mental health problems of the state, develop programs for mental health services, and recommend as to the integration within the department of any other related agencies and services as it considers proper.  It shall also periodically review and evaluate the mental health programs and shall report biennially to the general assembly.

Sec. 39.  18 V.S.A. chapter 177 is amended to read:

Chapter 177.  THE COMMISSIONER OF DEVELOPMENTAL AND MENTAL HEALTH SERVICES

§ 7401.  Powers and duties

* * *

(3)  designate, control and supervise the property, affairs and operation of hospitals, training schools and institutions equipped and otherwise qualified to provide inpatient care and treatment for individuals who are mentally ill or mentally retarded;

* * *

(6)  provide for the hospitalization of mentally ill or mentally retarded patients in designated hospitals, training schools or institutions of Vermont or negotiate and enter into contracts which shall incorporate safeguards consistent with this part of this title, with any hospital or institution for the care and treatment of patients in any other state;

(7)  prescribe the form of applications, records, reports, and medical certificates required by the statutes, and the information to be contained therein and to supply them to physicians and probate courts;

(8)  require reports from the head of a hospital, training school or other institution concerning the care of patients;

(9)  visit each hospital, training school or institution and review methods of care for all patients;

(10)  investigate complaints made by a patient, his or her attorney, or an interested party on his or her behalf;

(11)  establish rates, charges, and fees for the care of patients in hospitals and training schools, and determine ability to pay, liability for payments, and amounts to be paid and bill for and collect those amounts with the aid of the attorney general;

(12)  receive gifts and bequests of real and personal estate made for the use and benefit of any state hospital or training school, and invest any moneys so received in safe interest-bearing securities in the corporate name of the hospital or school;

(13)  delegate to any officer or agency of Vermont any of the duties and powers imposed upon him or her by this part of this title.  The delegation of authority and responsibility shall not relieve the commissioner of accountability for the proper administration of this part of this title;

(14)  plan and coordinate the development of community services which are needed to assist mentally ill, mentally retarded persons and children and adolescents with a severe emotional disturbance to become as financially and socially independent as possible.  These services shall consist of residential, rehabilitative, vocational, rehabilitative, day treatment, inpatient, outpatient, and emergency services, as well as client assessment, prevention, family, and individual support services and such other services as may be required by federal law or regulations;

(15)  contract with community mental health centers to assure that individuals who are mentally ill, mentally retarded or children and adolescents with a severe emotional disturbance can receive information, referral and assistance in obtaining those community services which they need and to which they are lawfully entitled;

* * *

§ 7402.  Records and reports

The commissioner shall keep records of all commitments and admissions to a hospital or training school and shall secure compliance with the laws relating thereto.  He The commissioner shall report biennially to the governor and the general assembly on the condition of hospitals and training schools, on the physical and medical treatment of patients and students therein, on the need for community services to former patients, students and those mentally ill and mentally retarded persons not hospitalized or admitted to training schools, and on any other matters he the commissioner deems advisable.

§ 7403.  Record of visits

The superintendent of the state hospital, and the retreat and the training school Brattleboro Retreat shall keep a record in a book kept for that purpose of the visits of the commissioner or any member of the board to the institution.

* * *

§ 7405.  Property in trust

The commissioner may take and hold in trust for the state any grant or devise of land or donation or bequest of money, or other personal property, to be applied to the maintenance of mentally ill or mentally retarded persons.

§ 7406.  Contracts

The commissioner, with the approval of the governor, may enter into contracts with the federal government or its agencies for the care, treatment or observation of those mentally ill or mentally retarded persons entitled to support by the federal government or agency as he the commissioner may deem desirable.  The receipts from those contracts shall be paid by the superintendent to the state treasurer to be applied to the general fund.

* * *

Sec. 40.  18 V.S.A. § 7624(a)(3) is amended to read:

(3)  has been committed to the custody of the commissioner of corrections as a convicted felon and is being held in a correctional facility which is a designated facility pursuant to section 7628 of this title and for whom the department of corrections and the department of developmental and mental health services have jointly determined that involuntary medication would be appropriate pursuant to subdivision 907(4)(H) of Title 28.

Sec. 41.  18 V.S.A. chapter 187 is amended to read:

Chapter 187.  TRANSFER OF PATIENTS

§ 7901.  Intrastate transfers

The commissioner may authorize the transfer of patients among and between any of the following:  the Vermont state hospital, the Brattleboro retreat, and designated hospitals, and the training school if he the commissioner determines that it would be consistent with the medical needs of the patient to do so.  Whenever a patient is transferred, written notice shall be given to his the patient’s attorney, his legal guardian, if any, spouse, parent, or parents, or, if none be known, to any other interested party in that order.  In all such transfers, due consideration shall be given to the relationship of the patient to his or her family, legal guardian, or friends, so as to maintain relationships and encourage visits beneficial to the patient.  Due consideration shall also be given to the separation of functions and to the divergent purposes of the Vermont state hospital, the Brattleboro retreat, and designated hospitals and the training school.  No patient may be transferred to a correctional institution without the order of a court of competent jurisdiction.  No patient may be transferred to a designated hospital unless the head of the hospital or his or her designee first accepts the patient.

§ 7902.  Interstate transfers

* * *

(b)  The transfer of nonresident patients from an out-of-state institution or hospital to a hospital or training school in Vermont for the purpose of being near relatives or friends shall be in the discretion of the commissioner who shall take into consideration the relationship of the patient to his or her family, legal guardian, or friends, in order to maintain those relationships and encourage visits beneficial to the patient.

* * *

Sec. 42.  18 V.S.A. § 8101(e) is amended to read:

(e)  In his or her investigation, keeping of accounts and collection of charges, the commissioner shall have the support and cooperation of the department of prevention, assistance, transition, and health access for children and families insofar as the records of that department relate to the ability to pay.

Sec. 43.  18 V.S.A. § 8711(d) is amended to read:

(d)  The court shall order the commissioner of developmental and mental health services disabilities, aging, and independent living to arrange for the preparation of a comprehensive medical, psychological and social evaluation of the person through community mental health developmental disability agencies affiliated with the department.  The comprehensive evaluation shall be completed within thirty 30 days of the receipt of the petition.  The medical report shall be prepared by a physician and shall describe the physical condition of the respondent and the availability of the effective alternative contraceptive measures to meet the needs of the person.  The psychological report shall include a diagnosis of the person’s intellectual ability and social functioning.  The social report shall be prepared by a qualified mental retardation professional, and shall describe the respondent’s developmental and social functioning.

Sec. 44.  18 V.S.A. § 8715(b) is amended to read:

(b)  The cost of evaluations required by sections 8707 and 8709 of this title shall be paid for out of appropriations of the department of developmental and mental health services disabilities, aging, and independent living.

Sec. 45.  18 V.S.A. § 8722(1) is amended to read:

(1)  “Department” means the department of developmental and mental health services disabilities, aging, and independent living.

Sec. 46.  18 V.S.A. § 8723 is amended to read:

§ 8723.  DEPARTMENT OF DEVELOPMENTAL AND MENTAL

              HEALTH SERVICES DISABILITIES, AGING, AND

              INDEPENDENT LIVING; DUTIES

The department shall plan, coordinate, administer, monitor, and evaluate state and federally funded services for people with developmental disabilities and their families within VermontThe department of disabilities, aging, and independent living shall be responsible for coordinating the efforts of all agencies and services, government and private, on a statewide basis in order to promote and improve the lives of individuals with developmental disabilities. Within the limits of available resources, the department shall:

* * *

Sec. 47.  18 V.S.A. chapter 207 is amended to read

Chapter 207.  COMMUNITY MENTAL HEALTH AND DEVELOPMENTAL SERVICES

§ 8901.  Purpose

The purpose of this chapter is to expand community mental health and developmental disability services; to encourage participation in such a program by persons in local communities; to obtain better understanding of the need for community mental health mental retardation and developmental services; to authorize funding for the program by state aid, local financial support and direct payment by clients who have the ability to pay and to provide services to mentally ill persons, mentally retarded developmentally disabled persons and children or adolescents with a severe emotional disturbance.

* * *

§ 8907.  Designation of agencies to provide mental

              health mental retardation AND developmental

DISABLITY services

(a)  Except as otherwise provided in this chapter, the commissioner of health and the commissioner of disabilities, aging, and independent living shall, within the limits of funds designated by the legislature for this purpose, ensure that community services to mentally ill and mentally retarded developmentally disabled persons throughout the state are provided through designated community mental health agencies.  The commissioner commissioners shall designate public or private nonprofit agencies to provide or arrange for the provision of these services.

(b)  Within the limits of available resources, each designated community mental health or developmental disability agency shall plan, develop and provide or otherwise arrange for those community mental health-mental retardation or developmental disability services that are not assigned by law to the exclusive jurisdiction of another agency and which are needed by and not otherwise available to persons with mentally ill, mentally retarded persons mental illness or developmental disabilities or children and adolescents with a severe emotional disturbance in accordance with the provisions of chapter 43 of Title 33 who reside within the geographic area served by the agency.

§ 8908.  Local community services plan

Each designated community mental health and developmental disability agency shall determine the need for community mental health mental retardation and developmental disability services within the area served by the agency and shall thereafter prepare a local community services plan which describes the methods by which the agency will provide those services.  The plan shall include a schedule for the anticipated provision of new or additional services and shall specify the resources which are needed by and available to the agency to implement the plan.  The community services plan shall be reviewed annually.

§ 8909.  Boards of directors of nonprofit corporations

              designated as community mental health AND

DEVELOPMENTAL DISABILITY agencies

(a)  The board of a nonprofit corporation that is designated by the commissioner of developmental and mental health services or of disabilities, aging, and independent living to be a community mental health and developmental disability agency shall be representative of the demographic makeup of the area served by the agency.  A majority of the members of the board shall be composed of both individuals who are or were eligible to receive services from an agency because of their disability, and family members of an individual who is or was eligible to receive services because of his or her disability.  The board president shall survey board members on an annual basis and shall certify to the commissioner that the composition of the board is comprised of a majority as required by this section.  This composition of the board shall be confirmed by the organization’s annual independent audit.  Annually, the board shall determine whether or not this disclosure shall be made available to the public on request.  The board shall have overall responsibility and control of the planning and operation of the community mental health agency.

(b)  The board shall direct the development of the local community services plan and shall consult with the commissioner commissioners, with consumers, with other organizations representing mentally ill, mentally retarded persons with developmental disabilities, and children and adolescents with a severe emotional disturbance, and with other governmental or private agencies that provide community services to the clients served by the mental health agency to determine the needs of the community for mental health mental retardation and developmental disability services, and the priority need for service.  The plan shall encourage utilization of existing agencies, professional personnel and public funds at both state and local levels in order to improve the effectiveness of mental health and mental retardation developmental disability services and to prevent unnecessary duplication of expenditures.

(c)  For the purpose of this section,

* * *

(3)  “Commissioner” means either the commissioner of the department of health or the commissioner of the department of disabilities, aging, and independent living, or both, depending on the circumstances and subject matter of the issue or issues being addressed.

§ 8910.  State aid; fees

(a)  Upon application to the commissioner by a designated community mental health and developmental disability agency, the commissioner of the appropriate department may grant to the agency funds to be used for carrying out its mental health mental retardation and developmental disability services.  Such grant of funds shall be based on a program plan and program budget developed by the agency and submitted to and approved by the commissioner or commissioners.  The budget plan must indicate cost per unit of service, anticipated fees for services and must represent a balanced plan of anticipated receipts and expenditures.

* * *

§ 8911.  Powers of the commissioner COMMISSIONERS

(a)  If the commissioner commissioners after discussion with the board of a community mental health and developmental disability agency determines that the local community services plan required by section 8908 of this chapter is inadequate to meet the needs of mentally ill, mentally retarded persons with mental illness or with developmental disabilities or children and adolescents with a severe emotional disturbance in accordance with the provisions of chapter 43 of Title 33 in the area served by a mental health and developmental disability agency or that an agency has, for reasons other than lack of resources, failed or refused to implement an otherwise adequate plan he, the commissioners shall take one or more of the following steps:

* * *

(c)  The board of directors of a community mental health and developmental disability agency will be given a six month notice of any intent on the part of the commissioner commissioners to terminate its designated status.  The commissioner commissioners shall provide a written notice which outlines the performance based rationale associated with such intent.  The board of directors shall have six months to review the commissioner’s commissioners’ stated concerns and implement a corrective action plan.  The board of directors shall also be informed, in writing, of current standards and procedures regarding appeal processes.

§ 8912.  Contracts with nondesignated agencies

The commissioner commissioners may enter into agreements with local community mental health and developmental disability agencies or with any public or private agency for the purpose of establishing specialized services which are needed by mentally ill, mentally retarded persons with mental illness or with developmental disabilities or children and adolescents with a severe emotional disturbance and are not available from designated community mental health agencies.

§ 8913.  Minimum program standards and other

             regulations

(a)  The commissioner commissioners shall establish minimum program standards for services provided by community mental health mental retardation and developmental disability agencies.  Minimum program standards shall specify the basic activities and resources which are necessary for the implementation of such programs.

(b)  The procedure for establishing such standards shall be in accordance with section 803 of Title 3 chapter 25 of Title 3.

Sec. 48.  18 V.S.A. chapter 209 is amended to read:

Chapter 209.  INTERSTATE COMPACT ON MENTAL HEALTH

§ 9001.  Purpose-Article I

The party states find that the proper and expeditious treatment of the mentally ill and mentally retarded and developmentally disabled can be facilitated by cooperative action, to the benefit of the patients, their families, and society as a whole.  Further, the party states find that the necessity of and desirability for furnishing such care and treatment bears no primary relation to the residence or citizenship of the patient but that, on the contrary, the controlling factors of community safety and humanitarianism require that facilities and services be made available for all who are in need of them.  Consequently, it is the purpose of this compact and of the party states to provide the necessary legal basis for the institutionalization or other appropriate care and treatment of the mentally ill and mentally retarded and developmentally disabled under a system that recognizes the paramount importance of patient welfare and to establish the responsibilities of the party states in terms of such welfare.

§ 9002.  Definitions-Article II

As used in this compact:

* * *

(c)  “Institution” shall mean any hospital or other facility maintained by a party state or political subdivision thereof for the care and treatment of mental illness or mental retardation or developmental disability.

* * *

(g)  “Mental retardation” shall mean mental retardation as defined by appropriate clinical authorities to such extent that a person so afflicted is incapable of managing himself and his affairs, but shall not include mental illness as defined herein.

(h)  “State” shall mean any state, territory or possession of the United States, the District of Columbia, and the commonwealth of Puerto Rico.

§ 9003.  Institutionalization of patients-Article III

(a)  Whenever a person physically present in any party state shall be in need of institutionalization by reason of mental illness or mental retardation or developmental disability, he or she shall be eligible for care and treatment in an institution in that state irrespective of his or her residence, settlement, or citizenship qualifications.

* * *

§ 9007.  Costs-Article VII

* * *

(e)  Nothing in this compact shall be construed to invalidate any reciprocal agreement between a party state and a nonparty state relating to institutionalization, care or treatment of the mentally ill or mentally retarded or developmentally disabled, or any statutory authority pursuant to which such agreements may be made.

* * *

§ 9009.  Criminal patients-Article IX

(a)  No provision of this compact except article V shall apply to any person institutionalized while under sentence in a penal or correctional institution or while subject to trial on a criminal charge, or whose institutionalization is due to the commission of an offense for which, in the absence of mental illness or mental retardation or developmental disability, said the person would be subject to incarceration in a penal or correctional institution.

(b)  To every extent possible, it shall be the policy of states party to this compact that no patient shall be placed or detained in any prison, jail or lockup, but such the patient shall, with all expedition, be taken to a suitable institutional facility for mental illness or mental retardation or developmental disability.

* * *

§ 9011.  Supplementary agreements-Article XI

The duly constituted administrative authorities of any two or more party states may enter into supplementary agreements for the provision of any service or facility or for the maintenance of any institution on a joint or cooperative basis whenever the states concerned shall find that such agreements will improve services, facilities, or institutional care and treatment in the fields of mental illness or mental retardation or developmental disability.  No such supplementary agreement shall be construed so as to relieve any party state of any obligation which it otherwise would have under other provisions of this compact.

* * *

§ 9051.  Administrator

The commissioner of developmental and mental health services is hereby designated the compact administrator.  He The commissioner shall administer the compact set out as subchapter 1 of this chapter with the power and duties therein specified and shall have authority to incur, on behalf of the state, financial obligations necessary for the proper performance of his or her duties under the compact.  If any supplementary agreement made under the compact requires or contemplates the use of any institution or facility of the state or other service of the state, such the agreement shall not take effect until its relevant provisions are approved by the general assembly.  The compact administrator shall cooperate with other officers, departments and agencies of the state which are affected by his the compact administrator’s actions in the performance of his or her duties.

* * *

Sec. 49.  18 V.S.A. § 9302(2) and (10) are amended to read:

(2)  “Commissioner” means the commissioner of developmental and mental health services disabilities, aging, and independent living.

(10)  “Department” means the department of developmental and mental health services disabilities, aging, and independent living.

Sec. 50.  18 V.S.A. § 9435(b) is amended to read:

(b)  Excluded from this subchapter are community mental health centers or developmental disability center health care projects proposed by a designated agency and supervised by the commissioner of developmental and mental health services under chapters 177 and 207 of this title or the commissioner of disabilities, aging, and independent living, or both, depending on the circumstances and subject matter of the project, provided the appropriate commissioner of developmental and mental health services or commissioners makes a written approval of the proposed health care project.  The designated agency shall submit a copy of the approval with a letter of intent to the commissioner.

* * * Labor * * *

Sec. 51.  21 V.S.A. § 497a is amended to read:

§ 497a.  Committee established

There is hereby established a permanent committee to be known as the Vermont governor’s committee on employment of people with disabilities, to consist of twenty-one 21 members, including a representative of the Vermont employment service division, one representative of the vocational rehabilitation division of the department of disabilities, aging, and disabilities  independent living, one representative of the veterans’ administration, one representative of the veterans’ employment service and seventeen members to be appointed by the governor.  The appointive members shall hold office for the term specified or until their successors are named by the governor.  The members shall receive no salary for their services as such, but the necessary expenses of the committee shall be paid by the state.  Those persons acting as said committee on June 29, 1963 shall continue as such until their successors are appointed as herein provided.

Sec. 52.  21 V.S.A. § 503 is amended to read:

§ 503.  Vending machines

If it is determined by the department of disabilities, aging, and disabilities independent living and the department of buildings and general services that a vending facility is not economically feasible in a particular location, vending machines may be placed in that location.  Contracts shall be awarded by the department of disabilities, aging, and disabilities independent living in accordance with the procedures set forth in 29 V.S.A. § 161, notwithstanding the $50,000.00 limitation therein.

Sec. 53.  21 V.S.A. § 1232(c) is amended to read:

(c)  The commissioner shall coordinate with existing services and other related state and federal organizations to assure communication and cooperation among programs and to share efforts and resources for new services and programs for displaced homemakers including, but not limited to: the department of education, the department of prevention, assistance, transition, and health access for children and families, VISTA, the state colleges, the University of Vermont, the Vermont extension service, and the governor’s commission on women.

* * * Motor Vehicles * * *

Sec. 54.  23 V.S.A. § 1258(b)(1) is amended to read:

(1) the motor vehicle is regularly used to transport passengers for hire except a motor vehicle owned or operated by a day child care facility; or

* * * Municipal and County Government * * *

Sec. 55.  24 V.S.A. § 1173 is amended to read:

§ 1173.  TOWN OR VILLAGE REPORTS

The clerk of a municipality shall supply annually each library in such municipality with two copies of the municipal report, upon its publication.  He The clerk shall also mail to the state library two copies thereof, and one copy each to the secretary of state, commissioner of taxes, highway board, state board of health, commissioner of prevention, assistance, transition, and health access for children and families, director of the office of Vermont health access, auditor of accounts and board of education.  Officers making such these reports shall supply the clerk of such the municipality with the printed copies necessary for him or her to comply with the provisions of this section and section 1174 of this title.

Sec. 56.  24 V.S.A. § 2691 is amended to read:

§ 2691.  AID TO SOCIAL SERVICES FOR TOWN RESIDENTS

At a meeting duly warned for that purpose, a town or incorporated village may appropriate such sums of money as it deems necessary for the support of social service programs and facilities within that town for its residents.  Social service programs, for which a town or incorporated village may appropriate sums of money, include, but are not limited to: transportation, nutrition, medical, day child care, and other rehabilitative services for persons with low incomes, senior citizens, children, disabled persons, drug and alcohol abusers, and persons requiring employment to eliminate their need for public assistance. The authority herein granted is not in derogation of other local powers to allocate funds.

* * * Public Institutions and Corrections * * *

Sec. 57.  28 V.S.A. § 755(2)(C) is amended to read:

(C)  Any sum as is needed for the support of the dependents of the inmate, in which case the commissioner shall notify the commissioner of prevention, assistance, transition, and health access for children and families of the support payments;

* * * Public Service * * *

Sec. 58.  30 V.S.A. § 218(c)(2) is amended to read:

(2)  A person shall be eligible for the lifeline benefit who meets the department of social welfare for children and families means test of eligibility, which shall include all persons participating in public assistance programs administered by the department of social welfare.  The department of prevention, assistance, transition, and health access for children and families shall verify this eligibility, in compliance with Federal Communications Commission requirements.  The benefit under this subdivision shall be equal to the full subscriber line charge, plus an amount equal to the larger of:

* * *

Sec. 59.  30 V.S.A. § 218a(d) is amended to read:

(d)  Upon approval of a contract by the public service board pursuant to subsection (c) of this section, the department of public service shall establish a Vermont telecommunications relay service advisory council composed of the following members:  one representative of the department of public service, who shall act as chair and who shall be designated by the commissioner of public service; one representative of the department of disabilities, aging, and disabilities independent living, who shall act as vice-chair; two representatives of the deaf community; one member of the hard of hearing or speech impaired community; one representative of a company providing local exchange service within the state; and one representative of an organization currently providing telecommunications relay services.  The members of the council who are not officers or employees of the state shall receive per diem compensation and expense reimbursement in amounts authorized by section 1010(b) of Title 32.  The costs of such compensation and reimbursement, and any other necessary administrative costs shall be included within the contract approved by the board under subsection (c) of this section.  The Vermont telecommunications relay service advisory council shall advise the department of public service and the contractor for telecommunications relay services on all matters concerning the implementation and administration of the state’s telecommunications relay service.

* * * Recreation and Sports * * *

Sec. 60.  31 V.S.A. § 1001(1) is amended to read:

(1)  “Commissioner” means the commissioner of the department of disabilities, aging, and disabilities independent living established by section 3088 3085a of Title 3.

* * * Taxation and Finance * * *

Sec. 61.  32 V.S.A. § 307(d) is amended to read:

(d)  The governor’s budget shall include his or her recommendations for an annual budget for Medicaid and all other health care assistance programs administered by the department of prevention, assistance, transition, and health access agency of human services.  The governor’s proposed Medicaid budget shall include a proposed annual financial plan, and a proposed five-year financial plan, with the following information and analysis:

* * *

(8)  any other recommendations or information affecting the financial sustainability of Medicaid and all other health care assistance programs administered by the department of prevention, assistance, transition, and health access agency of human services.

Sec. 62.  32 V.S.A. § 308b(a) is amended to read:

(a)  There is created within the general fund a human services caseload management reserve.  Expenditures from the reserve shall be subject to an appropriation by the general assembly or approval by the emergency board.  Expenditures from the reserve shall be limited to agency of human services caseload related needs primarily in the departments of prevention, assistance, transition, and health access for children and families, social and rehabilitation services, and developmental and mental health services, of health, and of disabilities, aging, and independent living, and in the office of Vermont health access.

Sec. 63.  32 V.S.A. § 3102(f) is amended to read:

(f)  Notwithstanding the provisions of this section, information obtained from the commissioner of prevention, assistance, transition, and health access for children and families under subsection (c) of section 2552 2552(c) of Title 33, from the Vermont student assistance corporation under section 2843 of Title 16 or the dental health program under section 3307 of Title 33, or a job development zone under subsection (c) of section 5926 5926(c) of Title 32 shall be confidential and it shall be unlawful for anyone to divulge such information except in accordance with a judicial order or as provided under another provision of law.

Sec. 64.  32 V.S.A. § 5932(2) is amended to read:

(2)  “Debtor” means any individual owing a debt to a claimant agency, or owing any support debt that may be collected by the department of prevention, assistance, transition, and health access for children and families.

Sec. 65.  32 V.S.A. § 9530(1) is amended to read:

(1)  “Commissioner” means the commissioner of prevention, assistance, transition, and health access.  “Director” means the director of the office of Vermont health access.

Sec. 66.  32 V.S.A. § 9533(b) and (e) are amended to read:

(b)  The tax shall be paid by the transferor to the department of prevention, assistance, transition, and office of Vermont health access within 10 days after the date of the transfer, accompanied by the nursing home transferor tax form prescribed by the commissioner.

(e)  Upon the receipt of the full amount of the tax, the commissioner director shall deposit receipts from the transferor tax in the health care trust fund established pursuant to 33 V.S.A. § 1956 and shall send a certificate of payment to the transferor, the transferee, and the division showing the date when the tax was received.

Sec. 67.  32 V.S.A. § 9535 is amended to read:

§ 9535.  REVIEW AND APPEALS

(a)  At any time before, or within ten 10 days after the date of a transfer of a nursing home, a transferor may request from the commissioner director a determination of the transferor’s liability to pay or the amount of the nursing home transfer tax due.  The commissioner director shall render a decision within 30 days of the receipt of all information that the commissioner director deems necessary to make a determination.

(b)  Within 30 days of the date of issuance of the commissioner’s director’s determination, a transferor aggrieved by that determination may request review by the secretary or the secretary’s designee.  This review shall not be subject to the provisions of 3 V.S.A. chapter 25.

* * * Human Services * * *

Sec. 68.  33 V.S.A. § 102 is amended to read:

§ 102. DEFINITIONS AND CONSTRUCTION

(a)  Unless otherwise expressly provided, the words and phrases in this chapter mean:

* * *

(4)  Commissioner: the commissioner of prevention, assistance, transition, and health access for children and families.

(5)  Department:  the department of prevention, assistance, transition, and health access for children and families.

* * *

(12)  Director:  the director of the office of Vermont health access.

(13)  Office:  the office of Vermont health access.

(b)  The laws relating to the programs of the department of prevention, assistance, transition, and health access for children and families shall be construed liberally to carry out the policies stated in this chapter.

Sec. 69.  33 V.S.A. § 103 is amended to read:

§ 103.  COMPOSITION OF DEPARTMENT

The department of prevention, assistance, transition, and health access for children and families, created under section 212 of Title 3, shall consist of the commissioner of prevention, assistance, transition, and health access for children and families and all councils and committees divisions and offices within the department.

Sec. 70.  33 V.S.A. § 112 is amended to read:

§ 112.  BANKS AND AGENCIES TO FURNISH INFORMATION

* * *

(b)  Any governmental official or agency in the state, when requested by the commissioner, shall furnish him or her information in the official’s or agency’s possession with reference to aid given or money paid or to be paid to any person or his person’s spouse who is applying for or is receiving assistance or benefits from the department.

(c)  The commissioner of taxes, when requested by the commissioner of prevention, assistance, transition, and health access for children and families, and unless otherwise prohibited by federal law, shall compare the information furnished by an applicant or recipient of assistance with the state income tax returns filed by such person and shall report his or her findings to the commissioner of prevention, assistance, transition, and health access for children and families.  Each application for assistance shall contain a form of consent, executed by the applicant, granting permission to the commissioner of taxes to disclose such information to the commissioner of prevention, assistance, transition, and health access only for children and families.

Sec. 71.  33 V.S.A. § 114 is amended to read:

§ 114.  ALLOCATION OF PAYMENTS WHEN APPROPRIATION

            INSUFFICIENT

Should the funds available for assistance be insufficient to provide assistance to all those eligible, the amounts of assistance granted in any program or portion thereof shall be reduced equitably, in the discretion of the commissioner or the director by regulation rule.

Sec. 72.  33 V.S.A. § 121 is amended to read:

§ 121.  CANCELLATION OF ASSISTANCE OR BENEFITS

If at any time the commissioner or the director has reason to believe that assistance or benefits have been improperly obtained, he or she shall cause an investigation to be made and may suspend assistance or benefits pending the investigation.  If on investigation the commissioner or the director is satisfied that the assistance or benefits were illegally obtained, he or she shall immediately cancel them.  A person having illegally obtained assistance or benefits shall not be eligible for reinstatement until his or her need has been reestablished.

Sec. 73.  33 V.S.A. § 122 is amended to read:

§ 122.  RECOVERY OF PAYMENTS

(a)  The amount of assistance or benefits may be changed or cancelled at any time if the commissioner or director finds that the recipient’s circumstances have changed.  Upon granting assistance or benefits the department or office shall inform the recipient that changes in his or her circumstances must be promptly reported to the department.

(b)  When on the death of a person receiving assistance it is found that the recipient possessed income or property in excess of that reported to the department or office, up to double the total amount of assistance in excess of that to which the recipient was lawfully entitled may be recovered by the commissioner or director as a preferred claim from the estate of the recipient.  The commissioner or director shall calculate the amount of the recovery by applying the legal interest rate to the amount of excess recovery paid, except that the recovery shall be capped at double the excess assistance paid.

(c)  When the commissioner or director finds that a recipient of benefits received assistance in excess of that to which the recipient was lawfully entitled, because the recipient possessed income or property in excess of department standards, the commissioner or director may take actions to recover the overpayment.

(d)  In the event of recovery, an amount may be retained by the commissioner or director in a special fund for use in offsetting program expenses and an amount equivalent to the pro rata share to which the United States of America is equitably entitled shall be paid promptly to the appropriate federal agency.

Sec. 74.  33 V.S.A. § 141(e) is amended to read:

(e)  A person providing service for which compensation is paid under a state or federally-funded assistance program who requests, and receives, either actually or constructively, any payment or contribution through a payment, assessment, gift, devise, bequest, or other means, whether directly or indirectly, from either a recipient of assistance from the assistance program or from the family of the recipient shall notify the commissioner of the department of prevention, assistance, transition, and health access or director, on a form provided by him or her, of the amount of the payment or contribution and of such other information as specified by the commissioner or director within 10 days after the receipt of the payment or contribution or, if the payment or contribution is to become effective at some time in the future, within 10 days of the consummation of the agreement to make the payment or contribution.  Failure to notify the commissioner or director within the time prescribed is punishable as provided in section 143 of this title.

Sec. 75.  33 V.S.A. § 143(b) and (c) are amended to read:

(b)  If the person convicted is receiving assistance, benefits or payments, the commissioner or director may recoup the amount of assistance or benefits wrongfully obtained by reducing the benefits or payments periodically paid to the recipient, as limited by federal law, until the amount is fully recovered.

(c)  If a provider of services is convicted of a violation of subsections (d) or (e) of section 141 subsection 141(d) or (e) of this title, the commissioner of prevention, assistance, transition, and health access director shall, within 90 days of the conviction, suspend the provider from further participation in the medical assistance program administered under Title XIX of the social security act Social Security Act for a period of four years.  The suspension required by this subsection may be waived by the secretary of human services only upon a finding that the recipients served by the convicted provider would suffer substantial hardship through a denial of medical services that could not reasonably be obtained through another provider.

Sec. 76.  33 V.S.A. § 143b is amended to read:

§ 143b.  EDUCATION AND INFORMATION

(a)  Within six months of the effective date of section 143a of this title, the department of prevention, assistance, transition, and office of Vermont health access shall issue rules establishing a procedure for health care providers enrolled in state- and federally-funded medical assistance programs to obtain advisory opinions regarding coverage and reimbursement under those programs.  Each advisory opinion issued by the department office shall be binding on the department office and the party or parties requesting the opinion only with regard to the specific questions posed in the opinion, the facts and information set forth in it, and the statutes and rules specifically noted in the opinion.

(b)  At least four times a year, the department of prevention, assistance, transition, and office of Vermont health access shall alert health care providers enrolled in state- and federally-funded assistance programs by publication distributed to such health care providers, regarding current issues relating to fraud and abusive billing in such programs.

Sec. 77.  33 V.S.A. § 306(b)(4) and (7) are amended to read:

(4)  Before a license is granted, the department shall visit and inspect the premises for which the license is requested, and make further inquiry and investigation as the commissioner may direct.  Before a family day child care home registration is granted, the department shall make inquiry and investigation.  Inquiry and investigation may include a visit to and inspection of the premises for which the registration is requested.  Further inquiry and investigation may be made as the commissioner may direct.

(7)  Whenever the department determines that a licensed day child care facility or registered family child care home has violated a health or safety rule, the facility or home shall post the department’s notice of violation in a conspicuous place in the facility or home.  In the case of a serious violation, as defined by the department by rule, the facility or home shall also notify a person responsible for the welfare of each child attending that facility or home, by mail.  A serious violation shall include violation of group size and staffing requirements and any violation involving a situation which immediately imperils the health, safety or well-being of persons in the care of the licensee or registrant.

Sec. 78.  33 V.S.A. § 308(a) is amended to read:

§ 308.  CHILD CARE SERVICES ADVISORY BOARD

(a)  A child care services advisory board is created.  The board shall be composed of 12 members appointed by the governor for terms of two years. One member of the board shall represent each of the following:  parents who use or have used child care services, licensed providers of child care services, registered providers of child care services, employers who provide child care services for their employees, research and referral programs and day child care provider trainers.  The remaining six members shall include at least three representatives of the public and no more than three representatives of state agencies which exercise functions relating to child care services.

Sec. 79.  33 V.S.A. chapter 5 is amended to read

Chapter 5:  DISABILITIES, AGING, AND DISABILITIES INDEPENDENT LIVING PROGRAMS

§ 501.  Aging Disabilities, aging, and disabilities

            independent living policy

(b)  The programs of the department of disabilities, aging, and disabilities independent living shall be administered in a manner consistent with this policy.

(c)  The laws pertaining to the department of disabilities, aging, and disabilities independent living and its programs shall be construed liberally to carry out the policies stated in this section.

§ 502.  Definitions

As used in this chapter:

* * *

(2)  “Commissioner” means the commissioner of disabilities, aging, and disabilities independent living.

(3)  “Department” means the department of disabilities, aging, and disabilities independent living.

* * *

§ 503.  Composition of department

The department, created pursuant to section 3085a of Title 3, shall consist of the commissioner of disabilities, aging, and disabilities independent living, the advisory board established under section 505 of this title, and all divisions and units of the department, including the division for the blind and visually impaired and the division of vocational rehabilitation.

§ 504.  Duties of department

(a)  The department shall administer all laws and programs specifically assigned to it for administration, including:

* * *

(5)  The duties, responsibilities, and authority of the division of licensing and protection pertaining to level IV facilities presently granted under the authority of chapter 71 of this title and any other provision of law.

(6)  All of the duties, responsibilities, and authority of the division of licensing and protection to level I and level II nursing homes and level III residential care homes, hospitals, and home health services granted under the authority of chapter 71 of this title and any other provision of law.

(7)  The duties, responsibilities and authority of the former developmental services division of the former department of developmental and mental health services, and the personal care and hi-tech programs in the former department of prevention, assistance, transition, and health access.

* * *

Sec. 79a.  33 V.S.A. § 504(c) is amended to read:

(c)  In addition to the powers vested in it by law, the department may:

(1)  Cooperate with, and contract with, with the approval of the governor, the federal government and appropriate federal agencies which fund programs which the department administers.

* * *

(3)  Take and hold in trust for the state any grant or devise of land or donation or bequest of money, or other personal property, to be applied to the maintenance of developmentally disabled persons.

Sec. 80.  33 V.S.A. § 902(b) is amended to read:

(b)  The division shall be headed by a director of administration and rate setting, appointed pursuant to 3 V.S.A. § 3086 or his or her designee.

Sec. 81.  33 V.S.A. § 905(b)(3) is amended to read:

(3)  Assessments of residents for classification purposes shall be made on the basis of standardized information made available by each facility to the division.  Each nursing home shall assess all its residents not less often than annually, in accordance with standards and a schedule developed by the department of disabilities, aging, and disabilities independent living.  The accuracy of the information shall be verified and final classifications made by the department of disabilities, aging, and disabilities independent living.

* * *

Sec. 82.  33 V.S.A. § 1101(8) and (9) are amended to read:

(8)  “Commissioner” means the commissioner of the department of prevention, assistance, transition, and health access for children and families, or his or her designee.

(9)  “Department” means the department of prevention, assistance, transition, and health access for children and families.

Sec. 83.  33 V.S.A. § 1107(e) is amended to read:

(e)  The commissioner of education, with the assistance and support of the commissioner of prevention, assistance, transition, and health access for children and families, the commissioner of aging and disabilities, aging, and independent living, and the commissioner of employment and training labor, shall develop and implement comparable and reciprocally recognized literacy assessment protocols that will be used for all clients seeking adult basic education services, related services of the department of education, or the services of the department of aging and disabilities disabilities, aging, and independent living, the department of employment and training labor, or the department of prevention, assistance, transition, and health access for children and families, when such services are being sought for the purpose of developing or strengthening competencies or skills related to the clients’ current or future employment.  Such protocols shall, to the extent practicable, utilize the same terminology and apply comparable criteria, consistent with individual program purposes and authorization, in determining when testing, other standardized measurement tools, or referrals to relevant professionals for evaluation or diagnosis are appropriate.

Sec. 84.  33 V.S.A. § 1134(b) is amended to read:

(b)  On or before January 15, 2001, the commissioner of education, with the assistance of the commissioner, the commissioner of disabilities, aging, and disabilities independent living, and the commissioner of employment and training labor shall report to the committees on health and welfare and education of the house of representatives and senate the progress they have achieved in developing and implementing the comparable and reciprocally recognized literacy assessment protocols as described in section subsection 1107(e) of this title.

Sec. 85.  33 V.S.A. § 1301(4) is amended to read:

(4)  Not have sufficient income or other resources to provide a reasonable subsistence compatible with decency and health, and not be receiving or able to secure support from persons legally responsible for his or her support.  In determining whether the income of an applicant for or a recipient of aid is sufficient, the department of prevention, assistance, transition, and health access for children and families may disregard, within the limits of available funds, income used to further the purposes of rehabilitation and self‑support.

Sec. 86.  33 V.S.A. § 1306 is amended to read:

§ 1306.  APPLICATION AND INVESTIGATION

Applications for state aid to the aged, blind or disabled may be made at any office of the department of prevention, assistance, transition, and health access for children and families.  Upon receipt of an application, the commissioner of prevention, assistance, transition, and health access for children and families shall investigate and prescribe the amount of the grant to be given, if any.  No person may receive more than one type of grant or aid under this chapter.

Sec. 87.  33 V.S.A. § 1307 is amended to read:

§ 1307.  AMOUNT OF STATE AID

The amount of state aid to which an eligible person is entitled shall be determined with due regard to the income, resources and maintenance available to him or her and, when an eligible person lives with his or her ineligible spouse and/or a needy essential person, as defined by the commissioner, with due regard to the needs of his the ineligible spouse and with due regard to the needs, income and resources of the needy essential person.  As far as funds are available, aid shall provide a reasonable subsistence compatible with decency and health.  The commissioner of prevention, assistance, transition, and health access for children and families may by regulation fix maximum amounts of aid and take measures to insure that the expenditures for the programs shall not exceed the funds provided for them.

Sec. 88.  33 V.S.A. § 1308 is amended to read:

§ 1308.  REGULATIONS

In fixing standards and issuing regulations under this chapter, the commissioner of prevention, assistance, transition, and health access for children and families shall be guided by the statutory standards set forth in this chapter, which standards shall not be deemed necessarily to incorporate by reference decisional or statutory law applicable to the aid to the aged, blind and disabled program in effect prior to January 1, 1974.

Sec. 89.  33 V.S.A. § 1501 is amended to read:

§ 1501.  Register

The department of social and rehabilitation services disabilities, aging, and independent living may prepare and maintain a register of blind persons in the state.  It shall describe their condition, cause of blindness, capacity for education and vocational training, and other pertinent data.

Sec. 90.  33 V.S.A. § 1502 is amended to read:

§ 1502.  Services for the blind

For the rehabilitation or amelioration of the condition of the blind, the department of social and rehabilitation services disabilities, aging, and independent living may:

* * *

Sec. 91.  33 V.S.A. § 1701(c) is amended to read:

(c)  When used in this section, “commissioner” means the commissioner of prevention, assistance, transition, and health access for children and families and “department” means the department of prevention, assistance, transition, and health access for children and families.

Sec. 92.  [DELETED]

Sec. 93.  [DELETED]

Sec. 94.  33 V.S.A. § 1901b is amended to read:

§ 1901b.  PHARMACY PROGRAM ENROLLMENT

(a)  The department of prevention, assistance, transition, and office of Vermont health access and the department for children and families shall monitor actual caseloads, revenue and expenditures, anticipated caseloads, revenue and expenditures, and actual and anticipated savings from implementation of the preferred drug list, supplemental rebates, and other cost containment activities in each state pharmaceutical assistance program, including the VScript-Expanded program, the VScript program, and the VHAP-Rx program VPharm and VermontRx.  The department and the office shall allocate supplemental rebate savings to each program proportionate to expenditures in each program.  During the second week of each month, the department office shall report such actual and anticipated caseload, revenue, expenditure and savings information to the joint fiscal committee and to the health access oversight committee.

(b)(1)  If at any time expenditures for the VScript-Expanded program, the VScript program, and the VHAP-Rx program VPharm and VermontRx are anticipated to exceed the aggregate amount of state funds expressly appropriated for such state pharmaceutical assistance programs during any fiscal year, the department office shall recommend to the joint fiscal committee and notify the health access oversight committee of a plan to cease new enrollments in the Vscript‑Expanded program VermontRx for individuals with incomes over 225 percent of the federal poverty level.

(2)  If at any time expenditures for the VScript-Expanded program, the VScript program, and the VHAP-Rx program VPharm and VermontRx are anticipated to exceed the aggregate amount of state funds expressly appropriated for such state pharmaceutical assistance programs during any fiscal year, even with the cessation of new enrollments in the VScript-Expanded program as provided for in subdivision (b)(1), the department office shall recommend to the joint fiscal committee and notify the health access oversight committee of a plan to cease new enrollments in the VScript program VermontRx for individuals with incomes more than 175 percent and less than 225 percent of the federal poverty level.

(3)  The department’s office’s determinations under subdivisions (1) and (2) shall be based on the information and projections reported monthly under subsection (a) of this section, and on the official revenue estimates for the Vermont health access trust fund under section 305a of Title 32.  An enrollment cessation plan shall be deemed approved unless the joint fiscal committee disapproves the plan after 21 days notice of the department’s office’s recommendation and financial analysis.

(4)  Upon the approval of, or failure to disapprove an enrollment cessation plan by the joint fiscal committee, the department office shall cease new enrollment in the VScript-Expanded program, and the VScript program if applicable, in VermontRx for the individuals with incomes at the appropriate level in accordance with the plan.

(c)(1)  If at any time after enrollment ceases under subsection (b) of this section expenditures for the VScript-Expanded program, the VScript program, and the VHAP-Rx program VermontRx, including expenditures attributable to renewed enrollment, are anticipated, by reason of increased federal financial participation or any other reason, to be equal to or less than the aggregate amount of state funds expressly appropriated for such state pharmaceutical assistance programs during any fiscal year, the department office shall recommend to the joint fiscal committee and notify the health access oversight committee of a plan to renew enrollment in the VScript program first, and the VScript-Expanded program second VermontRx, with priority given to individuals with incomes more than 175 percent and less than 225 percent, if adequate funds are anticipated to be available for each program for the remainder of the fiscal year.

(2)  The department’s office’s determination under subdivision (1) of this subsection shall be based on the information and projections reported monthly under subsection (a), and on the official revenue estimates for the Vermont health access trust fund under section 305a of Title 32.  An enrollment renewal plan shall be deemed approved unless the joint fiscal committee disapproves the plan after 21 days notice of the department’s office’s recommendation and financial analysis.

(3)  Upon the approval of, or failure to disapprove an enrollment renewal plan by the joint fiscal committee, the department office shall renew enrollment in the VScript-Expanded program, and the VScript program if applicable, VermontRx in accordance with the plan.

(d)  As used in this section:

(1)  “State pharmaceutical assistance program” means any health assistance programs administered by the department agency of human services providing prescription drug coverage, including but not limited to, the Medicaid program, the Vermont health access plan, the Vermont health access plan-pharmacy program, the VScript program, the VScript-Expanded program VPharm, VermontRx, the state children’s health insurance program, the state of Vermont AIDS medication assistance program, the General Assistance program, the pharmacy discount plan program, and any other health assistance programs administered by the department agency providing prescription drug coverage.

* * *

Sec. 95.  33 V.S.A. § 1901c is amended to read:

§ 1901c.  MEDICAL CARE ADVISORY COMMITTEE

(a)  The commissioner director of the office of Vermont health access shall appoint a medical care advisory committee to advise the department office about health care and medical services, consistent with the requirements of federal law.

(b)  The medical care advisory committee shall be given an opportunity to participate in policy development and program administration for Medicaid and for the VHAP and VScript programs, as they are defined in section 1901b of this subchapter, the Vermont health access plan, VPharm, and VermontRx.  It shall have an opportunity to review and comment upon agency policy initiatives pertaining to health care benefits and beneficiary eligibility.  It also shall have the opportunity to comment on proposed rules prior to commencement of the rulemaking process and on waiver or waiver amendment applications prior to submission to the Centers for Medicare and Medicaid Services.  Prior to the annual budget development process, the department office shall engage the medical care advisory committee in priority setting, including consideration of scope of benefits, beneficiary eligibility, funding outlook, financing options, and possible budget recommendations.

(c)  The medical care advisory committee shall make policy recommendations on department office of Vermont health access proposals to the department office, the health access oversight committee, and the standing committees on health and welfare.  When the general assembly is not in session, the commissioner director shall respond in writing to these recommendations, a copy of which shall be provided to each of the legislative committees.

(d)  During the legislative session, the commissioner director shall provide the committee at regularly scheduled meetings updates on the status of policy and budget proposals.

(e)  The commissioner director shall convene the medical care advisory committee at least six times each year.

(f)  At least one-third of the members of the medical care advisory committee shall be recipients of Medicaid, VHAP, or VScript VermontRx.  Such members shall receive per diem compensation and reimbursement of expenses pursuant to section 1010 of Title 32, including costs of travel, child care, personal assistance services, and any other service necessary for participation on the committee approved by the commissioner director.

(g)  The commissioner director shall appoint members of the medical care advisory committee for staggered, nonrecurring three-year terms.  The commissioner director may remove members of the committee who fail to attend three consecutive meetings and appoint replacements.

* * *

Sec. 96.  33 V.S.A. § 1903 is amended to read:

§ 1903.  CONTRACT AUTHORIZED

(a)  The commissioner director of the office of Vermont health access may contract with a private organization to operate, under his or her control and supervision, parts of the medical assistance program.

(b)  The contract shall provide that either party may cancel it upon reasonable notice to the other party.

(c)  In furtherance of the purposes of the contract, the commissioner director may requisition funds for the purposes of this subchapter, with the approval of the governor, and the commissioner of finance and management shall issue his a warrant in favor of the contracting party to permit the contracting party to make payments to vendors under the contract.  The commissioner director shall quarterly, and at other times as the commissioner of finance and management requires, render an account in such a form as the commissioner of finance and management prescribes of the expenditures of moneys so advanced.

Sec. 97.  33 V.S.A. § 1904 is amended to read:

§ 1904.  DEFINITIONS

When used in this subchapter, unless otherwise indicated:

(1)  “Agency” means the agency of human services.

(2)  “Commissioner” means the commissioner of prevention, assistance, transition, and health access for children and families.

(3)  “Department” means the department of prevention, assistance, transition, and health access for children and families.

(4)  “Director” means the director of the office of Vermont health access.

(5)  “Insurer” means any insurance company, prepaid health care delivery plan, self-funded employee benefit plan, pension fund, retirement system or similar entity that is under an obligation to make payments for medical services as a result of an injury, illness or disease suffered by an individual.

(5)(6)  “Legally liable representative” means a parent or person with an obligation of support to a recipient whether by contract, court order or statute.

(6)(7)  “Provider” means any person that has entered into an agreement with the state to provide any medical service.

(7)(8)  “Recipient” means any person or group of persons who receive Medicaid.

(8)(9)  “Secretary” means the secretary of the agency of human services.

(9)(10)  “Third party” means a person having an obligation to pay all or any portion of the medical expense incurred by a recipient at the time the medical service was provided.  The obligation is not discharged by virtue of being undiscovered or undeveloped at the time a Medicaid claim is paid.  Third parties include:

(A)  Medicare.

(B)  Health insurance, including health and accident but not that portion specifically designated for “income protection” which has been considered in determining recipient eligibility to participate in the Medicaid program.

(C)  Medical coverage provided in conjunction with other benefit or compensation programs including military and veteran programs or workers’ compensation.

(D)  Liability for medical expenses as agreed to or ordered in negligence suits, support settlements or trust funds.

(10)(11)  “Tobacco” means all products listed in 7 V.S.A. § 1001(4).

(11)(12)  “Tobacco manufacturer” means any person engaged in the process of designing, fabricating, assembling, producing, constructing or otherwise preparing a product containing tobacco, including packaging or labeling of these products, with the intended purpose of selling the product for gain or profit.  “Tobacco manufacturer” does not include persons whose activity is limited to growing natural leaf tobacco or to selling tobacco products at wholesale or retail to customers.  “Tobacco manufacturer” also does not include any person who manufactures or produces firearms, dairy products, products containing alcohol or other nontobacco products, unless such person also manufactures or produces tobacco products.

Sec. 98.  33 V.S.A. § 1908a is amended to read:

§ 1908a.  VERMONT PARTNERSHIP FOR LONG-TERM CARE

(a)  The commissioner secretary of human services or his or her designee, in consultation with the commissioner of banking, insurance, securities, and health care administration, shall establish by rule the Vermont partnership for long-term care program.

* * *

(c)(1)  The department of banking, insurance, securities, and health care administration shall adopt rules for precertification of long-term care partnership policies and for the information needed to evaluate the program. The department of banking, insurance, securities, and health care administration shall consider whether all precertified policies should require:

* * *

(F)  information to the purchaser about available consumer information and public education provided by the department of banking, insurance, securities, and health care administration and the department of prevention, assistance, transition, and office of Vermont health access; and

* * *

(d)  The commissioner is authorized to secretary or his or her designee may enter into reciprocal agreements with other states to extend the benefits of the Vermont partnership for long-term care program to Vermont residents who had purchased qualified long-term care policies in other states.

(e)  The departments of prevention, assistance, transition, and health access agency and the department of banking, insurance, securities, and health care administration shall make available consumer information regarding the long‑term care partnership program.  The commissioners secretary and commissioner may allocate responsibilities for providing consumer information between the departments agency and department.

(f)  As used in this section:

(1)  “Long-term care services” includes care, treatment, maintenance, and services:

* * *

(F)  such other long-term care services as determined by the commissioner secretary or his or her designee for which medical assistance is otherwise available under the Medicaid program.

* * *

Sec. 98a.  [DELETED]

Sec. 99.  33 V.S.A. § 1973 is amended to read:

§ 1973.  VERMONT HEALTH ACCESS PLAN

(a)  The department of prevention, assistance, transition, and health access agency of human services or its designee shall establish the Vermont health access plan (VHAP) pursuant to a waiver of federal Medicaid law.  The plan shall remain in effect as long as the a federal 1115 demonstration waiver is granted or renewed.

(b)  The purpose of the Vermont health access plan is to provide health care coverage for uninsured or underinsured low income Vermonters.  The commissioner of the department of prevention, assistance, transition, and health access agency of human services or its designee shall establish rules regarding eligibility and administration of the plan.

Sec. 100.  33 V.S.A. § 1997 is amended to read:

§ 1997.  DEFINITIONS

As used in this subchapter:

(1)  “Board” or “drug utilization review board” means the drug utilization review board established by the commissioner in connection with the Medicaid program.

(2)  “Commissioner” “Director” means the commissioner of prevention, assistance, transition, and health access director of the office of Vermont health access.

(3)  “Department” means the department of prevention, assistance, transition, and health access.

(4)(3)  “Health benefit plan” means a health benefit plan with prescription drug coverage offered or administered by a health insurer, as defined by subdivision 9402(7) of Title 18, and the out-of-state counterparts to such plans.  The term includes, but is not limited to:

(A)  any state public assistance program with a health benefit plan that provides coverage of prescription drugs;

(B)  any health benefit plan offered by or on behalf of the state of Vermont or any instrumentality of the state providing coverage for government employees and their dependents that agrees to participate in the program; and

(C)  any insured or self-insured health benefit plan that agrees to participate in the program.

(4)  “Office” means the office of Vermont health access.

* * *

(7)  “State public assistance program”, includes, but is not limited to, the Medicaid program, the Vermont health access plan, the Vermont health access plan-pharmacy, VScript and VScript-Expanded, VPharm, VermontRx, the state children’s health insurance program, the state of Vermont AIDS medication assistance program, the General Assistance program, the pharmacy discount plan program, and the out-of-state counterparts to such programs.

* * *

Sec. 101.  33 V.S.A. § 1998 is amended to read:

§ 1998.  Pharmacy best practices and cost control

              program established

(a)  The commissioner of prevention, assistance, transition, and director of the office of Vermont health access shall establish a pharmacy best practices and cost control program designed to reduce the cost of providing prescription drugs, while maintaining high quality in prescription drug therapies.  The program shall include:

(1)  A preferred list of covered prescription drugs that identifies preferred choices within therapeutic classes for particular diseases and conditions, including generic alternatives and over-the-counter drugs.

(A)  The commissioner director and the commissioner of banking, insurance, securities, and health care administration shall implement the preferred drug list as a uniform, statewide preferred drug list by encouraging all health benefit plans in this state to participate in the program.

* * *

(C)  The commissioner  director shall encourage all health benefit plans to implement the preferred drug list as a uniform, statewide preferred drug list by inviting the representatives of each health benefit plan providing prescription drug coverage to residents of this state to participate as observers or nonvoting members in the commissioner’s director’s drug utilization review board, and by inviting such plans to use the preferred drug list in connection with the plans’ prescription drug coverage;

* * *

(8)  Any other cost containment activity adopted, by rule, by the commissioner director that is designed to reduce the cost of providing prescription drugs while maintaining high quality in prescription drug therapies.

(b)  The commissioner director shall implement the pharmacy best practices and cost control program for Medicaid and all other state public assistance program health benefit plans to the extent permitted by federal law.

(c)(1)  The commissioner director may implement the pharmacy best practices and cost control program for any other health benefit plan within or outside this state that agrees to participate in the program.

(2)  The commissioner of prevention, assistance, transition, and director of the office of Vermont health access, and the secretary of administration shall take all steps necessary to enable Vermont’s participation in joint prescription drug purchasing agreements with any other health benefit plan or organization within or outside this state that agrees to participate with Vermont in such joint purchasing agreements.

* * *

(4)  The actions of the commissioners, the director, and the secretary shall include:

* * *

(C)  the execution of any joint purchasing agreements or other contracts with any participating health benefit plan or organization within or outside the state which the commissioner director determines will lower the cost of prescription drugs for Vermonters while maintaining high quality in prescription drug therapies; and

(D)  with regard to participation by the state employees health benefit plan, the execution of any joint purchasing agreements or other contracts with any health benefit plan or organization within or outside the state which the commissioner director determines will lower the cost of prescription drugs and provide overall quality of integrated health care services to the state employees health benefit plan and the beneficiaries of the plan, and which is negotiated through the bargaining process between the state of Vermont and the authorized representatives of the employees of the state of Vermont.

(5)  The commissioner director and the commissioner of human resources may renegotiate and amend existing contracts to which their departments the office of Vermont health access and the department of human resources are parties if such renegotiation and amendment will be of economic benefit to the health benefit plans subject to such contracts, and to the beneficiaries of such plans.  Any renegotiated or substituted contract shall be designed to improve the overall quality of integrated health care services provided to beneficiaries of such plans.

(6)  The director, the commissioners, and the secretary shall report quarterly to the health access oversight committee and the joint fiscal committee on their progress in securing Vermont’s participation in such joint purchasing agreements.

(7)  The commissioner, director, the commissioner of human resources, the commissioner of banking, insurance, securities, and health care administration, and the secretary of human services shall establish a collaborative process with the Vermont Medical Society, pharmacists, health insurers, consumers, employer organizations and other health benefit plan sponsors, the Northeast National Legislative Association on Prescription Drug Pricing Prices, pharmaceutical manufacturer organizations, and other interested parties designed to consider and make recommendations to reduce the cost of prescription drugs for all Vermonters.

(d)  A participating health benefit plan other than a state public assistance program may agree with the commissioner director to limit the plan’s participation to one or more program components.  The commissioner director shall supervise the implementation and operation of the pharmacy best practices and cost control program, including developing and maintaining the preferred drug list, to carry out the provisions of the subchapter.  The commissioner director may include such insured or self-insured health benefit plans as agree to use the preferred drug list or otherwise participate in the provisions of this subchapter.  The purpose of this subchapter is to reduce the cost of providing prescription drugs while maintaining high quality in prescription drug therapies.

(e)  The commissioner of prevention, assistance, transition, and director of the office of Vermont health access shall develop procedures for the coordination of state public assistance program health benefit plan benefits with pharmaceutical manufacturer patient assistance programs offering free or low cost prescription drugs, including the development of a proposed single application form for such programs.  The director may contract with a nongovernmental organization to develop the single application form.

(f)(1)  The drug utilization review board shall make recommendations to the commissioner director for the adoption of the preferred drug list. The board’s recommendations shall be based upon considerations of clinical efficacy, safety, and cost-effectiveness.

* * *

(3)  To the extent feasible, the board shall review all drug classes included in the preferred drug list at least every 12 months, and may recommend that the commissioner director make additions to or deletions from the preferred drug list.

* * *

Sec. 102.  33 V.S.A. § 2000 is amended to read:

§ 2000.  PHARMACY BENEFIT MANAGEMENT

The commissioner director may implement all or a portion of the pharmacy best practices and cost control program through a contract with a third party with expertise in the management of pharmacy benefits.

Sec. 103.  33 V.S.A. § 2001 is amended to read:

§ 2001.  LEGISLATIVE OVERSIGHT

(a)  In connection with the pharmacy best practices and cost control program, the commissioner of prevention, assistance, transition, and director of the office of Vermont health access shall report for review by the health access oversight committee, prior to initial implementation, and prior to any subsequent modifications:

* * *

(c)  The commissioner of prevention, assistance, transition, and director of the office of Vermont health access shall report quarterly to the health access oversight committee concerning the following aspects of the pharmacy best practices and cost control program:

* * *

(d)  On or before January 1, 2003, and on or before January 1 of each year for the duration of the pharmacy benefit manager contract, the commissioner of prevention, assistance, transition, and director of the office of Vermont health access shall report to the house and senate committees on health and welfare, and to the health access oversight committee, concerning implementation of any pharmacy benefit manager contract entered into by the pharmacy best practices and cost control program.  The report shall include:

* * *

(2)  an analysis of the success of the pharmacy benefit manager in achieving each of the department’s state’s public policy goals, together with the pharmacy benefit manager’s report of its activities and achievements;

* * *

(6)  if the department office has not entered into a contract with a pharmacy benefit manager, or if any such contract has been rescinded, any recommendations for pursuing Vermont’s public policy goals relating to pharmaceutical costs, quality and access through other means.

(e)(1)  The fiscal report required by subdivision (d)(4) of this section shall include the disclosure, in a manner that preserves the confidentiality of any proprietary information as determined by the commissioner director, of:

* * *

(2)  The commissioner director shall not enter into a contract with a pharmacy benefit manager unless the pharmacy benefit manager has agreed to disclose to the commissioner director the terms and the financial impact on Vermont and on Vermont beneficiaries of:

* * *

(3)  The commissioner director shall not enter into a contract with a pharmacy benefit manager who has entered into an agreement or engaged in a practice described in subdivision (2) of this subsection, unless the commissioner director determines, and certifies in the fiscal report required by subdivision (d)(4) of this section, that such agreement or practice furthers the financial interests of Vermont, and does not adversely affect the medical interests of Vermont beneficiaries.

Sec. 104.  33 V.S.A. § 2002 is amended to read:

§ 2002.  SUPPLEMENTAL REBATES

(a)  The commissioner director of the office of Vermont health access, separately or in concert with the authorized representatives of any participating health benefit plan, shall use the preferred drug list authorized by the pharmacy best practices and cost control program to negotiate with pharmaceutical companies for the payment to the commissioner director of supplemental rebates or price discounts for Medicaid and for any other state public assistance health benefit plans designated by the commissioner director, in addition to those required by Title XIX of the Social Security Act.  The commissioner director may also use the preferred drug list to negotiate for the payment of rebates or price discounts in connection with drugs covered under any other participating health benefit plan within or outside this state, provided that such negotiations and any subsequent agreement shall comply with the provisions of 42 U.S.C. § 1396r-8.  The program, or such portions of the program as the commissioner director shall designate, shall constitute a state pharmaceutical assistance program under 42 U.S.C. § 1396r-8(c)(1)(C).

* * *

(c)  The commissioner and the department office of Vermont health access shall prohibit the public disclosure of information revealing company-identifiable trade secrets (including rebate and supplemental rebate amounts, and manufacturer’s pricing) obtained by the department office, and by any officer, employee or contractor of the department in the course of negotiations conducted pursuant to this section.  Such confidential information shall be exempt from public disclosure under subchapter 3 of chapter 5 of Title 1 (open records law).

Sec. 105.  33 V.S.A. § 2003 is amended to read:

§ 2003.  PHARMACY DISCOUNT PLANS

(a)  The commissioner director of the office of Vermont health access shall implement pharmacy discount plans, to be known as the “Healthy Vermonters” program and the “Healthy Vermonters Plus” program, for Vermonters without adequate coverage for prescription drugs.  The provisions of section 1992 of this title shall apply to the commissioner’s director’s authority to administer the pharmacy discount plans established by this section.

(b)  The Healthy Vermonters program shall offer beneficiaries an initial discounted cost for covered drugs.  Upon approval by the Centers for Medicare and Medicaid Services of a Section 1115 Medicaid waiver program, and upon subsequent legislative approval, the Healthy Vermonters program and the Healthy Vermonters Plus program shall offer beneficiaries a secondary discounted cost, which shall reflect a state payment toward the cost of each dispensed drug as well as any rebate amount negotiated by the commissioner director.

(c)  As used in this section:

* * *

(7)  “Rebate amount” means the rebate negotiated by the commissioner director and required from a drug manufacturer or labeler under this section.  In determining the appropriate rebate, the commissioner director shall:

* * *

(8)  “Secondary discounted cost” means, under the Healthy Vermonters program, the price of the drug based on the Medicaid fee schedule, less payment by the state of at least two percent of the Medicaid rate, less any rebate amount negotiated by the commissioner director and paid for out of the Healthy Vermonters dedicated fund established under subsection (j) of this section and, under the Healthy Vermonters Plus program, the average wholesale price of the drug, less payment by the state of at least two percent of the Medicaid rate, less any rebate amount negotiated by the commissioner director and paid for out of the Healthy Vermonters dedicated fund established under subsection (j).

* * *

(e)  The Vermont board of pharmacy shall adopt standards of practice requiring disclosure by participating retail pharmacies to beneficiaries of the amount of savings provided as a result of the pharmacy discount plans.  The standards must consider and protect information that is proprietary in nature.  The department office of Vermont health access may not impose transaction charges under this program on pharmacies that submit claims or receive payments under the plans.  Pharmacies shall submit claims to the department to verify the amount charged to beneficiaries under the plans.  On a weekly or biweekly basis, the department office must reimburse pharmacies for the difference between the initial discounted price or the average wholesale price and the secondary discounted price provided to beneficiaries.

(f)  The names of drug manufacturers and labelers who do and do not enter into rebate agreements under pharmacy discount plans are public information.  The department office of Vermont health access shall release this information to health care providers and the public on a regular basis and shall publicize participation by manufacturers and labelers.  The department office shall impose prior authorization requirements in the Medicaid program, as permitted by law, to the extent the department office determines it is appropriate to do so in order to encourage manufacturer and labeler participation in the pharmacy discount plans and so long as the additional prior authorization requirements remain consistent with the goals of the Medicaid program and the requirements of Title XIX of the federal Social Security Act.

(g)  The commissioner director of the office of Vermont health access shall establish, by rule, a process to resolve discrepancies in rebate amounts claimed by manufacturers, labelers, pharmacies, and the department office.

(h)  The Healthy Vermonters dedicated fund is established to receive revenue from manufacturers and labelers who pay rebates as provided in this section and any appropriations or allocations designated for the fund.  The purposes of the fund are to reimburse retail pharmacies for discounted prices provided to individuals enrolled in the pharmacy discount plans; and to reimburse the department office of Vermont health access for contracted services, including pharmacy claims processing fees, administrative and associated computer costs, and other reasonable program costs.  The fund is a nonlapsing dedicated fund.  Interest on fund balances accrues to the fund. Surplus funds in the fund must be used for the benefit of the program.

(i)  Annually, the department office of Vermont health access shall report the enrollment and financial status of the pharmacy discount plans to the health access oversight committee by September 1, and to the general assembly by January 1.

(j)  The department office of Vermont health access shall undertake outreach efforts to build public awareness of the pharmacy discount plans and maximize enrollment.  Outreach efforts shall include steps to educate retail pharmacists on the purposes of the Healthy Vermonters dedicated fund, in particular as it relates to pharmacy reimbursements for discounted prices provided to program enrollees.  The department office may adjust the requirements and terms of the pharmacy discount plans to accommodate any new federally funded prescription drug programs.

(k)  The department office of Vermont health access may contract with a third party or third parties to administer any or all components of the pharmacy discount plans, including outreach, eligibility, claims, administration, and rebate recovery and redistribution.

(l)  The department office of Vermont health access shall administer the pharmacy discount plans and other medical and pharmaceutical assistance programs under this title in a manner advantageous to the programs and enrollees. In implementing this section, the department office may coordinate the other programs and the pharmacy discount plans and may take actions to enhance efficiency, reduce the cost of prescription drugs, and maximize benefits to the programs and enrollees, including providing the benefits of pharmacy discount plans to enrollees in other programs.

(m)  The department office of Vermont health access may adopt rules to implement the provisions of this section.

(n)  The department office of Vermont health access shall seek a waiver from the Centers for Medicare and Medicaid Services (CMS) requesting authorization necessary to implement the provisions of this section, including application of manufacturer and labeler rebates to the pharmacy discount plans.  The secondary discounted cost shall not be available to beneficiaries of the pharmacy discount plans until the department office receives written notification from CMS that the waiver requested under this section has been approved and until the general assembly subsequently approves all aspects of the pharmacy discount plans, including funding for positions and related operating costs associated with eligibility determinations.

Sec. 106.  33 V.S.A. § 2007 is amended to read:

§ 2007.  Canadian prescription drug information program

The department of prevention, assistance, transition and office of Vermont health access shall establish a website and prepare written information to offer guidance to Vermont residents seeking information about ordering prescription drugs through the mail or otherwise from a participating Canadian pharmacy.

Sec. 107.  33 V.S.A. § 2103 is amended to read:

§ 2103.  ELIGIBILITY

(a)  Consistent with available appropriations, the department of prevention, assistance, transition, and health access for children and families shall furnish general assistance under this chapter, except as provided below, to any otherwise eligible individual unable to provide the necessities of life for himself the individual and for those whom he or she is legally obligated to support.  Except for those in catastrophic situations as defined in regulations, no general assistance shall be provided in the following situations:

(1)  To any individual whose income from any source, including the department of prevention, assistance, transition, and health access for children and families, during the 30 days immediately preceding the date on which assistance is sought is equal to the general assistance eligibility standard;

* * *

(e)  As used in this section, “able-bodied individual” does not include a person subject to such conditions as are determined, by regulation of the commissioner of prevention, assistance, transition, and health access for children and families, to constitute barriers to employment.

Sec. 108.  33 V.S.A. § 2601a(4)(A) is amended to read:

(A)  Individuals in the custody of and placed in foster care by the department of social and rehabilitative services for children and families, and individuals placed in a home by or through a program administered by the department of developmental and mental health services or disabilities, aging, and independent living.

Sec. 109.  33 V.S.A. § 3502 is amended to read:

§ 3502.  DAY CHILD CARE FACILITIES; SCHOOL AGE CARE IN                       PUBLIC SCHOOLS; 21ST CENTURY FUND

(a)  Unless exempted under subsection (b) of this section, a person shall not operate a day child care facility without a license, or operate a family day care home without registration from the department.

(b)  The following persons are exempted from the provisions of subsection (a) of this section:

* * *

(3)  Day Child care facilities operated by religious organizations for the care and supervision of children during or in connection with religious services or church sponsored activities.

* * *

(c)  A person who has a license to operate a day child care facility shall not operate a family day child care home.  A person who operates a registered family day child care home shall not operate a day child care facility.

(d)  Regulations pertaining to day child care facilities and family day child care homes shall be designed to insure that children in day child care facilities and family day child care homes are provided with wholesome growth and educational experiences, and are not subjected to neglect, mistreatment or immoral surroundings.

(e)  At least each three years the department shall review the regulations for licensure and registration for revision or updating.

(f)  The commissioner, upon request, and in his discretion, may grant waivers and variances to child-adult ratios if licensure is applied for by a registered day child care facility.

(g)  In order to facilitate school districts and supervisory unions to apply for and receive federal funds provided by the United States 21st Century Fund, on or before September 1, 2001, the department of social and rehabilitation services and the agency of human services for programs that are in and operated by public schools and provide schoolage care before and after school hours shall:

* * *

(h)  Notwithstanding any provision of law to the contrary, the department of social and rehabilitation services and the agency of human services may provide technical assistance to schools in voluntarily meeting schoolage child care standards.

* * *

Sec. 110.  33 V.S.A. § 3511(4) is amended to read:

(4)  “Commissioner” means the commissioner of the department of social and rehabilitation services for children and families.

Sec. 111.  33 V.S.A. § 3514(a) is amended to read:

(a)  The commissioner shall establish a payment schedule for purposes of reimbursing providers for full or part-time child care services rendered to families who participate in the programs established under sections 3512 or 3513 of this title.  Payments established under this section shall reflect the following considerations: whether the provider operates a licensed day child care facility or a registered family day child care home, type of service provided, cost of providing the service and the prevailing market rate for comparable service.  Payments shall be based on enrollment status or any other basis agreed to by the provider and the division.

Sec. 112.  33 V.S.A. § 3521(a) is amended to read:

(a)  A day child care facilities loan financing program is established to facilitate the development or expansion of day child care facilities in this state.

Sec. 113.  33 V.S.A. § 3522 is amended to read:

§ 3522. LOAN PROGRAM

(a)  The economic opportunity office shall administer a low-interest loan program.

(b)  Loans may be made to persons unable to obtain conventional financing for the purpose of establishing or expanding or renovating a day child care facility in this state.  The terms of the loans shall be determined by the state economic opportunity office, but shall not be made in an amount in excess of $10,000.00 to any single applicant, nor at a rate to exceed eight and one-half percent, simple interest per annum.

(c)  A day child care facilities financing revolving loan fund shall be established for the day child care facilities financing program within the state economic opportunity office of the agency of human services.  The fund shall contain appropriations provided for that purpose and all repayments of principal and interest of loans under this section.  Interest earnings may be used for administration of this program.

* * *

Sec. 114.  33 V.S.A. § 3901(3) is amended to read:

(3)  “Department” means the Vermont department of prevention, assistance, transition, and health access for children and families;

Sec. 115.  33 V.S.A. § 3902(c) and (f) are amended to read:

(c)  Whenever a support obligation is in effect against a responsible parent for the benefit of a dependent child or a custodial parent, payments required thereunder shall be sent to the office of child support upon notice to the responsible parent, without further order of the court.  When an assignment is in effect pursuant to subsection (a) of this section, any amounts accrued under the support obligation as of the date of assignment, and any amount accruing while the assignment is in effect, shall be owing to and payable to the department of prevention, assistance, transition, and health access for children and families without further order of the court.

(f)  If a support order has been entered and the legal custodian and obligee relinquishes physical responsibility of the child to a caretaker without modifying the physical rights and responsibilities order, the office of child support may change the payee of support upon the caretaker’s receipt of Reach Up family assistance (RUFA) from the department of prevention, assistance, transition, and health access for children and families.  The obligor’s obligation under the support order to pay child support and medical support continues but shall be payable to the office of child support upon the caretaker’s receipt of RUFA and shall continue so long as the assignment is in effect.  The office of child support shall notify the obligor and obligee under the support order, by first class mail at last known address, of the change of payee.

Sec. 116.  33 V.S.A. § 3903 is amended to read:

§ 3903.  CHILD SUPPORT DEBT

Except as otherwise provided in this section, any payment of aid to needy families with dependent children (ANFC) Reach Up financial assistance made to or for the benefit of a dependent child creates a debt due and owing to the department of prevention, assistance, transition, and health access for children and families by any responsible parent in an amount equal to the amount of ANFC Reach Up financial assistance paid.

(1)  A debt shall not be incurred by any responsible parent while that parent receives public assistance for the benefit of any of his or her dependent children.  A debt previously incurred by any responsible parent shall not be collected from the responsible parent while that parent receives public assistance for the benefit of his or her dependent children, or assistance under Title XVI of the Social Security Act.

(2)  Collection of child support debts shall be made as provided by this section and section 3902 of this title and by subchapter 7 of chapter 11 of Title 15.  Regardless of the amount of ANFC Reach Up financial assistance paid, the court may limit the child support debt, taking into consideration the criteria of section 659 of Title 15.  The department of prevention, assistance, transition, and health access for children and families and the responsible parent may limit the child support debt by stipulation which shall be enforceable on its terms unless it is modified.

Sec. 117.  33 V.S.A. § 4901(3) is amended to read:

(3)  Protecting and promoting the welfare of children of working mothers parents.

Sec. 118.  33 V.S.A. § 4902 is amended to read:

§ 4902.  DEFINITIONS

Unless otherwise specifically provided, the following words and phrases in this chapter mean:

(1)  Child:  a person under the age of eighteen 18 years committed by the juvenile court to the department of prevention, assistance, transition, and health access for children and families prior to April 14, 1974 and to the department of social and rehabilitation services for children and families thereafter, except that for the purpose of subchapter 1 of chapter 35 of this title, a child is a person under the age of sixteen years.

(2)  Day Child care facility:  any place or program operated as a business or service on a regular or continuous basis, whether for compensation or not, whose primary function is protection, care and supervision of children under sixteen 16 years of age outside their homes for periods of less than twenty-four 24 hours a day by a person other than a child’s own parent, guardian, or relative, as defined by rules adopted by the department for children and families, but not including a kindergarten approved by the state board of education.

(3)  A family day child care home:  is a day child care facility which provides for care on a regular basis in the caregiver’s own residence for not more than ten 10 children at any one time.  Of this number up to six children may be provided care on a full-time basis and the remainder on a part-time basis.  For the purpose of this subdivision, care of a child on a part-time basis shall mean care of a school-age child for not more than four hours a day.  These limits shall not include children who reside in the residence of the caregiver; except:

* * *

(5)  Commissioner:  the commissioner of social and rehabilitation services for children and families.

(6)  Department:  the department of social and rehabilitation services for children and families.

Sec. 119.  33 V.S.A. § 4903(4) is amended to read:

(4)  Providing substitute parental care and custody for a child upon application of his or her parent, guardian, or any person acting in behalf of the child, when after investigation it is found that the care and custody will be in the best interest of the child.  The acceptance of a child by the department shall not abrogate parental rights or responsibilities, but the department may accept from the parents temporary delegation of certain rights and responsibilities necessary to provide care and custody for a period of up to six months under conditions agreed upon by the parents and the department.  Upon a stipulation approved by the juvenile court the period may be extended for additional periods of up to six months each, provided that each extension is first determined by the parties to be necessary, and that it is in the best interest of the child.

Sec. 120.  33 V.S.A. § 4914 is amended to read:

§ 4914.  Nature and content of report; to whom made

A report shall be made orally or in writing to the commissioner of social and rehabilitation services for children and families or designee.  The commissioner or designee shall request the reporter to follow the oral report with a written report.  Reports shall contain the name and address of the reporter as well as the names and addresses of the child and the parents or other persons responsible for the child’s care, if known; the age of the child; the nature and extent of the child’s injuries together with any evidence of previous abuse and neglect of the child or the child’s siblings; and any other information that the reporter believes might be helpful in establishing the cause of the injuries or reasons for the neglect as well as in protecting the child and assisting the family.  If a report of child abuse or neglect involves the acts or omissions of the commissioner of social and rehabilitation services for children and families or employees of that department, then such reports the report shall be directed to the secretary of the agency of human services who shall cause the report to be investigated by staff of the departments of developmental and mental health services, department of disabilities, aging, and independent living or of corrections or other appropriate staff other than staff of the department of social and rehabilitation services for children and families.  If the report is substantiated, services shall be offered according to the requirements of section 4915 of this title.

Sec. 121.  33 V.S.A. § 4919 is amended to read:

§ 4919.  Disclosure of information

* * *

(b)  The commissioner or the commissioner’s designee may disclose registry information only:

* * *

(4)  To the commissioner of disabilities, aging, and disabilities  independent living, or the commissioner’s designee, for purposes related to the licensing or registration of facilities regulated by the department of disabilities, aging, and disabilities independent living;

(5)  To the commissioner of developmental and mental health services or of disabilities, aging, and independent living, or the commissioner’s designee, for purposes related to oversight and monitoring of persons who are served by or compensated with funds provided by the department departments of developmental and mental health services and of disabilities, aging, and independent living, including persons to whom a conditional offer of employment has been made;

* * *

Sec. 122.  33 V.S.A. § 5562(c) is amended to read:

(3)  Cooperation among appropriate departments, including the departments of education, of corrections, social and rehabilitation services for children and families, employment and training of labor, developmental and mental of health services, of disabilities, aging, and independent living, and of public safety, and the office of alcohol and drug abuse programs.

Sec. 123.  33 V.S.A. § 6321(f) is amended to read:

(f)  Personal care attendants, as defined in program rules of the department of disabilities, aging, and disabilities independent living, are exempt from 21 V.S.A. § 342 and shall not be construed as state employees except for purposes of 21 V.S.A. chapters 9 and 17.

Sec. 124.  33 V.S.A. § 6501(1) is amended to read:

(1)  “Balance bill” means to charge to or collect from a Medicare or general assistance beneficiary any amount in excess of the reasonable charge for that service as determined by the United States secretary of health and human services, or the Vermont commissioner of prevention, assistance, transition, and director of the office of Vermont health access, as the case may be.

Sec. 125.  33 V.S.A. § 6504 is amended to read:

§ 6504.  Medicare beneficiary to sign statement

Annually and prior to treatment, a physician may request that a Medicare beneficiary sign a statement prepared in accordance with this section to determine whether or not the beneficiary may be balance billed.  The exceptions contained in subdivision (1) of section 6503 of this title shall not apply if the physician does not request that the beneficiary sign the statement.  The statement shall be prepared by the department of disabilities, aging, and disabilities independent living, and shall incorporate the exceptions contained in subdivision (1) of section 6503 of this title.

Sec. 126.  33 V.S.A. § 6506 is amended to read:

§ 6506.  Posting

A physician who treats Medicare or general assistance beneficiaries shall post a summary of the provisions of this chapter in a conspicuous place in his or her office.  The summary shall include the statement that any person aggrieved by a physician’s failure to comply with the provisions of this chapter may contact the department of disabilities, aging, and disabilities independent living for assistance or file a complaint with the division of registration, licensing and secretarial services within the office of the secretary of state and shall include toll-free telephone numbers to be used for these purposes.  The summary shall be written by the department of disabilities, aging, and disabilities independent living and distributed by the secretary of state.

Sec. 127.  33 V.S.A. § 6508 is amended to read:

§ 6508.  Report required

On or before January 15 of each year up to and including 1992, the department of disabilities, aging, and disabilities independent living shall evaluate the effect of this chapter and report its findings to the chairpersons of the senate and house health and welfare committees.  At a minimum, the report shall address the following:  inquiries or complaints received by the department of disabilities, aging, and disabilities independent living concerning physician balance billing practices, changes in actual billing of Medicare beneficiaries for physician services, issues relating to access to physician services for beneficiaries, and any other information necessary to enable the committees to assess the effect of this chapter on physicians and beneficiaries.  In compiling its report, the department of disabilities, aging, and disabilities independent living shall consult with the secretary of state, the carrier for Medicare physician services for Vermont, and the professional societies of professions affected by this chapter.

Sec. 128.  33 V.S.A. § 6703 is amended to read:

§ 6703.  CONTRACT FOR SERVICES

(a)  Subject to the provisions of subsection (b) of this section, the commissioner of prevention, assistance, transition, and director of the office of Vermont health access shall contract on an annual basis with individuals or private organizations to provide services authorized by this chapter to dual eligible individuals including pursuit of subrogation claims under section 6705 of this chapter.

(b)  The commissioner director shall not be required to enter into contracts under this section if:

* * *

(2)  the commissioner director determines that the program is not accomplishing its goal of protecting dual eligible individuals from improper denials of Medicare coverage.  The commissioner director shall base his or her determination under this subdivision on information obtained from the contractors, providers of health care, area agencies on aging and other individuals and organizations affected by the program.  On or before January 15 of any fiscal year in which a determination is made under this subdivision, the commissioner director shall report his or her determination to the general assembly.

Sec. 129.  33 V.S.A. § 6705 is amended to read:

§ 6705.  SUBROGATION

(a)  Upon furnishing medical assistance under chapter 19 of this title to any individual, the department of prevention, assistance, transition, and office of Vermont health access shall be subrogated, to the extent of the expenditure for medical care furnished, to any rights such individual may have to third party reimbursement for such care.

(b)  The department office of Vermont health access or its designee shall be entitled to obtain from any medical service provider any records of the treatment of any individual covered by subsection (a) of this section which are in any way relevant to the treatment paid for through medical assistance without regard to any other privilege or right of confidentiality or privacy which may exist.  The department office shall ensure that any records obtained are not released to any other individual, agency or other entity except insofar as is necessary to pursue the department’s office’s rights of subrogation.

(c)  The department of prevention, assistance, transition, and office of Vermont health access may contract with a private attorney or attorneys, or other private persons, for the purpose of obtaining third party reimbursement for Medicaid expenditures under this section.  In awarding contracts under this section, the department office shall give preference to bidders who maintain a place of business in this state.

Sec. 130.  33 V.S.A. § 6902(3) and (4) are amended to read:

(3)  “Commissioner” means the commissioner of the department of disabilities, aging, and disabilities independent living.

(4)  “Department” means the state department of disabilities, aging, and disabilities independent living.

Sec. 131.  33 V.S.A. § 6906(e) is amended to read:

(e)  If a report is found to be unsubstantiated, the records shall be retained as part of the confidential records of the department of disabilities, aging, and disabilities independent living.  If no court proceeding is brought pursuant to subdivision 6903(c)(3) of this title within six years of the date of the notice to the person against whom the complaint was lodged, the records relating to the unsubstantiated report shall be destroyed after notice to such person, unless he or she requests that the records not be destroyed.

Sec. 132.  33 V.S.A. § 6911(c) is amended to read:

(c)  The commissioner or the commissioner’s designee may disclose registry information only to:

* * *

(5)  the commissioner of social and rehabilitation services the department for children and families, or the commissioner’s designee, for purposes related to the licensing or registration of facilities regulated by the department of social and rehabilitation services for children and families;

(6)  the commissioner of developmental and mental health services, or the commissioner’s designee, for purposes related to oversight and monitoring of persons who are served by or compensated with funds provided by the department of developmental and mental health services, including persons to whom a conditional offer of employment has been made; and

* * *

Sec. 133.  33 V.S.A. § 6914(d) and (g) are amended to read:

(d)  The commissioner of developmental and mental health services, or the commissioner’s designee, for purposes related to oversight and monitoring of persons who are served by or compensated with funds provided by the department of developmental and mental health services, may ask the Vermont crime information center for the record of convictions of a person who is a current employee, volunteer or contractor, or a person to whom the employer has given a conditional offer of a contract, volunteer position, or employment.  If the individual has a record of convictions, the Vermont crime information center shall inform the commissioner, or the commissioner’s designee, of the date and type of conviction.

(g)  As used in this section, “commissioner” means the commissioner of the department of disabilities, aging, and disabilities independent living or the commissioner of developmental and mental health services, or their the commissioner’s designees.

Sec. 134.  33 V.S.A. § 6931 is amended to read:

§ 6931.  Definitions

In addition to the definitions in section 6902 of this title, for the purposes of this subchapter, “interested person” means a representative of the vulnerable adult, the commissioner of the department of disabilities, aging, and disabilities independent living, or the commissioner’s designee.

Sec. 135.  33 V.S.A. § 7302(b) is amended to read:

(b)  A resident grievance mechanism plan shall include, but not be limited to, a method by which each resident filing a grievance will be made aware of the state ombudsman program and that the ombudsman may be contacted as an alternative or in addition to the home’s grievance mechanism.  “Ombudsman” refers to the long-term care ombudsman program established within the Vermont department of disabilities, aging, and disabilities independent living pursuant to the Older Americans Act of 1965 as amended.

Sec. 136.  33 V.S.A. § 7303 is amended to read:

§ 7303.  Notice to residents; posting

A summary of the obligations of the nursing home to residents using its facilities shall be written in clear language, in easily readable print, and posted conspicuously in a public place on each floor of the home.  Such This notice shall also summarize the facility’s grievance procedure and directions for contacting the ombudsman program.  The directions for contacting the ombudsman program shall be written by the department of disabilities, aging, and disabilities independent living, shall include a description of the ombudsman program, and shall be underscored.

Sec. 137.  33 V.S.A. § 7304 is amended to read:

§ 7304.  Administrative penalty

The commissioner of disabilities, aging, and disabilities independent living may, after a hearing, impose an administrative penalty of not more than $1,000.00 against any facility or employee of a facility who violates a provision of this chapter.

Sec. 138.  33 V.S.A. § 7305 is amended to read:

§ 7305.  Readmission

Notwithstanding any provision of this chapter, a facility may petition the commissioner of disabilities, aging, and disabilities independent living to deny readmission to the facility of any former resident returning from a period of hospitalization.  Such petitions A petition shall be made as soon as possible after the hospitalization of any such the resident and only shall be granted if in the judgment of the commissioner, upon consultation with the ombudsman, the resident has exhibited a nonremedial pattern of violent behavior which poses a danger to others.

Sec. 139.  33 V.S.A. § 7502 is amended to read:

§ 7502.  Office of the long-term care ombudsman

              established

The office of the long-term care ombudsman is established in the department of disabilities, aging and independent living to represent the interests of older persons and persons with disabilities under the age of 60 receiving in long-term care in accordance with the provisions of this chapter and the Older Americans Act.  For the purposes of this section, long-term care facilities shall include facilities in which placements are made by, and facilities funded through, the department of disabilities, aging, and independent living, division of disabilities and aging services.  Subject to the provisions of 42 U.S.C. § 3058g, the department may operate the office and carry out the program, directly or by contract or other arrangement with any public agency or nonprofit private organization.  The office shall be headed by an individual, to be known as the state long-term care ombudsman, who shall be selected from among individuals with expertise and experience in the fields of long-term care and advocacy.

Sec. 140.  REPEAL

The following are repealed:

(1)  3 V.S.A. §§ 212(20) (department of developmental and mental health services); and 3085 (creation of the department of prevention, assistance, transition, and health access);

(2)  12 V.S.A. § 3688 (bastardy prosecutions);

(3)  14 V.S.A. §§ 2682 (guardian appointment for spendthrifts), 2689 (petition filing for guardian appointment); and 3007 (discharge of guardian);

(4)  18 V.S.A. §§ 7101(21) and (22) (definitions of “student” and “training school”); 7203 (department of developmental and mental health services personnel); 7303 (appointment of commissioner of developmental and mental health services); 7403 (superintendent of state hospital records); 7904 (transfer of students to boarding home); and 8301 (treatment of aged, chronically ill, and physically handicapped at retreat); and

(5)  33 V.S.A. §§ 1701(b) (food stamp program); 1791(b) (town clerk as agent for food stamp sales); 3502(i) (expired report); and 4501(6) and (7) (definitions of “commissioner” and “department”) are repealed. 

Sec. 141.  INTENT; APPLICATION

The purpose of this act is to make amendments to conform the Vermont Statutes Annotated with the restructuring of the agency of human services pursuant to No. 45 of the Acts of 2003.  Nothing in this act is intended to undo or supersede any other act of the 2006 general assembly.  Likewise, any act of the general assembly which fails to amend a section of the Vermont Statutes Annotated which is amended by this act shall not be intended to undo or supercede this act.

Sec. 142.  [DELETED]

Sec. 143.  [DELETED]

Sec. 144.  LEGISLATIVE COUNCIL; STATUTORY REVISION

The legislative council is directed to reassign the codified sections of this act pursuant to section 424 of Title 2.

Approved:  May 22, 2006



Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont


www.leg.state.vt.us