friday, february 23, 2007
TABLE OF CONTENTS
S. 91 Re: Dept. of Banking, Ins., Securities & Health Care Admin............ .103
JRH 1 Requesting Congress to ban exportation of elemental mercury............ 103
S. 50 Relating to Chiropractic coverage in Medicaid and VHAP................. 103
Health and Welfare Committee Report............................... 103
H. 131 Amendment to the charter of the village of North Troy....................... 103
Government Operations Committee Report........................ 103
Favorable with Recommendation of Amendment
S. 7 Relating to medical marijuana............................................................ 103
Judiciary Committee Report............................................... 103
Health and Welfare Committee Report............................... 108
Finance Committee Report................................................ 108
Favorable with Proposals of Amendment
H. 302 Fiscal Year 2007 budget adjustments................................................ 109
Appropriations Committee Report..................................... 109
Concurrent Resolutions for Adoption
For text of Resolutions, see Addendum to February 22, 2007 Calendar
SCR 9 Employees who work in the Bennington state office building................. 79
HCR 43 Agency of transportation for response to Valentine’s Day blizzard........ 80
HCR 44 Vermont wood products, fine furnishings, and creative artisans............. 81
HCR 45 Adeline Baker on the conclusion of her career..................................... 83
HCR 46 Frederick H. Tuttle Middle School Odyssey of the Mind team............. 85
HCR 47 Honoring retiring Vermont Life Magazine editor Tom Slayton.............. 86
An act relating to the department of banking, insurance, securities, and health care administration.
Joint resolution to request Congress to ban exportation of elemental mercury.
An act relating to chiropractic coverage in Medicaid and VHAP.
Reported favorably by Senator Mullin for the Committee on Health and Welfare.
(Committee vote: 6-0-0)
An act relating to approval of an amendment to the charter of the village of North Troy.
Reported favorably by Senator Doyle for the Committee on Government Operations.
(Committee vote: 4-0-1)
(No House amendments)
Favorable with Recommendation of Amendment
An act relating to medical marijuana.
Reported favorably with recommendation of amendment by Senator Campbell for the Committee on Judiciary.
The Committee recommends that the bill be amended by striking out all after the enacting clause and inserting in lieu thereof the following:
Sec. 1. 18 V.S.A. chapter 86 is amended to read:
CHAPTER 86. THERAPEUTIC USE OF CANNABIS
* * *
Marijuana for Medical Use
by Persons with Severe Illness
§ 4472. DEFINITIONS
For the purposes of this subchapter:
(1) “Bona fide physician-patient relationship” means a treating or consulting relationship of not less than six months duration, in the course of which a physician has completed a full assessment of the registered patient’s medical history and current medical condition, including a personal physical examination.
(2) “Debilitating medical condition,” provided that, in the context of the specific disease or condition described in subdivision (A) or (B) of this subdivision (2), reasonable medical efforts have been made over a reasonable amount of time without success to relieve the symptoms, means:
(A) end of life care for cancer or acquired immune deficiency
syndrome; or (B) cancer, acquired immune deficiency syndrome, positive status for
human immunodeficiency virus, multiple sclerosis, or the treatment of these
diseases or medical conditions if: (i) the disease or condition or its treatment results in severe,
persistent, and intractable symptoms; and (ii) in the context of the specific disease or condition, reasonable
medical efforts have been made over a reasonable amount of time without success
in relieving the symptoms.
(A) cancer, multiple sclerosis, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, or the treatment of these conditions, if the disease or the treatment results in severe, persistent, and intractable symptoms; or
(B) a disease, medical condition, or its treatment that:
(i) is chronic, progressive, and debilitating; and
(ii) produces severe, persistent, and one or more of the following intractable symptoms: cachexia or wasting syndrome; severe pain; severe nausea; or seizures.
(3) “Marijuana” shall have the same meaning as provided in subdivision 4201(15) of this title.
(4) “Possession limit” means the amount of marijuana collectively
possessed between the registered patient and the patient’s registered caregiver
which is no more than
one four mature marijuana plant plants,
two ten immature plants, and two ounces of usable marijuana.
(5) “Physician” means a person who is licensed:
(A) under chapter 23 or chapter 33 of Title 26, and is licensed with authority to prescribe drugs under Title 26; or
(B) to practice medicine and prescribe drugs under the comparable provisions of another jurisdiction.
(6) “Registered caregiver” means a person who is at least 21 years old who has never been convicted of a drug-related crime and who has agreed to undertake responsibility for managing the well-being of a registered patient with respect to the use of marijuana for symptom relief.
(7) “Registered patient” means a person who has been issued a registration card by the department of public safety identifying the person as having a debilitating medical condition pursuant to the provisions of this subchapter.
(8) “Secure indoor facility” means a building or room equipped with locks or other security devices that permit access only by a registered caregiver or registered patient.
(9) “Usable marijuana” means the dried leaves and flowers of marijuana, and any mixture or preparation thereof, and does not include the seeds, stalks, and roots of the plant.
(10) “Use for symptom relief” means the acquisition, possession, cultivation, use, transfer, or transportation of marijuana or paraphernalia relating to the administration of marijuana to alleviate the symptoms or effects of a registered patient’s debilitating medical condition which is in compliance with all the limitations and restrictions of this subchapter. For the purposes of this definition, “transfer” is limited to the transfer of marijuana and paraphernalia between a registered caregiver and a registered patient.
§ 4473. REGISTERED PATIENTS; QUALIFICATION STANDARDS AND PROCEDURES
(a) To become a registered patient, a person must be diagnosed with a debilitating medical condition by a physician in the course of a bona fide physician-patient relationship.
(b) The department of public safety shall review applications to become a registered patient using the following procedures:
(1) A patient with a debilitating medical condition shall submit, under oath, a signed application for registration to the department. If the patient is under the age of 18 the application must be signed by both the patient and a parent or guardian. The application shall require identification and contact information for the patient and the patient’s registered caregiver applying for authorization under section 4474 of this title, if any. The applicant shall attach to the application a copy of relevant portions of the patient’s medical record sufficient to establish that the patient has a debilitating medical condition.
(2) The department shall contact the physician for purposes of verifying the existence of a bona fide physician-patient relationship and the accuracy of the medical record. The department may approve an application, notwithstanding the six-month requirement in subdivision 4472(1) of this title, if the department is satisfied that the debilitating medical condition is of recent or sudden onset and that the patient has not had a previous physician who is able to verify the nature of the disease and its symptoms.
(3) The department shall approve or deny the application for registration in writing within 30 days from receipt of a completed registration application. If the application is approved, the department shall issue the applicant a registration card which shall include the registered patient’s name and photograph, as well as a unique identifier for law enforcement verification purposes under section 4474d of this title.
(4)(A) A review board is established. The medical practice board shall appoint three physicians licensed in Vermont to constitute the review board. If an application under subdivision (1) of this subsection is denied, within seven days the patient may appeal the denial to the board. Review shall be limited to information submitted by the patient under subdivision (1) of this subsection, and consultation with the patient’s treating physician. All records relating to the appeal shall be kept confidential. An appeal shall be decided by majority vote of the members of the board.
(B) The board shall meet periodically to review studies, data, and any other information relevant to the use of marijuana for symptom relief. The board may make recommendations to the general assembly for adjustments and changes to this chapter.
(C) Members of the board shall serve for three-year terms, beginning February 1 of the year in which the appointment is made, except that the first members appointed shall serve as follows: one for a term of two years, one for a term of three years, and one for a term of four years. Members shall be entitled to per diem compensation authorized under section 1010 of Title 32. Vacancies shall be filled in the same manner as the original appointment for the unexpired portion of the term vacated.
§ 4474. REGISTERED CAREGIVERS; QUALIFICATION STANDARDS AND PROCEDURES
(a) A person may submit a signed application to the department of public safety to become a registered patient’s registered caregiver. The department shall approve or deny the application in writing within 30 days. The department shall approve a registered caregiver’s application and issue the person an authorization card, including the caregiver’s name, photograph, and a unique identifier, after verifying:
(1) the person will serve as the registered caregiver for one registered patient only; and
(2) the person has never been convicted of a drug‑related crime.
(b) Prior to acting on an application, the department shall obtain from the Vermont criminal information center a Vermont criminal record, an out-of-state criminal record, and a criminal record from the Federal Bureau of Investigation for the applicant. For purposes of this subdivision, “criminal record” means a record of whether the person has ever been convicted of a drug-related crime. Each applicant shall consent to release of criminal records to the department on forms substantially similar to the release forms developed by the center pursuant to section 2056c of Title 20. The department shall comply with all laws regulating the release of criminal history records and the protection of individual privacy. The Vermont criminal information center shall send to the requester any record received pursuant to this section or inform the department of public safety that no record exists. If the department disapproves an application, the department shall promptly provide a copy of any record of convictions and pending criminal charges to the applicant and shall inform the applicant of the right to appeal the accuracy and completeness of the record pursuant to rules adopted by the Vermont criminal information center. No person shall confirm the existence or nonexistence of criminal record information to any person who would not be eligible to receive the information pursuant to this subchapter.
(c) A registered caregiver may serve only one registered patient at a time, and a registered patient may have only one registered caregiver at a time.
§ 4474a. REGISTRATION; FEES
(a) The department shall collect a fee of
$100.00 $50.00 for
the application authorized by sections 4473 and 4474 of this title. The fees
received by the department shall be deposited into a registration fee fund and
used to offset the costs of processing applications under this subchapter.
(b) A registration card shall expire one year after the date of issue,
with the option of renewal, provided the patient submits a new application
which is approved by the department of public safety, pursuant to
section 4473 or 4474 of this title, and pays the fee required under
subsection (a) of this section.
§ 4474b. EXEMPTION FROM CRIMINAL AND CIVIL PENALTIES; SEIZURE OF PROPERTY
* * *
(e) It shall not be a violation of state nursing home regulations to allow a registered patient to possess or use medical marijuana in a nursing facility.
* * *
and that, after passage, the title of the bill be amended to read: “AN ACT RELATING TO THE COMPASSIONATE USE OF MARIJUANA FOR MEDICAL PURPOSES.”
(Committee vote: 4-1-0)
Reported favorably with recommendation of amendment by Senator Kevin Mullin for the Committee on Health and Welfare.
The Committee recommends that the bill be amended as recommended by the Committee on Judiciary with the following amendment thereto:
In Sec. 1, 13 V.S.A. § 4472, by striking out subdivision (5) in its entirety and inserting in lieu thereof a new subdivision (5) to read as follows:
(5) “Physician” means a person who is:
(A) licensed under chapter 23 or chapter 33 of Title 26, and is licensed with authority to prescribe drugs under Title 26; or
(B) a physician, surgeon, or osteopathic physician licensed to practice medicine and prescribe drugs under comparable provisions in New Hampshire, Massachusetts or New York.
(Committee vote: 6-0-0)
Reported favorably by Senator Ayer for the Committee on Finance.
(Committee vote: 4-0-3)
An act relating to fiscal year 2007 budget adjustments.
Reported favorably with recommendation of proposals of amendment by Senator Bartlett for the Committee on Appropriations.
The Committee recommends that the Senate propose to the House to amend the bill as follows:
First: By striking out Sec. 8 in its entirety and inserting in lieu thereof a new Sec. 8 to read as follows:
Sec. 8. Sec. 56 of No. 215 of the Acts of 2006 is amended to read:
Sec. 56. Vermont court diversion
* * *
(a) Court diversion programs may use funds allocated in the appropriation above for increased wages to maintain salaries and benefits.
Second: After Sec. 9, by adding a new section to be numbered Sec. 9a to read as follows:
Sec. 9a. Sec. 63 of No. 215 of the Acts of 2006 is amended to read:
Sec. 63. Public safety – administration
* * *
(b) Of the funds appropriated to the department of public safety $26,000 shall be used to make a grant to the Essex county sheriff department. The commissioner may transfer this amount from line items in this appropriation or other department of public safety appropriations to implement this directive forthwith.
Third: By striking out Sec. 11(d) in its entirety
Fourth: By striking out Sec. 22 in its entirety and inserting in lieu thereof a new Sec. 22 to read as follows:
Sec. 22. Sec. 101 of No. 215 of the Acts of 2006 is amended to read:
Sec. 101. Secretary’s office – Global Commitment
Source of funds
Tobacco fund 19,299,711 19,299,711
State health care resource fund 153,832,688 153,832,688
Interdepartmental transfer 2,279,203 2,279,203
(b) In addition to the state funds appropriated in this section, a total
estimated sum of
$35,594,773 $33,133,325 is anticipated to be
certified as state matching funds under the Global Commitment as follows:
$19,536,7351 $17,075,287 certified state match
available from local education agencies. This amount combined with $27,665,633
$24,379,713 of federal funds appropriated in this section equals a total
estimated expenditure of $47,202,367 $41,455,000 for eligible
special education school-based Medicaid services under the Global Commitment.
An amount equal to the actual amount of the federal matching funds for eligible
special education school-based Medicaid services under global commitment shall
be transferred from the Global Commitment fund to the Medicaid reimbursement
special fund created in 16 V.S.A. § 2959a. (2) $1,497,110 certified state match available from local education
agencies for eligible services under the Global Commitment provided to students
under Section 504 of the Rehabilitation Act of 1973.
32) $7,459,137 $8,956,247 certified state
match available from local education agencies for eligible services under the
Global Commitment provided to students through school-based health services,
including school nurses.
43) $4,215,210 certified state match available from local
education and social service agencies for eligible services provided to students
in the success beyond six programs eligible persons through the
children’s collaborative services program.
54) $1,847,186 certified state match available from local
designated mental health agencies for eligible mental health services provided
under the Global Commitment.
65) $1,039,395 certified state match available from local
designated developmental services agencies for eligible developmental services
provided under the Global Commitment.
Fifth: After Sec. 22, by adding a new section to be numbered Sec. 22a to read as follows:
Sec. 22a. GLOBAL COMMITMENT APPROPRIATIONS; TRANSFER; REPORT
(a) In order to facilitate the end of year closeout for fiscal year 2007, the secretary of the agency of human services, with approval from the secretary of administration, may make transfers among the appropriations authorized for Medicaid and Medicaid-waiver program expenses. At least three business days prior to any transfer, the agency shall submit a proposal of transfers to be made pursuant to this section to the joint fiscal office. A final report on all transfers made under this section shall be made to the joint fiscal committee for review at the September 2007 meeting. The purpose of this section is to provide the agency with limited authority to modify the appropriations to comply with the terms and conditions of the global commitment for health waiver approved by the Centers for Medicare and Medicaid Services under Section 1115 of the Social Security Act.
Sixth: In Sec. 24, by adding a new subsection (c) to read as follows:
(c) The director of the office of Vermont health access shall not encumber or expend more than 10 percent of the $3,034,333 allocated in the appropriation above for marketing, outreach and associated internal systems for the Catamount, Medicaid and SCHIP programs until a plan has been reviewed and approved by the commission on health care reform created pursuant to Sec. 277c of No. 71 of the Acts of 2005.
Seventh: By striking out Sec. 25 in its entirety and inserting in lieu thereof a new Sec. 25 to read as follows:
Sec. 25. Sec. 109 of No. 215 of the Acts of 2006 is amended to read:
Office of Vermont health access - Medicaid program –
long-term care waiver
Source of funds
(a) The director of the office of Vermont health access and the commissioner of the department of disabilities, aging and independent living shall provide services to all eligible persons deemed high needs or greater. The intent of this subsection is that for the remainder of fiscal year 2007 persons who are determined to be high or highest needs and eligible for services under the choices for care waiver shall receive services and not be placed on a waiting list.
(b) The director of the office of Vermont health access and the commissioner of the department of disabilities, aging and independent living shall report to the house and senate committees on appropriations by April 1, 2007 with recommendations on: the methodology to be used for calculating program savings due to the Choices for Care waiver; and a framework for deciding how savings are to be reinvested.
Eighth: By striking out Sec. 30 in its entirety and inserting in lieu thereof a new Sec. 30 to read as follows:
Sec. 30. Sec. 117 of No. 215 of the Acts of 2006 is amended to read:
Sec. 117. Health - health protection
Personal services 3,282,307 3,282,307
Grants 1,689,500 1,689,500
Source of funds
Global Commitment fund
Federal funds 4,239,401 4,239,401
Interdepartmental transfer 303,000 303,000
Ninth: By striking out Sec. 34 in its entirety and inserting in lieu thereof a new Sec. 34 to read as follows:
Sec. 34. Sec. 121 of No. 215 of the Acts of 2006 is amended to read:
Sec. 121. Health – alcohol and drug abuse programs
Operating expenses 1,130,648 1,130,648
Source of funds
Special funds 195,500 195,500
Tobacco fund 2,382,834 2,382,834
Global Commitment fund
Interdepartmental transfer 150,000 150,000
* * *
(g) In addition to the $345,000 of funds allocated for grants to recovery centers in the above appropriation, $12,500 of funds shall be granted to the Vermont’s recovery center network.
Tenth: By striking out Sec. 45(a) in its entirety and inserting in lieu thereof a new Sec. 45(a) to read as follows:
(a) In fiscal year 2007, the department for children and families may provide financial assistance and support services to families through solely state funded programs in order to maintain the separate state programs and segregated funds program established in subchapter 3 of chapter 11 of Title 33 and to assist the department in complying with the requirements relating to Temporary Assistance to Needy Families contained in the Deficit Reduction Act of 2005 pending further action by the general assembly. This section shall not be interpreted to modify the requirements for families receiving services or the programs established in subchapter 3 of chapter 11 of Title 33, but is intended to permit the department flexibility in reporting maintenance-of-effort funds.
Eleventh: After Sec. 58, by adding two new sections to be numbered Sec. 58a and Sec. 58b to read as follows:
Sec. 58a. Sec. 177 of No. 215 of the Acts of 2006 is amended to read:
Sec. 177. Education – adjusted education payment
Source of funds
* * *
Sec. 58b. Sec. 180 of No. 215 of the Acts of 2006 is amended to read:
Sec. 180. Education – small school grants
Source of funds
Twelfth: In Sec. 74(a), by striking out the word “catagory” and inserting in lieu thereof the word category
Thirteenth: In Sec. 90(a)(3), by striking out the words “up to”
Fourteenth: By striking out Sec. 109 in its entirety and inserting in lieu thereof a new Sec. 109 to read as follows:
Sec. 109. NEXT GENERATION FUND
(a) Of the total sum transferred from the fiscal year 2007 general fund to the next generation initiative fund, the sum of $1,700,000 is appropriated as follows:
(1) The sum of $500,000 is appropriated to the agency of commerce and community development for the issuance of Vermont training program grants pursuant to 10 V.S.A. § 531.
(2) The sum of $500,000 is appropriated to the workforce education and training fund created in Sec. 157a(d) of No. 62 of the Acts of 1999 as amended by Sec. 14 of No. 212 of the Acts of 2006.
(3) The sum of $500,000 is appropriated to the Vermont student assistance corporation for its nondegree grant program.
(4) The sum of $200,000 is appropriated to the Vermont student assistance corporation for need-based scholarships enabling dual enrollment by high school students in college courses.
And by renumbering all of the sections of the bill to be numerically correct (including internal references) and adjusting all of the totals to be arithmetically correct.
(Committee vote: 7-0-0)
(No House amendments.)
Concurrent Resolutions for Adoption Under Joint Rule 16a
The following concurrent resolutions have been introduced for approval by the Senate and House and will be adopted automatically unless a Senator or Representative requests floor consideration before today’s adjournment. Requests for floor consideration in either chamber should be communicated to the Secretary’s office and/or the House Clerk’s office, respectively. For text of resolutions, see Addendum to Senate Calendar of Thursday, February 22, 2007.
Senate concurrent resolution thanking the state employees who work in the Bennington state office building.
House concurrent resolution thanking the Vermont agency of transportation’s district and central garage forces for their heroic response to the 2007 Valentine’s Day blizzard.
House concurrent resolution honoring Vermont wood products and fine furnishings and the creative artisans who produce these products.
House concurrent resolution honoring Adeline Baker on the conclusion of her outstanding career at the Mountain Valley Medical Clinic.
House concurrent resolution congratulating the 2006 Frederick H. Tuttle Middle School Odyssey of the Mind team.
House concurrent resolution honoring retiring Vermont Life Magazine editor Tom Slayton.
The following appointments will be considered by the Senate, as a group, under suspension of the Rules, as moved by the President pro tempore, for confirmation together and without debate, by consent thereby given by the Senate. However, upon request of any senator, any appointment may be singled out and acted upon separately by the Senate, with consideration given to the report of the Committee to which the appointment was referred, and with full debate; and further, all appointments for the positions of Secretaries of Agencies, Commissioners of Departments, Judges, Magistrates, and members of the Public Service Board shall be fully and separately acted upon.
Robert Britt of South Burlington - Member of the Vermont Economic Development Authority - By Sen. Condos for the Committee on Finance. (1/25)
David E. L. Brown of Shelburne - Member of the Board of Libraries - By Sen. Giard for the Committee on Education. (1/31)
John Rosenthal of Charlotte - Member of the Board of Libraries - By Sen. Doyle for the Committee on Education. (1/31)
Kenneth Gibbons of Hyde Park - Member of the Vermont Educational and Health Buildings Finance Agency - By Sen. McCormack for the Committee on Finance. (2/2)
David R. Coates of Colchester - Member of the Municipal Bond Bank - By Sen. Condos for the Committee on Finance. (2/21)
Paul. Beaulieu of Manchester Center - Member of the Vermont Housing Finance Agency - By Sen. Maynard for the Committee on Finance. (2/21)
Robert D. Hofmann of Waterbury – Commissioner of the Department of Corrections – By Senator Scott for the Committee on Institutions. (2/23)
REPORTS ON FILE
Pursuant to the provisions of 2 V.S.A. §20(c), one (1) copy of the following reports is on file in the office of the Secretary of the Senate:
111. Implementation of Act 114 at the Vermont State Hospital Report. (Agency of Human Services, Dept. of Health, Division of Mental Health) (February 2007).
112. Weighting for Secondary and Elementary Students 2007 Report on Act 182, Section 20(a). (Department of Education, Finance Division) (February 2007).
113. CHANGE - The Implementation of Act 114 at the Vermont State Hospital Report. (Agency of Human Services, Department of Health, Division of Mental Health) (February 2007).
114. Aquatic Nuisance Sticker Program Legislative Report. (Agency of Natural Resources, Department of Environmental Conservation) (February 2007).
Friday, February 23, 2007 - 9:00 A.M. - 12:00 Noon - Room 10 - Re: Fiscal Year 2008 Appropriations Bill - House Committee on Appropriations.
Tuesday, February 27, 2007 - 6:30-9:30 P.M. - House Chamber - Re: H. 44 - An act relating to patient choice and control at end of life - House Committee on Human Services and other relevant committees.
The Vermont General Assembly
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