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Journal of the House

________________

WEDNESDAY, MARCH 21, 2007

At one o'clock in the afternoon minutes in the forenoon the Speaker called the House to order.

Devotional Exercises

Devotional exercises were conducted by Rep. Carolyn Partridge of Windham.

Message from the Senate No. 35

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

Madam Speaker:

I am directed to inform the House that the Senate has on its part passed Senate bill of the following title:

S. 51.  An act relating to prohibiting discrimination on the basis of gender identity.

In the passage of which the concurrence of the House is requested.

The Governor has informed the Senate that on the sixteenth day of March, 2007, he approved and signed a bill originating in the Senate of the following title:

S. 83.  An act relating to delinquent tax penalties.

House Bills Introduced

House bills of the following titles were severally introduced, read the first time and referred as follows:

H. 528

By Rep. Kitzmiller of Montpelier,

An act relating to approval of amendment to the charter of the city of Montpelier;

To the committee on Government Operations.

 

 

 H. 529

By Reps. Hudson of Lyndon, Lawrence of Lyndon and Peaslee of Guildhall,

An act relating to establishing the town line between Burke and Kirby;

To the committee on Government Operations.

 Senate Bill Referred

S. 51

Senate bill, entitled

An act relating to prohibiting discrimination on the basis of gender identity;

Was taken up, read the first time and referred to the committee on Judiciary.

Bill Referred to Committee on Appropriations

H. 523

House bill, entitled

An act relating to moving families out of poverty;

Appearing on the Calendar, carrying an appropriation, under rule 35a, was referred to the committee on Appropriations.

Bills Referred to Committee on Ways and Means

House bills of the following titles, appearing on the Calendar, affecting the revenue of the state, under the rule, were referred to the Committee on Ways and Means:

H. 524

House bill, entitled

An act relating to establishing a rebate for retail sales of biodiesel blends;

H. 526

House bill, entitled

An act relating to education quality and cost control.

House Resolution Placed on Calendar

H.R. 14

Reps. Krawczyk of Bennington, Morrissey of Bennington, Botzow of Pownal, Browning of Arlington, Corcoran of Bennington, Komline of Dorset, Livingston of Manchester, Miller of Shaftsbury and Mook of Bennington  offered a House resolution, entitled

House resolution requesting that Congress enact assured federal funding for veterans’ health care

Whereas, the U.S. Department of Veterans Affairs (VA) provides medical care for veterans, both men and women, who have risked their lives to protect the security of our nation, and

Whereas, Congress appropriates funding for VA health care each year as part of the discretionary federal budget, and

Whereas, each year’s federal budget for veterans’ health care has been very seriously underfunded, and

Whereas, this serious and now chronic shortfall affects the access to and the quality of medical care services that the VA provides for our veterans, and

Whereas, the priority of serving veterans must be absolute and irrevocable, and must serve as the foundation for the VA and of our nation’s public policy, now therefore be it

Resolved by the House of Representatives:

That this legislative body urgently requests that Congress enact assured funding for veterans’ health care, and be it further

Resolved:  That Governor Douglas also request that Congress enact assured funding for veterans’ health care, and be it further

Resolved:  That the clerk of the house be directed to send a copy of this resolution to the Governor, the President of the United States, the Vice President, Secretary of Veterans Affairs R. James Nicholson, Speaker of the House Nancy Pelosi, House Minority Leader John Boehner, Senate Majority Leader Harry Reid, Senate Minority Leader Trent Lott, the members of the Vermont Congressional Delegation, and Vermont veterans organizations.

Which was read and, in the Speaker’s discretion, placed on the Calendar for action tomorrow under Rule 52.

Action on Bill Postponed

H. 353

House bill, entitled

An act relating to employee free choice for bargaining representative;

Was taken up and pending the reading of the report of the committee on General, Housing and Military Affairs, on motion of Rep. Head of South Burlington, action on the bill was postponed until the next legislative day.

Bill Amended; Third Reading Not Ordered

H. 44

Rep. Frank of Underhill, for the committee on Human Services, to which had been referred House bill, entitled

An act relating to patient choice and control at end of life;

Reported in favor of its passage when amended by striking all after the enacting clause and inserting in lieu thereof the following:

Sec. 1.  FINDINGS

The general assembly finds:

(1)  The state of Oregon has been implementing its Death with Dignity Act since 1998.  According to the Eighth Annual Report on Oregon’s Death with Dignity Act, Oregon, in eight years, has seen a total of  390 terminal patients receive prescriptions to hasten death and, of those, 246 patients took the medication and died pursuant to the act.  Oregon’s annual report on the act shows that in 2005, 64 prescriptions were written, and 38 patients died after ingesting the medication.

(2)  Vermont has about one‑fifth the population of Oregon.  In the 2000 census, Oregon had a population of 3,421,399 and Vermont a population of 608,827.

(3)  In the past decade, Oregon has seen its hospice enrollment increase significantly.  In 1993, only 20 percent of dying patients were enrolled in hospice.  By 2005, enrollment increased to 54 percent.  In 2005, 92 percent of the patients who used medication under the Death with Dignity Act were in hospice care.

(4)  Oregon health care professionals report that ten terminal patients investigate their rights under the act for every patient who formally requests a prescription.

(5)  Despite continuing improvements in techniques for palliative care, most medical experts agree that not all pain can be relieved.  Some terminal diseases, such as bone cancer, inflict untreatable agony at the end of life.  Many cancer patients report that they would have greater comfort and courage in facing their future if they were assured they could use a Death with Dignity law if their suffering became unbearable.

Sec. 2.  18 V.S.A. chapter 113 is added to read:

CHAPTER 113.  RIGHTS OF QUALIFIED PATIENTS SUFFERING A TERMINAL CONDITION

§ 5280.  DEFINITIONS

For purposes of this chapter:

(1)  “Attending physician” means the physician who has primary responsibility for the care of the patient and who is willing to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.

(2)  “Capacity” shall have the same meaning as in subdivision 9701(4)(B) of this title.

(3)  “Consulting physician” means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient’s illness and who is willing to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.

(4)  “Counseling” means a consultation between a psychiatrist, psychologist, or clinical social worker licensed in Vermont and a patient for the purpose of confirming that the patient: 

(A)  has capacity; and

(B)  is not suffering from a mental disorder or disease that causes the patient to have impaired judgment.

(5)  “Health care provider” shall have the same meaning as in subdivision 9432(8) of this title.

(6)  “Informed decision” means a decision by a patient to request and obtain a prescription to hasten his or her death based on the patient’s understanding and appreciation of the relevant facts and was made after the patient was fully informed by the attending physician of all the following:

(A)  The patient’s medical diagnosis.

(B)  The patient’s prognosis.

(C)  The range of possible results, including potential risks associated with taking the medication to be prescribed.

(D)  The probable result of taking the medication to be prescribed.

(E)  All feasible end-of-life services, including comfort care, hospice care, and pain control.

(7)  “Patient” means a person who is 18 years of age or older, a resident of Vermont, and under the care of a physician.

(8)  “Physician” means a physician licensed pursuant to chapters 23 and 33 of Title 26.

(9)  “Qualified patient” means a patient with capacity who has satisfied the requirements of this chapter in order to obtain a prescription for medication to hasten his or her death.  No individual shall qualify under the provisions of this chapter solely because of age or disability.

(10)  “Terminal condition” means an incurable and irreversible disease which would, within reasonable medical judgment, result in death within six months.

§ 5281.  REQUESTS FOR MEDICATION

(a)  In order to qualify under this chapter:

(1)  A patient with capacity who has been determined by the attending physician and consulting physician to be suffering from a terminal condition and who has voluntarily expressed a wish to hasten the dying process may request medication to be self-administered for the purpose of hastening his or her death in accordance with this chapter.

(2)  A patient shall have made an oral request and a written request and shall have reaffirmed the oral request to his or her attending physician not less than 15 days after the initial oral request.  At the time the patient makes the second oral request, the attending physician shall offer the patient an opportunity to rescind the request.

(b)  Oral requests for medication under this chapter by the patient shall be made in the presence of the attending physician.

(c)  A written request for medication shall be signed and dated by the patient and witnessed by at least two individuals who, in the presence of the patient, attest that, to the best of their knowledge and belief, the patient has capacity, is acting voluntarily, and is not being coerced to sign the request.  Neither witness shall be any of the following persons:

(1)  The patient’s attending physician.

(2)  A relative of the patient by blood, marriage, civil union, or adoption.

(3)  A person who at the time the request is signed would be entitled to any portion of the estate of the patient under any will or by operation of law.

(4)  An owner, operator, or employee of a health care facility, nursing home, or residential care facility where the patient is receiving medical treatment or is a resident.

(d)  A person who knowingly fails to comply with the requirements in subsection (d) of this section is subject to prosecution under section 2004 of Title 13.

(e)  The written request shall be completed after the patient has been examined by a consulting physician as required by under section 5283 of this title.

§ 5282.  ATTENDING PHYSICIAN; DUTIES

The attending physician shall perform all the following:

(1)  Make the initial determination of whether a patient:

(A)  is suffering a terminal condition;

(B)  has capacity; and

(C)  has made a voluntary request for medication to hasten his or her death.

(2)  Request proof of Vermont residency, which may be shown by:

(A)  a Vermont driver’s license or photo identification card;

(B)  proof of Vermont voter’s registration;

(C)  evidence of property ownership or a lease of residential premises in Vermont; or

(D)  a Vermont personal income tax return for the most recent tax year.

(3)  Inform the patient in person and in writing of all the following:

(A)  The patient’s medical diagnosis.

(B)  The patient’s prognosis.

(C)  The range of possible results, including potential risks associated with taking the medication to be prescribed.

(D)  The probable result of taking the medication to be prescribed.

(E)  All feasible end-of-life services, including comfort care, hospice care, and pain control.

(4)  Refer the patient to a consulting physician for medical confirmation of the diagnosis, prognosis, and a determination that the patient has capacity and is acting voluntarily.

(5)  Refer the patient for counseling if appropriate under section 5284 of this chapter.

(6)  Recommend that the patient notify the next of kin or someone with whom the patient has a significant relationship.

(7)  Counsel the patient about the importance of having another individual present when the patient takes the medication pursuant to this chapter and the importance of not taking the medication in a public place.

(8)  Inform the patient that the patient has an opportunity to rescind the request at any time and in any manner, and offer the patient an opportunity to rescind at the end of the 15-day waiting period.

(9)  Verify, immediately prior to writing the prescription for medication under this chapter, that the patient is making an informed decision.

(10)  Fulfill the medical record documentation requirements of section 5289 of this title.

(11)  Ensure that all required steps are carried out in accordance with this chapter prior to writing a prescription for medication to hasten death.

(12)(A)  Dispense medication directly, including ancillary medication intended to facilitate the desired effect to minimize the patient’s discomfort, provided the attending physician is licensed to dispense medication in Vermont, has a current Drug Enforcement Administration certificate, and complies with any applicable administrative rules; or

(B)  With the patient’s written consent:

(i)  contact a pharmacist and inform the pharmacist of the prescription; and

(ii)  deliver the written prescription to the pharmacist, who will dispense the medication to the patient, the attending physician, or an expressly identified agent of the patient.

(13)  Notwithstanding any other provision of law, the attending physician may sign the patient’s death certificate.

§ 5283.  MEDICAL CONSULTATION REQUIRED

Before a patient is qualified in accordance with this chapter, a consulting physician shall physically examine the patient, review the patient’s relevant medical records, and confirm in writing the diagnosis of the attending physician that the patient is suffering from a terminal condition and verify that the patient has capacity, is acting voluntarily, and has made an informed decision.

§ 5284.  COUNSELING REFERRAL

If a patient is not receiving hospice services at the time the written request for medication is made under this chapter, he or she shall undergo counseling under this section.  If a patient is receiving hospice services at the time the written request for medication is made under this chapter and if, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a mental disorder or disease causing impaired judgment, either physician shall refer the patient for counseling.  No medication to end the patient’s life shall be prescribed until the person performing the counseling determines that the patient is not suffering from a mental disorder or disease that causes the patient to have impaired judgment.

§ 5285.  INFORMED DECISION

No person shall receive a prescription for medication to hasten his or her death unless the patient has made an informed decision.  Immediately prior to writing a prescription for medication in accordance with this chapter, the attending physician shall verify that the patient is making an informed decision.

§ 5286.  RECOMMENDED NOTIFICATION

The attending physician shall recommend that the patient notify the patient’s next of kin or someone with whom the patient has a significant relationship of the patient’s request for medication in accordance with this chapter.  A patient who declines or is unable to notify the next of kin shall not be refused medication in accordance with this chapter.

§ 5287.  RIGHT TO RESCIND

A patient may rescind the request at any time and in any manner regardless of the patient’s mental state.  No prescription for medication under this chapter may be written without the attending physician offering the patient an opportunity to rescind the request.

§ 5288.  WAITING PERIOD

The attending physician shall write a prescription no less than 48 hours after the last to occur of all of the following events:

(1)  the patient’s written request for medication to hasten his or her death;

(2)  the patient’s second oral request; and

(3)  the attending physician’s offering the patient an opportunity to rescind the request.

§ 5289.  MEDICAL RECORD DOCUMENTATION

The following shall be documented and filed in the patient’s medical record:

(1)  The date and wording of all oral requests of the patient for medication to hasten his or her death.

(2)  All written requests by a patient for medication to hasten his or her death.

(3)  The attending physician’s diagnosis, prognosis, and basis for the determination that the patient has capacity, is acting voluntarily, and has made an informed decision.

(4)  The consulting physician’s diagnosis, prognosis, and verification that the patient has capacity, is acting voluntarily, and has made an informed decision.

(5)  A report of the outcome and determinations made during any counseling which the patient may have received.

(6)  The date and wording of the attending physician’s offer to the patient to rescind the request for medication at the time of the patient’s second oral request.

(7)  A note by the attending physician indicating that all requirements under this chapter have been satisfied and all the steps that have been taken to carry out the request, including a notation of the medication prescribed.

§ 5290.  REPORTING REQUIREMENT

(a)  The department of health shall require that any physician who writes a prescription pursuant to this chapter file a report with the department covering all the prerequisites for writing a prescription under this chapter.  In addition, physicians shall report the number of written requests for medication that were received, regardless of whether or not a prescription was actually written in each instance.

(b)  The department of health shall annually review the medical records of qualified patients who have hastened their deaths in accordance with this chapter.

(c)  The department of health shall make rules to facilitate the collection of information regarding compliance with this chapter.  The information collected shall not be public record and shall not be made available for inspection by the public.

(d)  The department of health shall generate and make available to the public an annual statistical report of information collected under subsections (a) and (b) of this section.  The report shall include the number of instances in which medication was taken by a qualified patient to hasten death but failed to have the intended effect.

§ 5290a.  COLLECTION AND DISPOSAL OF UNUSED MEDICATIONS

The department of health shall develop a policy for ensuring that unused medications prescribed under this chapter are collected and disposed of appropriately.

§ 5291.  PROHIBITIONS; CONTRACT CONSTRUCTION

(a)  No provision in a contract, will, or other agreement, whether written or oral, shall be valid, to the extent the provision would affect whether a person may make or rescind a request for medication to hasten his or her death in accordance with this chapter.

(b)  The sale, procurement, or issue of any life, health, or accident insurance or annuity policy or the rate charged for any policy shall not be conditioned upon or affected by the making or rescinding of a request by a person for medication to hasten his or her death in accordance with this chapter or the act by a qualified patient to hasten his or her death pursuant to this chapter.  Neither shall a qualified patient’s act of ingesting medication to hasten his or her death have an effect on a life, health, or accident insurance or annuity policy.

§ 5292.  IMMUNITIES

(a)  No person shall be subject to civil or criminal liability or professional disciplinary action for participating in good faith compliance in accordance with this chapter.  This includes being present when a qualified patient takes the prescribed medication to hasten his or her death in accordance with this chapter.

(b)  No professional organization or association or health care provider may subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for participating or refusing to participate in good faith compliance with this chapter.

(c)  No request by a patient for or provision by an attending physician of medication in good faith compliance with the provisions of this chapter shall constitute neglect for any purpose of law.

(d)  No request by a patient for medication under this chapter shall provide the sole basis for the appointment of a guardian or conservator.

(e)  No health care provider shall be under any duty, whether by contract, by statute, or by any other legal requirement, to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.  If a health care provider is unable or unwilling to carry out a patient’s request in accordance with this chapter and the patient transfers his or her care to a new health care provider, the previous health care provider, upon request, shall transfer a copy of the patient’s relevant medical records to the new health care provider.  A decision by a health care provider not to participate in the provision of medication to a qualified patient shall not constitute the abandonment of the patient or unprofessional conduct under section 1354 of Title 26.

§ 5293.  HEALTH CARE FACILITY EXCEPTION

Notwithstanding any other provision of law, a health care facility may prohibit an attending physician from writing a prescription for medication under this chapter for a patient who is a resident in its facility and intends to use the medication on the facility’s premises, provided the facility has notified the attending physician in writing of its policy with regard to such prescriptions.  Notwithstanding subsection 5292(b) of this title, any health care provider who violates a prohibition established under this section may be subject to sanctions otherwise allowable under law or contract.

§ 5294.  LIABILITIES AND PENALTIES

(a)  Nothing in this chapter shall be construed to limit liability for civil damages resulting from negligent conduct or intentional misconduct by any person.

(b)  Nothing in this chapter or in section 2312 of Title 13 shall be construed to limit criminal prosecution under any other provision of law.

(c)  A health care provider is subject to review and disciplinary action by the appropriate licensing entity for failing to act in accordance with this chapter, provided such failure is not in good faith.

§ 5295.  FORM OF THE REQUEST

A request for medication as authorized by this chapter shall be substantially in the following form:

REQUEST FOR MEDICATION

TO HASTEN MY DEATH

I, ___________________ , am an adult of sound mind.

I am suffering from _______________, which my attending physician has determined is a terminal disease and which has been confirmed by a consulting physician.

I have been fully informed of my diagnosis, prognosis, the nature of medication to be prescribed and potential associated risks, the expected result, and the feasible end-of-life services, including comfort care, hospice care, and pain control.

I request that my attending physician prescribe medication that will hasten my death.

INITIAL ONE:

_____ I have informed my family or others with whom I have a significant relationship of my decision and taken their opinions into consideration.

_____ I have decided not to inform my family or others with whom I have a significant relationship of my decision.

_____ I have no family or others with whom I have a significant relationship to inform of my decision.

I understand that I have the right to change my mind at any time.

I understand the full import of this request, and I expect to die when I take the medication to be prescribed.  I further understand that although most deaths occur within three hours, my death may take longer, and my physician has counseled me about this possibility.

I make this request voluntarily and without reservation, and I accept full moral responsibility for my actions.

Signed: _________________________ Dated: ____________

DECLARATION OF WITNESSES

We declare that the person signing this request:

(a)  Is personally known to us or has provided proof of identity;

(b)  Signed this request in our presence;

(c)  Appears to be of sound mind and not under duress, fraud, or undue influence;

(d)  Is not a patient for whom either of us is the attending physician.

Witness 1/Date ______________________________________

Witness 2/Date ______________________________________

NOTE:  Neither witness may be a relative (by blood, marriage, civil union, or adoption) of the person signing this request, may be entitled to any portion of the person’s estate upon death, or may own, operate, or be employed at a health care facility where the person is a patient or resident.  A knowing false declaration by a witness may result in criminal penalties.

§ 5296.  STATUTORY CONSTRUCTION

Nothing in this chapter shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing, or active euthanasia.  Action taken in accordance with this chapter shall not be construed for any purpose to constitute suicide, assisted suicide, mercy killing, or homicide under the law.

Sec. 3.  13 V.S.A. § 2312 is added to read:

§ 2312.  Violation of PATIENT CHOICE AND CONTROL AT END OF

               LIFE ACT

(a)(1)  No person shall:

(A)  willfully alter or forge a patient’s request for medication under chapter 113 of Title 18, with the intent or effect of causing the patient’s death; or

(B)  conceal or destroy a rescission of a patient’s request for medication  under chapter 113 of Title 18, with the intent or effect of causing the patient’s death.

(2)  No person shall coerce or exert undue influence on a patient:

(A)  to request medication under chapter 113 of Title 18; or

(B)  to destroy a patient’s rescission of a request for medication under chapter 113 of Title 18.

(b)  A person who violates this section and thereby causes the death of the patient shall be guilty of first degree murder and subject to the penalties provided in subsection 2303(a) of this title.

Sec. 4.  13 V.S.A. § 2004 is added to read:

§ 2004.  FALSE WITNESSING

A person who knowingly violates the requirements of subsection 5281(d) of Title 18 shall be imprisoned for not more than 10 years or fined not more than $2,000.00, or both.

Rep. Marek of Newfane, for the committee on Judiciary, recommended the bill be amended by striking all after the enacting clause and inserting in lieu thereof the following:

Sec. 1.  FINDINGS

The general assembly finds:

(1)  The state of Oregon has been implementing its Death with Dignity Act since 1998.  According to the Eighth Annual Report on Oregon’s Death with Dignity Act, Oregon, in eight years, has seen a total of 390 terminal patients receive prescriptions to hasten death and, of those, 246 patients took the medication and died pursuant to the act.  Oregon’s annual report on the act shows that in 2005, 64 prescriptions were written, and 38 patients died after ingesting the medication.

(2)  Vermont has about one‑fifth the population of Oregon.  In the 2000 census, Oregon had a population of 3,421,399 and Vermont a population of 608,827.

(3)  In the past decade, Oregon has seen its hospice enrollment increase significantly.  In 1993, only 20 percent of dying patients were enrolled in hospice.  By 2005, enrollment increased to 54 percent.  In 2005, 92 percent of the patients who used medication under the Death with Dignity Act were in hospice care.

(4)  Oregon health care professionals report that ten terminal patients investigate their rights under the act for every patient who formally requests a prescription.

(5)  Despite continuing improvements in techniques for palliative care, most medical experts agree that not all pain can be relieved.  Some terminal diseases, such as bone cancer, inflict untreatable agony at the end of life.  Many cancer patients report that they would have greater comfort and courage in facing their future if they were assured they could use a Death with Dignity law if their suffering became unbearable.

Sec. 2.  18 V.S.A. chapter 113 is added to read:

CHAPTER 113.  RIGHTS OF QUALIFIED PATIENTS SUFFERING A TERMINAL CONDITION

§ 5280.  DEFINITIONS

For purposes of this chapter:

(1)  “Attending physician” means the physician who the patient has designated to have primary responsibility for the care of the patient and who is willing to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.

(2)  “Capacity” shall have the same meaning as in subdivision 9701(4)(B) of this title.

(3)  “Consulting physician” means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient’s illness and who is willing to participate in the provision of medication to a qualified patient to hasten his or her death in accordance with this chapter.

(4)  “Counseling” means a consultation between a psychiatrist, psychologist, or clinical social worker licensed in Vermont and a patient for the purpose of confirming that the patient: 

(A)  has capacity; and

(B)  is not suffering from impaired judgment.

(5)  “Good faith” shall mean objective good faith.

(6)  “Health care provider” shall have the same meaning as in subdivision 9432(8) of this title.

(7)  “Informed decision” means a decision by a patient to request and obtain a prescription to hasten his or her death based on the patient’s understanding and appreciation of the relevant facts and was made after the patient was fully informed by the attending physician of all the following:

(A)  The patient’s medical diagnosis.

(B)  The patient’s prognosis.

(C)  The range of possible results, including potential risks associated with taking the medication to be prescribed.

(D)  The probable result of taking the medication to be prescribed.

(E)  All feasible end-of-life services, including comfort care, hospice care, and pain control.

(8)  “Patient” means a person who is 18 years of age or older, a resident of Vermont, and under the care of a physician.

(9)  “Physician” means a physician licensed pursuant to chapters 23 and 33 of Title 26.

(10)  “Qualified patient” means a patient with capacity who has satisfied the requirements of this chapter in order to obtain a prescription for medication to hasten his or her death.  No individual shall qualify under the provisions of this chapter solely because of age or disability.

(11)  “Terminal condition” means an incurable and irreversible disease which would, within reasonable medical judgment, result in death within six months.

§ 5281.  REQUESTS FOR MEDICATION

(a)  In order to qualify under this chapter:

(1)  A patient with capacity who has been determined by the attending physician and consulting physician to be suffering from a terminal condition and who has voluntarily expressed a wish to hasten the dying process may request medication to be self-administered for the purpose of hastening his or her death in accordance with this chapter.

(2)  A patient shall have made an oral request and a written request and shall have reaffirmed the oral request to his or her attending physician not less than 15 days after the initial oral request.  At the time the patient makes the second oral request, the attending physician shall offer the patient an opportunity to rescind the request.

(b)  Oral requests for medication by the patient under this chapter shall be made in the presence of the attending physician.

(c)  A written request for medication shall be signed and dated by the patient and witnessed by at least two persons, at least 18 years of age, who, in the presence of the patient, sign and affirm that the principal appeared to understand the nature of the document and to be free from duress or undue influence at the time the request was signed.  Neither witness shall be any of the following persons:

(1)  The patient’s attending physician, consulting physician, or any person who has provided counseling for the patient pursuant to section 5284 of this title.

(2)  A person who knows that he or she is a relative of the patient by blood, marriage, civil union, or adoption.

(3)  A person who at the time the request is signed knows that he or she would be entitled upon the patient’s death to any portion of the estate or assets of the patient under any will, by operation of law, or by contract.

(4)  An owner, operator, or employee of a health care facility, nursing home, or residential care facility where the patient is receiving medical treatment or is a resident.

(d)  A person who knowingly fails to comply with the requirements in subsection (c) of this section is subject to prosecution under section 2004 of Title 13.

(e)  The written request shall be completed after the patient has been examined by a consulting physician as required under section 5283 of this title.

(f)  Under no circumstances shall a guardian or conservator be permitted to act on behalf of a ward for purposes of this chapter.

§ 5282.  ATTENDING PHYSICIAN; DUTIES

The attending physician shall perform all the following:

(1)  Make the initial determination of whether a patient:

(A)  is suffering a terminal condition;

(B)  has capacity; and

(C)  has made a voluntary request for medication to hasten his or her death.

(2)  Request proof of Vermont residency, which may be shown by:

(A)  a Vermont driver’s license or photo identification card;

(B)  proof of Vermont voter’s registration;

(C)  evidence of property ownership or a lease of residential premises in Vermont; or

(D)  a Vermont personal income tax return for the most recent tax year.

(3)  Inform the patient in person and in writing of all the following:

(A)  The patient’s medical diagnosis.

(B)  The patient’s prognosis.

(C)  The range of possible results, including potential risks associated with taking the medication to be prescribed.

(D)  The probable result of taking the medication to be prescribed.

(E)  All feasible end-of-life services, including comfort care, hospice care, and pain control.

(4)  Refer the patient to a consulting physician for medical confirmation of the diagnosis, prognosis, and a determination that the patient has capacity and is acting voluntarily.

(5)  Refer the patient for counseling under section 5284 of this chapter.

(6)  Recommend that the patient notify the next of kin or someone with whom the patient has a significant relationship.

(7)  Counsel the patient about the importance of having another individual present when the patient takes the medication pursuant to this chapter and the importance of not taking the medication in a public place.

(8)  Inform the patient that the patient has an opportunity to rescind the request at any time and in any manner, and offer the patient an opportunity to rescind at the end of the 15-day waiting period.

(9)  Verify, immediately prior to writing the prescription for medication under this chapter, that the patient is making an informed decision.

(10)  Fulfill the medical record documentation requirements of section 5289 of this title.

(11)  Ensure that all required steps are carried out in accordance with this chapter prior to writing a prescription for medication to hasten death.

(12)(A)  Dispense medication directly, including ancillary medication intended to facilitate the desired effect to minimize the patient’s discomfort, provided the attending physician is licensed to dispense medication in Vermont, has a current Drug Enforcement Administration certificate, and complies with any applicable administrative rules; or

(B)  With the patient’s written consent:

(i)  contact a pharmacist and inform the pharmacist of the prescription; and

(ii)  deliver the written prescription to the pharmacist, who will dispense the medication to the patient, the attending physician, or an expressly identified agent of the patient.

(13)  Notwithstanding any other provision of law, the attending physician may sign the patient’s death certificate.   

§ 5283.  MEDICAL CONSULTATION REQUIRED

Before a patient is qualified in accordance with this chapter, a consulting physician shall physically examine the patient, review the patient’s relevant medical records, and confirm in writing the diagnosis of the attending physician that the patient is suffering from a terminal condition and verify that the patient has capacity, is acting voluntarily, and has made an informed decision.

§ 5284.  COUNSELING REFERRAL

No medication to end the patient’s life shall be prescribed until:

(1)  the patient receives counseling as defined in subdivision 5280(4) of this title; and

(2)  the person performing the counseling determines that the patient has capacity and is not suffering from impaired judgment.

§ 5285.  INFORMED DECISION

No person shall receive a prescription for medication to hasten his or her death unless the patient has made an informed decision.  Immediately prior to writing a prescription for medication in accordance with this chapter, the attending physician shall verify that the patient is making an informed decision.

§ 5286.  RECOMMENDED NOTIFICATION

The attending physician shall recommend that the patient notify the patient’s next of kin or someone with whom the patient has a significant relationship of the patient’s request for medication in accordance with this chapter.  A patient who declines or is unable to notify the next of kin or the person with whom the patient has a significant relationship shall not be refused medication in accordance with this chapter.

§ 5287.  RIGHT TO RESCIND

A patient may rescind the request at any time and in any manner regardless of the patient’s mental state.  No prescription for medication under this chapter may be written without the attending physician offering the patient an opportunity to rescind the request.

§ 5288.  WAITING PERIOD

The attending physician shall write a prescription no sooner than 48 hours after all of the following events have occurred:

(1)  the patient’s written request for medication to hasten his or her death;

(2)  the patient’s second oral request; and

(3)  the attending physician’s offering the patient an opportunity to rescind the request.

§ 5289.  MEDICAL RECORD DOCUMENTATION

(a)  The following shall be documented and filed in the patient’s medical record:

(1)  The date and wording of all oral requests of the patient for medication to hasten his or her death.

(2)  All written requests by a patient for medication to hasten his or her death.

(3)  The attending physician’s diagnosis, prognosis, and basis for the determination that the patient has capacity, is acting voluntarily, and has made an informed decision.

(4)  The consulting physician’s diagnosis, prognosis, and verification that the patient has capacity, is acting voluntarily, and has made an informed decision.

(5)  A report of the outcome and determinations made during any counseling which the patient may have received.

(6)  The date and wording of the attending physician’s offer to the patient to rescind the request for medication at the time of the patient’s second oral request.

(7)  A note by the attending physician indicating that all requirements under this chapter have been satisfied and all the steps that have been taken to carry out the request, including a notation of the medication prescribed.

(b)  Medical records compiled pursuant to this chapter shall be subject to discovery only if the court finds that the records are necessary to resolve issues of compliance with or immunity under this chapter.

§ 5290.  REPORTING REQUIREMENT

(a)  The department of health shall require that any physician who writes a prescription pursuant to this chapter file a report with the department covering all the prerequisites for writing a prescription under this chapter.  In addition, physicians shall report the number of written requests for medication that were received, regardless of whether or not a prescription was actually written in each instance.

(b)  The department of health shall annually review the medical records of qualified patients who have hastened their deaths in accordance with this chapter.

(c)  The department of health shall make rules to facilitate the collection of information regarding compliance with this chapter.  Individual medical information collected and reports filed pursuant to subsection (a) of this section shall not be public record and shall not be made available for inspection by the public.

(d)  The department of health shall generate and make available to the public an annual statistical report of information collected under subsections (a) and (b) of this section.  The report shall include the number of instances in which medication was taken by a qualified patient to hasten death but failed to have the intended effect.

§ 5290a.  SAFE DISPOSAL OF UNUSED MEDICATIONS

(a) The department of health shall adopt rules providing for the safe disposal of unused medications prescribed under this chapter. 

(b)  Expedited rulemaking.  Notwithstanding the provisions of chapter 25 of Title 3, the department of health may adopt rules under this section pursuant to the following expedited rulemaking process:

(1)  Within 90 days after the date this act is passed, the department shall file proposed rules with the secretary of state and the legislative committee on administrative rules under 3 V.S.A. § 841 after publication in three daily newspapers with the highest average circulation in the state of a notice that lists the rules to be adopted pursuant to this process and a seven-day public comment period following publication.

(2)  The department shall file final proposed rules with the legislative committee on administrative rules 14 days after the public comment period.

(3)  The legislative committee on administrative rules shall review and may approve or object to the final proposed rules under 3 V.S.A. § 842, except that its action shall be completed no later than 14 days after the final proposed rules are filed with the committee.

(4)  The department may adopt a properly filed final proposed rule after the passage of 14 days from the date of filing final proposed rules with the legislative committee on administrative rules or after receiving notice of approval from the committee, provided the department:

(A)  has not received a notice of objection from the legislative committee on administrative rules; or

(B)  after having received a notice of objection from the committee, has responded pursuant to 3 V.S.A. § 842.

(5)  Rules adopted under this section shall be effective upon being filed with the secretary of state and shall have the full force and effect of rules adopted pursuant to chapter 25 of Title 3.  Rules filed with the secretary of state pursuant to this section shall be deemed to be in full compliance with

3 V.S.A. § 843 and shall be accepted by the secretary of state if filed with a certification by the secretary of human services that a rule is required to meet the purposes of this section.

§ 5291.  PROHIBITIONS; CONTRACT CONSTRUCTION

(a)  No provision in a contract, will, or other agreement, whether written or oral, shall be valid, to the extent the provision would affect whether a person may make or rescind a request for medication to hasten his or her death in accordance with this chapter.

(b)  The sale, procurement, or issue of any life, health, or accident insurance or annuity policy or the rate charged for any policy shall not be conditioned upon or affected by the making or rescinding of a request by a person for medication to hasten his or her death in accordance with this chapter or the act by a qualified patient to hasten his or her death pursuant to this chapter.  Neither shall a qualified patient’s act of ingesting medication to hasten his or her death have an effect on a life, health, or accident insurance or annuity policy.

§ 5292.  IMMUNITIES

(a)  No person shall be subject to civil or criminal liability or professional disciplinary action for actions taken in good faith reliance on the provisions of this chapter.  This includes being present when a qualified patient takes the prescribed medication to hasten his or her death in accordance with this chapter.

(b)  No professional organization or association or health care provider may subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for actions taken in good faith reliance on the provisions of this chapter or refusals to act under this chapter.

(c)  No provision by an attending physician of medication in good faith reliance on the provisions of this chapter shall constitute patient neglect for any purpose of law.

(d)  No request by a patient for medication under this chapter shall provide the sole basis for the appointment of a guardian or conservator.

(e)  No health care provider shall be under any duty, whether by contract, by statute, or by any other legal requirement, to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.  If a health care provider is unable or unwilling to carry out a patient’s request in accordance with this chapter and the patient transfers his or her care to a new health care provider, the previous health care provider, upon request, shall transfer a copy of the patient’s relevant medical records to the new health care provider.  A decision by a health care provider not to participate in the provision of medication to a qualified patient shall not constitute the abandonment of the patient or unprofessional conduct under section 1354 of Title 26.

§ 5293.  HEALTH CARE FACILITY EXCEPTION

Notwithstanding any other provision of law, a health care facility may prohibit an attending physician from writing a prescription for medication under this chapter for a patient who is a resident in its facility and intends to use the medication on the facility’s premises, provided the facility has notified the attending physician in writing of its policy with regard to such prescriptions.  Notwithstanding subsection 5292(b) of this title, any health care provider who violates a policy established by a health care facility under this section may be subject to sanctions otherwise allowable under law or contract.

§ 5294.  LIABILITIES AND PENALTIES

(a)  With the exception of the immunities established by section 5292 of this title and with the exception of the provisions of section 5296 of this title, nothing in this chapter shall be construed to limit liability for civil damages resulting from negligent conduct or intentional misconduct by any person.

(b)  With the exception of the immunities established by section 5292 of this title and with the exception of the provisions of section 5296 of this title, nothing in this chapter or in section 2312 of Title 13 shall be construed to limit criminal prosecution under any other provision of law.

(c)  A health care provider is subject to review and disciplinary action by the appropriate licensing entity for failing to act in accordance with this chapter, provided such failure is not in good faith.

§ 5295.  FORM OF THE WRITTEN REQUEST

A written request for medication as authorized by this chapter shall be substantially in the following form:

REQUEST FOR MEDICATION

TO HASTEN MY DEATH

I, ___________________ , am an adult of sound mind.

I am suffering from _______________, which my attending physician has determined is a terminal disease and which has been confirmed by a consulting physician.

I have been fully informed of my diagnosis, prognosis, the nature of medication to be prescribed and potential associated risks, the expected result, and the feasible end-of-life services, including comfort care, hospice care, and pain control.

I request that my attending physician prescribe medication that will hasten my death.

INITIAL ONE:

_____ I have informed my family or others with whom I have a significant relationship of my decision and taken their opinions into consideration.

_____ I have decided not to inform my family or others with whom I have a significant relationship of my decision.

_____ I have no family or others with whom I have a significant relationship to inform of my decision.

I understand that I have the right to change my mind at any time.

I understand the full import of this request, and I expect to die when I take the medication to be prescribed.  I further understand that although most deaths occur within three hours, my death may take longer, and my physician has counseled me about this possibility.

I make this request voluntarily and without reservation, and I accept full moral responsibility for my actions.

Signed: _________________________ Dated: ____________

AFFIRMATION OF WITNESSES

We affirm that, to the best of our knowledge and belief:

(a)  that the person signing this request:

(1)  is personally known to us or has provided proof of identity;

(2)  signed this request in our presence;

(3)  appears to understand the nature of the document and to be free from duress or undue influence at the time the request was signed; and

(b)  that neither of us:

(1)  is under 18 years of age;

(2)  is a relative (by blood, marriage, civil union, or adoption) of the person signing this request;

(3)  is the patient’s attending physician, consulting physician, or a person who has provided counseling for the patient pursuant to section 5284 of this title;

(4)  is entitled to any portion of the person’s assets or estate upon death; or

(5)  owns, operates, or is employed at a health care facility where the person is a patient or resident.

Witness 1/Date ______________________________________

Witness 2/Date ______________________________________

NOTE:  A knowingly false affirmation by a witness may result in criminal penalties.

§ 5296.  STATUTORY CONSTRUCTION

Nothing in this chapter shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing, or active euthanasia.  Action taken in accordance with this chapter shall not be considered tortious under law, and shall not be construed for any purpose to constitute suicide, assisted suicide, mercy killing, or homicide under the law. 

Sec. 3.  13 V.S.A. § 2312 is added to read:

§ 2312.  Violation of PATIENT CHOICE AND CONTROL AT END OF

               LIFE ACT

A person who violates chapter 113 of Title 18 with the intent to cause the death of a qualified patient as defined in subdivision 5280(9) of that title shall be prosecuted under chapter 53 of this title (homicide).

Sec. 4.  13 V.S.A. § 2004 is added to read:

§ 2004.  FALSE WITNESSING

A person who knowingly violates the requirements of subsection 5281(c) of Title 18 shall be imprisoned for not more than 10 years or fined not more than $2,000.00, or both.

Sec. 5.  EFFECTIVE DATE

This act shall take effect on September 1, 2007.

The bill, having appeared on the Calendar one day for notice, was taken up and read the second time.

Thereupon, Rep. Frank of Underhill asked and was granted leave of the House to withdraw the report of the committee on Human Services.

Pending the question, Shall the House amend the bill as recommended by the committee on Judiciary? Rep. Frank of Underhill moved to amend the report of the committee on Judiciary as follows:

First: in Sec. 1, by striking out subdivision (1) in its entirety and inserting in lieu thereof a new subdivision (1) to read as follows:

(1)  The state of Oregon has been implementing its Death with Dignity Act since 1998.  According to the Ninth Annual Report on Oregon’s Death with Dignity Act, Oregon, in nine years, has seen a total of 456 terminal patients receive prescriptions to hasten death and, of those, 292 patients took the medication and died pursuant to the act.  Oregon’s annual report on the act shows that in 2006, 65 prescriptions were written, and 46 patients died after ingesting the medication.

Second: in Sec. 1, by striking out subdivision (3) in its entirety and inserting in lieu thereof a new subdivision (3) to read as follows:

(3)  In the past decade, Oregon has seen its hospice enrollment increase significantly.  In 1993, only 20 percent of dying patients were enrolled in hospice.  By 2005, enrollment increased to 54 percent.  In 2005, 92 percent of the patients who used medication under the Death with Dignity Act were in hospice care.  In 2006, 76 percent of the patients who used medication under the Death with Dignity Act were in hospice care.

Third: in Sec. 2, 18  V.S.A. § 5281, by striking out subsection (f) in its entirety and inserting in lieu thereof a new subsection (f) to read as follows:

(f)(1)  Under no circumstances shall a guardian or conservator be permitted to act on behalf of a ward for purposes of this chapter.

(2)  Under no circumstances shall an agent under an advance directive be permitted to act on behalf of a principal for purposes of this chapter.

Fourth: by striking out Sec. 3 in its entirety and inserting in lieu thereof a new Sec. 3 to read as follows:

Sec. 3.  13 V.S.A. § 2312 is added to read:

§ 2312.  Violation of PATIENT CHOICE AND CONTROL AT END OF

               LIFE ACT

A person who violates chapter 113 of Title 18 with the intent to cause the death of a patient as defined in subdivision 5280(8) of that title shall be prosecuted under chapter 53 of this title (homicide).

Which was agreed to. 

Thereupon, the report of the committee on Judiciary, as amended, was agreed to.

Pending the question, Shall the bill be read a third time?  Rep. McAllister of Highgate demanded the Yeas and Nays, which demand was sustained by the Constitutional number.  The Clerk proceeded to call the roll and the question, Shall the bill be read a third time?  was decided in the negative.  Yeas, 63.  Nays, 82.

Those who voted in the affirmative are:


Aswad of Burlington

Barnard of Richmond

Chen of Mendon

Cheney of Norwich

Clarkson of Woodstock

Condon of Colchester

Copeland-Hanzas of Bradford

Davis of Washington

Deen of Westminster

Dostis of Waterbury

Emmons of Springfield

Fallar of Tinmouth

Fisher of Lincoln

Frank of Underhill

French of Randolph

Grad of Moretown

Haas of Rochester

Head of S. Burlington

Heath of Westford

Hosford of Waitsfield

Hube of Londonderry

Hunt of Essex

Hutchinson of Randolph

Jewett of Ripton

Johnson of South Hero

Kitzmiller of Montpelier

Klein of East Montpelier

Komline of Dorset

Larson of Burlington

Lenes of Shelburne

Lippert of Hinesburg

Lorber of Burlington

Maier of Middlebury

Manwaring of Wilmington

Marek of Newfane

Martin, C. of Springfield

Masland of Thetford

McCullough of Williston

Miller of Shaftsbury

Minter of Waterbury

Mitchell of Barnard

Mrowicki of Putney

Nease of Johnson

Nuovo of Middlebury

Ojibway of Hartford

Orr of Charlotte

Partridge of Windham

Pearson of Burlington

Pellett of Chester

Peltz of Woodbury

Pillsbury of Brattleboro

Pugh of S. Burlington

Rodgers of Glover

Shand of Weathersfield

Sharpe of Bristol

Smith of Morristown

Spengler of Colchester

Stevens of Shoreham

Sweaney of Windsor

Trombley of Grand Isle

Weston of Burlington

Zenie of Colchester

Zuckerman of Burlington


Those who voted in the negative are:


Acinapura of Brandon

Adams of Hartland

Ainsworth of Royalton

Allard of St. Albans Town

Ancel of Calais

Andrews of Rutland City

Atkins of Winooski

Audette of S. Burlington

Baker of West Rutland

Bissonnette of Winooski

Bostic of St. Johnsbury

Botzow of Pownal

Branagan of Georgia

Bray of New Haven

Brennan of Colchester

Browning of Arlington

Canfield of Fair Haven

Clark of St. Johnsbury

Clark of Vergennes

Clerkin of Hartford

Consejo of Sheldon

Corcoran of Bennington

Courcelle of Rutland City

Devereux of Mount Holly

Donaghy of Poultney

Donahue of Northfield

Donovan of Burlington

Errecart of Shelburne

Evans of Essex

Fitzgerald of St. Albans City

Flory of Pittsford

Gervais of Enosburg

Gilbert of Fairfax

Godin of Milton

Howard of Rutland City

Howrigan of Fairfield

Hudson of Lyndon

Jerman of Essex

Johnson of Canaan

Keenan of St. Albans City

Keogh of Burlington

Kilmartin of Newport City

Koch of Barre Town

Krawczyk of Bennington

Kupersmith of S. Burlington

Larocque of Barnet

LaVoie of Swanton

Lawrence of Lyndon

Leriche of Hardwick

Livingston of Manchester

Malcolm of Pawlet

Marcotte of Coventry

Martin of Wolcott

McAllister of Highgate

McCormack of Rutland City

McDonald of Berlin

McFaun of Barre Town

Milkey of Brattleboro

Monti of Barre City

Mook of Bennington

Moran of Wardsboro

Morley of Barton

Morrissey of Bennington

Myers of Essex

Obuchowski of Rockingham

O'Donnell of Vernon

Otterman of Topsham

Oxholm of Vergennes

Peaslee of Guildhall

Perry of Richford

Peterson of Williston

Potter of Clarendon

Randall of Troy

Scheuermann of Stowe

Shaw of Derby

Sunderland of Rutland Town

Turner of Milton

Valliere of Barre City

Westman of Cambridge

Wheeler of Derby

Winters of Williamstown

Wright of Burlington


Those members absent with leave of the House and not voting are:


Edwards of Brattleboro

Helm of Castleton

Larrabee of Danville


 

Rep. Zuckerman of Burlington explained his vote as follows:

“Madam Speaker:

     I fully respect folks who have come to their peace with this vote based on moral, religious or personal beliefs.  I am concerned, however, when people base their votes on constituent calls that were, in part, derived through misinformation.

     I have heard of numerous instances and read petitions that vastly misled the public with respect to the ramifications of this bill.  When parishioners are told that seniors going to their doctor for a hip replacement will be met by a doctor who will instead kill them, I understand when the calls are so overwhelmingly opposed.  In my own district the calls were a ratio of 4 to 1 against.  Yet, as a lead sponsor of the bill for the last six years, I was not removed from office.

     I do not believe the calls were indicative of the feelings of the silent majority.

     Instilling fear through misinformation is a powerful tool.  I am sorry that that those in positions of trust have chosen to use that tool.”

Message from the Senate No. 36

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

Madam Speaker:

I am directed to inform the House that the Senate has on its part passed Senate bill of the following title:

S. 34.  An act relating to humane treatment of animals in schools and the right to an instructional alternative to dissection.

In the passage of which the concurrence of the House is requested.

Bill Amended; Third Reading Ordered

H. 73

Rep. Deen of Westminster, for the committee on Fish, Wildlife and Water Resources, to which had been referred House bill, entitled

An act relating to water management types for state waters;

Reported in favor of its passage when amended by striking all after the enacting clause and inserting in lieu thereof the following:

Sec. 1.  FINDINGS

The general assembly finds and declares that:

(1)  It is the settled policy of the state as set forth in section 1250 of this title to protect and enhance the existing quality, character, and usefulness of surface water and to seek over the long term to upgrade the quality of the surface waters of the state.

(2)  The adoption of any water management types within the classifications of state surface waters shall conform to the state water policy.

(3)  During the process preceding adoption of revised basin plans for the state, the secretary of natural resources shall maximize public participation and public input in a manner consistent with the department of conservation’s 2004 Vermont watershed initiative guidelines for watershed planning.

(4)  Basin plans or water management type designations and redesignations proposed by the agency of natural resources shall include sufficient information and documentation to ensure transparency regarding agency decision-making.

(5)  The agency of natural resources is expected to and should strive to update all 17 basin plans for the state by the 2010 deadline authorized by this act.

Sec. 2.  10 V.S.A. § 1251a(c) is added to read:

(c)  The secretary of natural resources shall propose for point source discharges to state waters an implementation process for the antidegradation policy of the water quality standards of the state and shall seek the concurrence of the water resources panel of the board prior to initiating rulemaking for adoption of an implementation process.

Sec. 3.  10 V.S.A. § 1253(d) is amended to read:

(d)  The board shall determine what degree of water quality and classification should be obtained and maintained for those waters not classified by it before 1981 following the procedures in sections 1254 and 1258 of this title.  Those waters shall be classified in the public interest.  The secretary shall revise all 17 basin plans by January 1, 2006 December 31, 2010, and update them every five years thereafter.  Prior to July 1, 2008, the secretary may adopt revised basin plans without including proposals for water management types in Class B waters to ensure that the strategies to improve and restore waters contained in the basin plans are available to the people of the state.  On or before January 1 15 of each year, the secretary shall report to the house committees on agriculture and natural resources and energy on fish, wildlife and water resources and to the senate committees on agriculture and on natural resources and energy regarding the progress made and difficulties encountered in revising basin plans.  By January 1, 1993, the secretary shall prepare an overall management plan to ensure that the water quality standards are met in all state waters.

Sec. 4.  EFFECTIVE DATE

This act shall take effect upon passage.

The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on Fish, Wildlife and Water Resources agreed to and third reading ordered.

Bill Amended; Third Reading Ordered

H. 154

Rep. Shaw of Derby, for the committee on Fish, Wildlife and Water Resources, to which had been referred House bill, entitled

An act relating to stormwater management;

Reported in favor of its passage when amended by striking all after the enacting clause and inserting in lieu thereof the following:

Sec. 1.  10 V.S.A. § 1264(f) is amended to read:

(f)(1)  In a stormwater-impaired water, the secretary may issue:

(A)  An individual permit in a stormwater-impaired water for which no TMDL, water quality remediation plan, or watershed improvement permit has been established or issued, provided that the permitted discharge meets the discharge standard set by rule;

(B)  A watershed improvement permit, provided that the watershed improvement permit provides reasonable assurance of compliance with the Vermont water quality standards in five years;

(C)  A general or individual permit that is implementing a TMDL or water quality remediation plan; or

(D)  A statewide general permit for new discharges that the secretary deems necessary to assure attainment of the Vermont water quality standards.

(2)  An authorization to discharge regulated stormwater runoff pursuant to a permit issued under this subsection shall be valid for a time period not to exceed five years.  A person seeking to discharge regulated stormwater runoff after the expiration of that period shall obtain an individual permit or coverage under a general permit, whichever is applicable, in accordance with subsection 1263(e) of this title.

(3)  By September 30, 2007 January 15, 2010, the secretary shall issue a watershed improvement permit, submit a TMDL to the EPA for approval issue a general or individual permit implementing a TMDL approved by the EPA, or establish issue a general or individual permit implementing a water quality remediation plan for each of the stormwater-impaired waters on the Vermont Year 2004 Section 303(d) List of Waters required by 33 U.S.C.

§ 1313(d).  In developing a TMDL or a water quality remediation plan for a stormwater-impaired water, the secretary shall consult “A Scientifically Based Assessment and Adaptive Management Approach to Stormwater Management” and “Areas of Agreement about the Scientific Underpinnings of the Water Resources Board’s Original Seven Questions” set out in appendices A and B, respectively, of the final report of the water resources board’s “Investigation Into Developing Cleanup Plans For Stormwater Impaired Waters, Docket No. Inv-03-01,” issued March 9, 2004.  Beginning January 30, 2005 and until a watershed improvement permit, a general or individual permit implementing a TMDL, or a general or individual permit implementing a water quality remediation plan is set for each of the stormwater-impaired waters on the Vermont Year 2004 Section 303(d) List of Waters required by 33 U.S.C. § 1313(d), the secretary shall report annually to the general assembly on agency progress in establishing the watershed improvement permits, TMDLs, and water quality remediation plans for the stormwater-impaired waters of the state; on the accuracy of assessment and environmental efficacy of any stormwater impact fee paid to the state stormwater-impaired waters restoration fund; and on the efforts by the secretary to educate and inform owners of real estate in watersheds of stormwater-impaired waters regarding the requirements of the state stormwater law.

Sec. 2.  27 V.S.A. § 613(e) is amended to read:

(e)  This section shall not apply to any impaired watershed for which the secretary of natural resources has issued a watershed improvement permit, submitted issued an individual permit under a total maximum daily load approved by the U.S. Environmental Protection Agency, issued a general permit implementing a total maximum daily load to approved by the U.S. Environmental Protection Agency, or established issued a general or individual permit implementing a water quality remediation plan.

Sec. 3.  EXTENSION OF SUNSET OF INTERIM STORMWATER
 PERMITTING PROGRAM AND CONVEYANCE OF REAL
 ESTATE WITH STORMWATER PERMITS

Sec. 10 of No. 140 of the Acts of the 2003 Adj. Sess. (2004), as amended by Sec. 8 of No. 154 of the Acts of the 2005 Adj. Sess. (2006), is further amended to read:

Sec. 10.  SUNSET

(a)  Sec. 2 of this act (interim permitting authority for regulated stormwater runoff), except for subsection 1264a(e) of Title 10, shall be repealed on September 30, 2007 January 15, 2010.

(b)  Sec. 4 of this act (local communities implementation fund) shall be repealed on September 30, 2012.

(c)  Sec. 6 of this act (stormwater discharge permits during transition period) shall be repealed on September 30, 2007 January 15, 2010.

Sec. 4.  AGENCY OF NATURAL RESOURCES REPORT ON IMPLEMENTATION OF STORMWATER TMDLS

Beginning January 15, 2009, and every two years thereafter, the agency of natural resources’ report required under 10 V.S.A. § 1264(f)(3) regarding agency progress in establishing watershed improvement permits, TMDLs, or water quality remediation plans for the stormwater‑impaired waters of the state shall include a review and analysis of the effectiveness of any TMDL implemented by the agency of natural resources for a stormwater impaired water of the state.  Prior to issuing the report required under this section, the agency of natural resources shall hold a public hearing in each watershed of a stormwater impaired water for which a permit has been issued implementing a total maximum daily load.  The review and analysis required by this section shall include:

(1)  An assessment of the implementation plan for the TMDL based on available data, including an evaluation of the efficacy of the implementation plan;

(2)  An assessment of the hydrologic targets of the TMDL based on available data, including an evaluation of the adequacy of the hydrologic targets of the TMDL;

(3)  Recommendations, if any, for amending an implementation plan or reopening a TMDL.

The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on Fish, Wildlife and Water Resources agreed to and third reading ordered.

Bill Amended; Third Reading Ordered

H. 175

Rep. Baker of West Rutland, for the committee on General, Housing and Military Affairs, to which had been referred House bill, entitled

An act relating to increasing funeral benefits under workers’ compensation;

Reported in favor of its passage when amended by striking all after the enacting clause and inserting in lieu thereof the following:

Sec. 1.  21 V.S.A. § 639 is amended to read:

§ 639.  -DEATH,; PAYMENT TO DEPENDENTS

In cases of the death of a person from any cause other than the accident during the period of payments for disability or for the permanent injury, the remaining payments for disability then due or for the permanent injury shall be made to the person's dependents according to the provisions of sections 635 and 636 of this title, or if there are none, the remaining amount due, but not exceeding $5,500.00 $10,000.00 for burial and funeral expenses and expenses for out-of-state transportation of the decedent to the place of burial not to exceed $1,000.00, shall be paid in a lump sum to the proper person.

The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on General, Housing and Military Affairs agreed to and third reading ordered.

Third Reading; Bills Passed

House bills of the following titles were severally taken up, read the third time and passed:

 

H. 403

House bill, entitled

An act relating to postretirement cost of living adjustments for state employees;

H. 518

House bill, entitled

An act relating to technical tax amendments.

Bill Amended; Third Reading Ordered

H. 332

Rep. Trombley of Grand Isle, for the committee on General, Housing and Military Affairs, to which had been referred House bill, entitled

An act relating to sale and closure of mobile home parks;

Reported in favor of its passage when amended as follows:

By adding Secs. 1a and 3a to read as follows:

Sec. 1a.  10 V.S.A. § 6236(c), (d), and (e) are amended to read:

(c)  A prospective resident shall be furnished with a copy of the proposed lease prior to any agreement to lease or occupy a mobile home lot, and upon acceptance of the lease terms the lease shall be signed by the lessor and lessee. Any provision in a lease governing rental and utility charges shall be effective for a minimum of one year, except in the case of a new tenant in a mobile home park in which there is a uniform rent schedule which affects all lots in that park simultaneously.  The initial lease for a new tenant may include the anticipated increase in the rent and utility charge at the time it occurs for the other lots.  A mobile home park owner shall provide residents with a minimum of 60 days notice prior to any rent increase.  Rent increase notices shall not be given within six months prior to the issuance of a closure notice or any time during which the closure notice is in effect.  All increases in rent received by the mobile home park owner during the six months prior to the issuance of a closure notice shall be returned to the affected residents within seven days of issuance of the closure notice.  This subsection shall not apply to proprietary leases in mobile home parks owned by limited equity housing cooperatives established under chapter 14 of Title 11.  The rental and utility charge may be increased during a year if the operating expenses of the park increase 20 percent or more during that year as the result of legislative action taken during that year and the increase could not have been anticipated.  The rental and utility charge may be increased during a year only to the extent necessary to cover the increase in operating expenses of the park.

(d)  No person shall sublease a mobile home resident may sublet the resident's mobile home without the express permission or a lot in a mobile home park without first obtaining the approval of the park owner, which shall not be unreasonably withheld.  A violation of this subsection shall be grounds for eviction.

(e)  All mobile home leases shall contain the following:

* * *

(5)  The requirement of to obtain permission, if any, from the park owner for subletting a mobile home or a lot to another person.

* * *

Sec. 3a.  10 V.S.A. § 6240 is amended to read:

§ 6240.  SALE OF HOMES LOCATED IN PARKS

(a)  No person shall purchase a mobile home in a mobile home park without first obtaining approval from the park owner which shall not be unreasonably withheld.  A violation of this section shall be grounds for eviction.

(b)  Prior to selling a mobile home located in a mobile home park, the mobile home owner shall notify the park owner by certified or registered mail of the name of the prospective purchaser.  The seller may be held liable by the purchaser or prospective purchaser for failure to comply with this section.

(b)(c)  A purchaser or prospective purchaser of a mobile home located in a park shall not be refused entrance if the purchaser and his the purchaser’s household qualify under the lease terms admission policy of the park.  Upon approval for entrance into the mobile home park, the purchaser or prospective purchaser shall be offered a written lease pursuant to section 6236 of this title.

(c)(d)  A park owner shall not charge or collect any commission on the sale of a mobile home located in a park unless he the park owner contracts to sell the home.

The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on General, Housing and Military Affairs agreed to and third reading ordered.

Bill Amended; Third Reading Ordered

H. 372

Rep. Jerman of Essex, for the committee on Government Operations, to which had been referred House bill, entitled

An act relating to the rendering of nursing and medical services by professional corporations;

Reported in favor of its passage when amended as follows:

In Sec. 2, 26 V.S.A. § 1585, by striking “as an advanced practice registered nurse” and inserting in lieu thereof to practice registered or licensed practical nursing.

The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on Government Operations agreed to and third reading ordered.

Adjournment

At five o’clock and fifty-five minutes in the evening, on motion of Rep. Adams of Hartland, the House adjourned until tomorrow at one o’clock in the afternoon.

 

 

 



Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont


www.leg.state.vt.us