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Journal of the Senate

________________

Thursday, April 24, 2008

The Senate was called to order by the President.

Devotional Exercises

Devotional exercises were conducted by the Reverend Ethan Kallberg of Morrisville.

Message from the House No. 58

     A message was received from the House of Representatives by Ms. Wrask, its Second Assistant Clerk, as follows:

Mr. President:

     I am directed to inform the Senate the House has passed bills of the following titles:

     H. 659.  An act relating to approval of the adoption of the charter of the town of Enosburg.

     H. 892.  An act relating to approval of amendments to the charter of the village of Enosburg Falls.

     H. 893.  An act relating to approval of amendments to the charter of the city of Rutland.

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

The House has considered Senate bills of the following titles:

S. 89.  An act relating to permitting payment of rent into court pursuant to a commercial lease.

S. 368.  An act relating to the addition of new types of disinfectants to public water systems.

And has passed the same in concurrence.

The House has considered Senate bills of the following titles:

S. 107.  An act relating to mapping class four town highways and trails and mass discontinuances of unmapped town highways.

S. 171.  An act relating to discharge of a mortgage by an attorney.

S. 201.  An act relating to state employee whistleblower protection.

S. 283.  An act relating to managed care organizations and the blueprint for health.

S. 313.  An act relating to a license to store and ship wine.

S. 322.  An act relating to the Vermont Dairy Promotion Council.

S. 372.  An act relating to evictions, unpaid rent, and abandoned property in rental property.

And has passed the same in concurrence with proposals of amendment in the adoption of which the concurrence of the Senate is requested.

The House has considered Senate proposals of amendment to House bills of the following titles:

     H. 149.  An act relating to liquor identification and tobacco licenses.

     H. 257.  An act relating to the codification of existing community justice centers.

And has severally concurred therein.

The House has considered Senate proposal of amendment to House bill of the following title:

H. 748.  An act relating to permitting students to possess and self-administer emergency medication.

And has concurred therein with proposals of amendment in the adoption of which the concurrence of the Senate is requested.

The House has considered Senate proposals of amendment to House bills of the following titles and has refused to concur therein and asks for Committees of Conference upon the disagreeing votes of the two Houses to which the Speaker has appointed as members of such Committees on the part of the House:

H. 615.  An act relating to juvenile judicial proceedings.

                                         Rep. Lippert of Hinesburg

                                         Rep. Flory of Pittsford

                                         Rep. Haas of Rochester

H. 709.  An act relating to campgrounds.

                                         Rep. Wright of Burlington

                                         Rep. Trombley of Grand Isle

                                         Rep. Botzow of Pownal


H. 889.  An act relating to the State’s transportation program.

                                         Rep. Westman of Cambridge

                                         Rep. Corcoran of Bennington

                                         Rep. Minter of Waterbury

H. 891.  An act relating to making appropriation for the support of government.

                                         Rep. Heath of Westford

                                         Rep. Hunt of Essex

                                         Rep. Helm of Castleton

The Speaker has changed an appointment to the Committee of Conference of House bill of the following title:

H. 635.  An act relating to reports of child abuse or neglect.

And has replaced Rep. Clarkson of Woodstock with Rep. Fisher of Lincoln.

The House has adopted a joint resolution of the following title:

J.R.H.  59.  Joint resolution urging secondary school and postsecondary educators and administrators to collaborate on accelerated learning opportunities for Vermont high school students.

In the adoption of which the concurrence of the Senate is requested.

The House has considered a joint resolution originating in the Senate of the following title:

J.R.S. 64.  Joint resolution in observance of the 2008 National Crime Victims’ Rights Week.

And has adopted the same in concurrence.

Bills Referred

House bills of the following titles were severally read the first time and referred:

H. 659.

An act relating to approval of the adoption of the charter of the town of Enosburg.

To the Committee on Government Operations.

H. 892.

An act relating to approval of amendments to the charter of the village of Enosburg Falls.

To the Committee on Government Operations.

H. 893.

An act relating to approval of amendments to the charter of the city of Rutland.

To the Committee on Government Operations.

Bill Referred to Committee on Finance

H. 863.

House bill of the following title, appearing on the Calendar for notice, and affecting the revenue of the state, under the rule was referred to the Committee on Finance:

An act relating to creation and preservation of affordable housing and smart growth development.

Joint Resolution Adopted on the Part of the Senate

Joint Senate resolution of the following title was offered, read and adopted on the part of the Senate, and is as follows:

   By Senator Shumlin,

     J.R.S. 66.  Joint resolution relating to weekend adjournment.

Resolved by the Senate and House of Representatives:

That when the two Houses adjourn on Friday, April 25, 2008, it be to meet again no later than Tuesday, April 29, 2008.

Joint Resolution Placed on Calendar

J.R.H. 59.

Joint resolution originating in the House of the following title was read the first time and is as follows:

Joint resolution urging secondary school and postsecondary educators and administrators to collaborate on accelerated learning opportunities for Vermont high school students.

Whereas, in today’s global economy, knowledge is power, and the U.S. Bureau of Labor Statistics has estimated that the majority of the fastest‑growing and highest‑paying occupations between now and 2014 will require postsecondary educational preparation, and

Whereas, research has shown that postsecondary success is predicated on rigorous academic preparation in high school and on students’ clear understanding of colleges’ and universities’ expectations of them once enrolled, and

Whereas, although more students enter college today than in 1988, the proportion of students graduating has declined, and the overall academic attrition results in fewer than 20 percent of 9th graders graduating with a college degree by the age of 24, and

Whereas, the United States cannot afford the loss of human capital on this scale and remain globally competitive, and

Whereas, programs providing for students to be enrolled simultaneously in high school and college courses enable students to experience the rigors of college studies while earning both high school and college credits, and

Whereas, according to the U.S. Department of Education, students participating in dual enrollment programs complete their college degrees more quickly and have higher graduation rates, and

Whereas, as of January 2006, over 40 states had policies related to dual enrollment, and in Vermont, there are currently agreements related to postsecondary technical education, and

Whereas, dual enrollment policies led to a nearly 1,000 percent increase in Minnesota high school students taking advanced placement tests, and a coordinated k-college education initiative in Georgia raised the percentage of high school students studying a rigorous core curriculum, and postremediation levels fell precipitously, and

Whereas, Vermont has recognized the value of accelerated learning, and the state’s high schools have experienced the highest percentage increase in the nation of advanced placement tests taken, the number of students taking the exams, and the number of students earning a score of at least 3 on a grading scale in which the highest grade is 5, and

Whereas, the Vermont State Colleges have multiple dual enrollment programs, and the UVM administration is publicly committed to the university’s participation in a council of both pre-k-12 and postsecondary educators to inform and move forward pre-K-12 and postsecondary education as a continuum, now therefore be it

Resolved by the Senate and House of Representatives:

That the General Assembly applauds the existing dual enrollment programs in Vermont and encourages future efforts to expand the availability of postsecondary educational offerings for high school students, and be it further

Resolved:  That the secretary of state be directed to send a copy of this resolution to the commissioner of education, to the president of each public and private institution of higher education in Vermont, and to the chancellor of the Vermont State Colleges.

Thereupon, in the discretion of the President, under Rule 51, the joint resolution was placed on the Calendar for action tomorrow.

Rules Suspended; House Proposal of Amendment Not Concurred In

S. 372.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate bill entitled:

An act relating to evictions, unpaid rent, and abandoned property in rental property.

Was taken up for immediate consideration.

The House proposes to the Senate to amend the bill as follows:

     First:  By striking out Sec. 1 and inserting in lieu thereof the following:

Sec. 1.  9 V.S.A. § 4451(1) is amended to read:

(1)  “Actual notice” means receipt of written notice hand-delivered or mailed to the last known address.  A rebuttable presumption that the notice was received three days after mailing is created if the sending party proves that the notice was sent by first class or certified United States mail.   

     Second:  In Sec. 2 9 V.S.A. § 4461 in subsection (c) by striking out the first two sentences and inserting in lieu thereof the following:

A landlord shall return the security deposit along with a written statement itemizing any deductions to a tenant within 14 days from the date on which the landlord discovers that the tenant vacated or abandoned the dwelling unit, with a written statement itemizing any deductions or the date the tenant vacated the dwelling unit, provided the landlord received notice from the tenant of that date.

     Third:  In Sec. 4, 9 V.S.A. §4465(c) by striking out the words “it may be presumed” and inserting in lieu thereof the words there is a rebuttable presumption

     Fourth:  In Sec. 5. 9 V.S.A. § 4467 by striking out subsection (a) and inserting in lieu thereof a new subsection (a) to read as follows:

(a) Termination for nonpayment of rent. Termination for nonpayment of rent. The landlord may terminate a tenancy for nonpayment of rent by providing actual notice to the tenant of the date on which the tenancy will terminate which shall be at least 14 days after the date of the actual notice. The rental agreement shall not terminate if the tenant pays or tenders all arrearages prior to the termination date. A tenant may not defeat a notice to terminate by payment of arrearages more than three times in 12 months rent due through the end of the rental period in which payment is made or tendered. Acceptance of partial payment of rent shall not constitute a waiver of the landlord's remedies for nonpayment of rent.

     Fifth:  In Sec. 5, 9 V.S.A. §4467(b), by striking out subdivision (2) and inserting in lieu thereof a new subdivision (2) to read as follows:

(2)  When termination is based on criminal activity, illegal drug activity, or acts of violence any of which threaten the health or safety of other residents, the landlord may terminate the tenancy by providing actual notice to the tenant of the date on which the tenancy will terminate which shall be at least 15 days from the date of the actual notice.

     Sixth:  In Sec. 5.  9 V.S.A. § 4467 by striking out subsection (e) and inserting in lieu thereof a new subsection (e) to read as follows:

(e)  Termination by landlord for no cause under terms of written rental agreement.  If the landlord terminates a tenancy in accordance with the terms of there is a written rental agreement, the notice to terminate for no cause shall be at least 30 days before the end or expiration of the stated term of the rental agreement, if rent is payable on a monthly basis and the tenancy has continued for two years or less. The notice to terminate for no cause shall be at least 60 days the rent is paid on a monthly basis and before the end or expiration of the term of the rental agreement if the tenancy has continued for more than two years.  The If there is a written week-to-week rental agreement, the notice to terminate for no cause shall be at least seven days, if rent is payable on a weekly basis; however, a notice to terminate for nonpayment of rent shall be as provided in subsection (a) of this section.

     Seventh:  In Sec. 5, 9 V.S.A. §4467, in subsection (i) by striking out the first complete sentence and inserting in lieu thereof the following;

All actual notices that are in compliance with this section shall not invalidate any other actual notice and shall be a valid basis for commencing and maintaining an action for possession pursuant to this chapter, chapter 153 of Title 10, chapter 14 of Title 11, or chapter 169 of Title 12, notwithstanding that the notices may be based on different or unrelated grounds, dates of termination, or that the notices are sent at different times prior to or during an ejectment action. 

     Eighth:  In Sec. 5, by adding a new subsection (k) to read as follows:

(k)  A notice to terminate a tenancy shall be insufficient to support a judgment of eviction unless the proceeding is commenced no later than 60 days from the termination date set forth in the notice.

     Ninth:  In Sec.7, 12 V.S.A. §4773 by striking out the final sentence and inserting in lieu thereof the following: A defendant may not defeat an ejectment action by payment of all rent in arrears, interest, and court costs more than one time in 12 months.  The 12-month period shall begin on the day the payment is made.

     Tenth:  In Sec. 8, 12 V.S.A. § 4853a(b), before the final period by adding the words but shall cease upon execution of a writ of possession

     Eleventh: By adding two new sections to be numbered Secs. 10 and 11, to read as follows:

Sec. 10.  20 V.S.A. Part 7A, chapter 181 is added to read:

Chapter 181.  RENtal Housing Safety and Habitability

§ 3201.  LEGISLATIVE PURPOSE AND INTENT

It is the intent of the general assembly to provide for rental housing safety and habitability and to establish a statewide rental housing inspection program and registry to achieve all the following goals:

(1)  Promote the health and safety of the citizens of Vermont.

(2)  Facilitate compliance with existing health and safety standards.

(3)  Provide support to municipal health officers.

(4)  Create a resource for tenants and landlords.

(5)  Enable communities to focus on problem properties.

(6)  Encourage a private sector response to a public health and safety need.

(7)  Reduce fire fatalities.

§ 3202.  SAFE RENTAL HOUSING TASK FORCE

(a)  A safe rental housing task force is created to consist of the following 12 members:

(1)  The director of the division of fire safety or designee.

(2)  The commissioner of the department of health or designee.

(3)  The commissioner of the department of housing and community affairs or designee.

(4)  The attorney general or designee.

(5)  The executive director of the Vermont housing finance agency or designee.

(6)  A representative of commercial landlords.

(7)  A representative of nonprofit landlords.

(8)  A tenant representative.

(9)  A municipal inspection program representative.

(10)  A town health officer from a municipality without an exempt program.

(11)  A regional revolving loan fund representative.

(12)  An architect.

(b)  The speaker of the house and the senate president pro tempore shall appoint members of the task force that are not ex-officio and shall designate a chair.

(c)  Before January 15, 2009, the task force shall:

(1)  Identify information to be gathered for the rental housing registry, develop a questionnaire for rental unit sites and coordinate with existing data collected by the department of health, the department of taxes, the department of housing and community affairs, and the department of public service.

(2)  Develop a simplified rental housing code, to include lead safety, habitability, and basic life safety standards.

(3)  Establish a priority for inspections based on factors including:  the age of the rental unit, a score of the rental units’ self-assessment, and complaints from rental units at the address.

(4)  Develop procedures for scheduled, complaint-based, emergency and time-of-sale inspections, including a time frame and a priority for scheduled inspections.

(5)  Develop standards for licensed rental housing inspectors to include:

(A)  Training standards.

(B)  A code of professional ethics.

(C)  Curriculum outlines and a delivery mechanism.

(6)  Recommend a fee structure necessary and appropriate to implement the inspection program and registry.

(7)  Establish a procedure for issuing a certificate of habitability.

(8)  Develop procedures to assure enforcement and compliance.

(9)  Make recommendations regarding the role of town health officers in regard to safe rental housing in municipalities without an exempt program.

(10)  Develop training and education resources for landlords and tenants, including all the following:

(A)  A rental housing code self-assessment checklist.

(B)  A one‑stop shopping resource for rental unit owners and managers that provides:

(i)  Lead safety, minimum housing habitability, and basic life safety standards available from one site.

(ii)  Coordinated training across disciplines for owners and managers of rental housing units.

(11)  Recommend incentives and develop a process for nonexempt municipalities to establish an inspection program.

(12)  Establish an implementation schedule, to begin July 1, 2009, that includes all the following:

(A)  Training of inspectors and certification by the department of public safety.

(B)  Collection of rental housing information for the registry.

(C)  Collection of fees.

(D)  Commencement of inspections beginning January 1, 2010.

(13)  Recommend staffing levels necessary to establish and maintain the program and provide for enforcement.

(14)  Recommend an appropriation sufficient to fund the certification program, licensing, complaint-driven inspections, enforcement, and the registry.

(15)  Develop a system for coordinating appropriate displacement services.

(16)  Develop a program and identify resources for repair and improvement.

(d)  The task force shall submit a written report on its progress on or before January 15 of each year to the house committee on general, housing and military affairs and the senate committee on economic development, housing and general affairs.

§ 3203.  RENTAL HOUSING SAFETY AND HABITABILITY FUND; ESTABLISHED

(a)  A rental housing safety and habitability fund is established in the state treasury for the purpose of creating a statewide rental housing inspection program to be administered by the department of public safety for the purposes of collecting and maintaining data about rental housing units in Vermont and providing education, training, and support to landlords and tenants to assure that the safety and habitability of rental housing are maintained for the benefit of owners, tenants, and communities.  The fund shall provide financing for scheduled, complaint-based, and emergency inspections of rental housing units, the enforcement of orders issued in conjunction with inspections, and enhancing communications among owners, tenants, and compliance personnel.

(b)  Proceeds from fees, grants, donations, contributions, and other sources of revenue that may be provided by statute or by rule may be deposited in the fund.  Interest earned on the fund and any balances remaining at the end of a fiscal year shall be retained in the fund.

§ 3204.  RENTAL HOUSING REGISTRY

The department of public safety in association with the Vermont housing finance agency, the department of health, and the department of housing and community affairs shall manage a database set up by a private contractor to include all rental housing, including rented single-family homes and rental units in owner-occupied multi-family buildings of two or more rental units and excluding vacation homes.

§ 3205.  RENTAL HOUSING SAFETY INSPECTOR LICENSING PROGRAM

The department of public safety shall establish and manage a licensing program for rental housing safety inspectors to begin by July 1, 2009.

§ 3206.  RENTAL HOUSING HEALTH AND SAFETY STANDARDS

The department of public safety shall adopt minimum standards that apply to existing rental housing.  The standards shall include life safety, electrical, plumbing, and boiler codes, the rental housing health code, and lead paint requirements.

§ 3207.  RENTAL HOUSING SAFETY INSPECTION PROGRAM

The department of public safety shall establish a cyclical and point-of-sale rental housing safety inspection program beginning January 1, 2010.

(1)  Regular inspections shall be carried out by a licensed rental housing safety inspector under contract with the unit owner to assure units meet the rental housing health and safety standards.

(2)  Complaint-driven inspections shall be carried out by a licensed rental housing safety inspector under contract with the state or the municipality.

§ 3208.  RULES

The department of public safety shall adopt rules to implement the recommendations of the safe rental housing task force to carry out the purposes of this chapter.  The department shall propose such rules no later than January 15, 2009.

§ 3209.  EXEMPTIONS

Rental housing units subject to the jurisdiction of municipal housing programs organized pursuant to 24 V.S.A. chapter 123 are exempt from the provisions of this chapter.  This chapter shall not be interpreted to limit or decrease the authority of the exempt municipal housing program in regard to building, housing, and fire safety codes.  A municipal program may lose this exemption if the commissioner of public safety determines that any of the following is true:

(1)  The habitability and enforcement criteria, including standards for issuing certificates of habitability, are less stringent than those of the state program.

(2)  Regularly scheduled inspections of the municipal program are less frequent than those of the state program.

(3)  The municipal program permits rental of units that lack a current certificate of habitability.

(4)  Any other aspect of the municipal program is less stringent than the state program.

Sec. 11.  APPROPRIATION

In fiscal year 2009, there is appropriated from the general fund to the department of public safety the amount of $30,000.00 to be used by the department for the purpose of retaining a consultant to assist the safe rental housing task force in carrying out its duties under chapter 181 of Title 20.

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, on motion of Senator Shumlin, the Senate refused to concur in the House proposal of amendment.


Consideration Postponed

H. 700.

House bill entitled:

An act relating to sale of bottles of wine at festivals.

Was taken up.

Thereupon, without objection consideration of the bill was postponed until tomorrow.

Proposal of Amendment; Bill Passed in Concurrence with Proposal of Amendment

H. 619.

House bill entitled:

An act relating to the regulation of sexual assault nurse examiners.

Was taken up.

Thereupon, pending third reading of the bill, Senator White moved to amend the Senate proposal of amendment in Sec. 2, 33 V.S.A. § 324(b), by striking out subdivisions (3) and (4) in their entirety and inserting in lieu thereof new subdivisions (3), (4) and (5) to read as follows:

(3)  a standardized sexual assault protocol and kit to be used by all physicians or hospitals in this state when providing forensic examinations of victims of alleged sexual offenses;

(4)  a system of monitoring for compliance; and

(5)  processes for investigating complaints, revoking certification, and appealing decisions of the board.

Which was agreed to.

Thereupon, the bill was read the third time and passed in concurrence with proposal of amendment.

Third Reading Ordered; Rules Suspended; Bill Passed in Concurrence

H. 894.

Senator White, for the Committee on Government Operations, to which was referred House bill entitled:

An act relating to approval of amendments to the charter of the town of Windsor.

Reported that the bill ought to pass in concurrence.

Thereupon, the bill was read the second time by title only pursuant to Rule 43, and third reading of the bill was ordered.

Thereupon, on motion of Senator Shumlin, the rules were suspended and the bill was placed on all remaining stages of its passage in concurrence.

Thereupon, the bill was read the third time and passed in concurrence.

Proposals of Amendment; Third Reading Ordered; Rules Suspended; Bill Passed in Concurrence with Proposal of Amendment

H. 558.

Senator MacDonald, for the Committee on Natural Resources and Energy, to which was referred House bill entitled:

An act relating to wastewater facility franchise tax exemption for mining waste.

Reported that the bill ought to pass in concurrence.

Senator Ayer, for the Committee on Finance, to which the bill was referred, reported recommending that the Senate propose to the House to amend the bill as follows:

First:  By striking out Sec. 1 in its entirety and inserting in lieu thereof the following:

Sec. 1.  3 V.S.A. § 2822(j)(6) is amended to read:

(6)  For solid waste treatment, storage, transfer, or disposal facility certifications issued under 10 V.S.A. chapter 159:

* * *

(E)  original and renewal                  $200.00 plus $0.41

applications for facilities, certified                    per cubic yard of certified

pursuant to 10 V.S.A §§ 6605 and 6605b,     for facilities with an operational

that treat, store, or dispose of waste               capacity less than 25,000 cubic

generated solely from mining, extraction,         yards; for facilities with

or mineral processing                                      operational capacity above 15,000

                                                                      25,000 cubic yards $0.95 per

                                                                      cubic yard of operational capacity

                                                                      prorated and paid on an

                                                                      annual basis over the term

                                                       of the certification.


                                                       Maximum annual

                                                                      payment, $35,000.00

                                                                      $75,000.00.

* * *

Second:  By adding a new section to be numbered Sec. 2a to read as follows:

Sec. 2a.  AGENCY OF NATURAL RESOURCES PUBLICATION OF MONITORING

(a)  Upon certification of the OMYA facility under 10 V.S.A. chapter 159, the secretary of natural resources shall post on the website of the agency of natural resources the results of the monitoring activities required under the certification.

(b)  The agency of natural resources shall require staff time associated with the OMYA facility to be assigned a specific accounting code, and all work or review of the OMYA facility shall be accounted for with the assigned OMYA code.

And that the bill ought to pass in concurrence with such proposals of amendment.

Thereupon, the bill was read the second time by title only pursuant to Rule 43, the proposals of amendment were collectively agreed to, and third reading of the bill was ordered.

Thereupon, on motion of Senator Shumlin, the rules were suspended and the bill was placed on all remaining stages of its passage in concurrence with proposal of amendment forthwith.

Thereupon, the bill was read the third time and passed in concurrence with proposal of amendment forthwith.

Proposals of Amendment; Third Reading Ordered

H. 870.

Senator White, for the Committee on Government Operations, to which was referred House bill entitled:

An act relating to the regulation of professions and occupations.

     Reported recommending that the Senate propose to the House to amend the bill as follows:


First:  By adding a new section to be numbered Sec. 6a to read as follows:

Sec. 6a.  26 V.S.A. § 273 is amended to read:

§ 273.  EXEMPTIONS

The provisions of this chapter regulating barbers and cosmetologists shall not:

* * *

(3)  prohibit a licensee from providing barbering or cosmetology services outside a licensed shop so long as those services are limited to only:

* * *

(C)  persons as part of a special occasion event so long as those services are limited to hair styling and makeup and the sanitation standards expected of licensees in licensed shops are followed;

* * *

Second:  By adding a new section to be numbered Sec. 8a to read as follows:

Sec. 8a.  26 V.S.A. § 378 is added to read:

§ 378.  LIMITED TEMPORARY LICENSES

(a)  Notwithstanding section 371 of this title, the board may grant an applicant a limited temporary license to practice podiatry for a period of up to 54 weeks if the applicant:

(1)  furnishes the board with satisfactory proof that he or she has attained the age of majority;

(2)  has received a diploma or certificate of graduation from an accredited school of podiatric medicine approved by the board;

(3)  has been appointed as an intern, resident, fellow, or medical officer in a licensed hospital or in a clinic which is affiliated with a licensed hospital, or in a hospital or an institution maintained by the state, or in a clinic or an outpatient clinic affiliated with or maintained by the state; and

(4)  pays the fee set forth in subdivision 1401a(a)(3) of this title.

(b)  A limited temporary license may be renewed upon payment of the fee set forth in subdivision 1401a(a)(3) of this title for the period of the applicant’s postgraduate training, internship, or fellowship program.

(c)  A limited temporary license shall entitle the applicant to practice podiatry only in the hospital or other institution designated on his or her certificate of limited temporary license and in clinics operated by or affiliated with that designated hospital or institution and only if the applicant is under the direct supervision and control of a licensed podiatrist.  The licensed podiatrist shall be legally responsible and liable for all negligent or wrongful acts or omissions of the limited temporary licensee and shall file with the board the name and address both of himself or herself and of the limited temporary licensee and the name of the hospital or other institution.

(d)  A limited temporary license shall be revoked upon the death or legal incompetency of the supervising licensed podiatrist or, upon 10 days’ written notice, by withdrawal of his or her filing by the supervising licensed podiatrist.  A limited temporary licensee shall at all times exercise the same standard of care and skill as a licensed podiatrist.  Termination of appointment as intern, resident, fellow, or medical officer of a designated hospital or institution shall operate as a revocation of a limited temporary license.

Third:  By adding a new section to be numbered Sec. 9a to read as follows:

Sec. 9a.  26 V.S.A. § 996(e) is amended to read:

(e) In addition to the provisions of subsection (a) of this section, an applicant for renewal shall have satisfactorily completed continuing education as required by the board. For purposes of this subsection, the board shall require, by rule, not less than six nor more than ten hours of approved continuing education as a condition of renewal.   A licensee who is licensed as a funeral director shall only be required to complete continuing education requirements for a funeral director and not those for an embalmer.

Fourth:  By adding a new section to be numbered Sec. 10a to read as follows:

Sec. 10a.  26 V.S.A. § 1256(e) is amended to read:

(e) In addition to the provisions of subsection (a) of this section, an applicant for renewal as a funeral director shall have satisfactorily completed continuing education as required by the board. For purposes of this subsection, the board shall require, by rule, not less than six nor more than ten hours of approved continuing education as a condition of renewal and may require up to three hours of continuing education for removal personnel in the subject area of universal precautions and infectious diseases.  An applicant for renewal as a funeral director who is over the age of 65 shall have satisfactorily completed two hours of approved continuing education as a condition of renewal.

Fifth:  In Sec. 14, 26 V.S.A. § 2081a(1), by striking out the first instance of the word “therapy” and inserting in lieu thereof the word therapist

Sixth:  In Sec. 17, 26 V.S.A. § 2085(a), by striking out the first sentence in its entirety and inserting in lieu thereof a new first sentence to read as follows:  A physical therapist shall be professionally responsible and legally liable for all aspects of the physical therapy care of each of his or her patients, including care provided by physical therapist assistants, physical therapy aides, and assistive personnel.

Seventh:  In Sec. 17, 26 V.S.A. § 2085(c)(2), in the second sentence, by striking out the word “delegated” and inserting in lieu thereof the word assigned

Eighth:  In Sec. 37, 26 V.S.A. § 4121, by striking out subdivision (11)(12) in its entirety and inserting in lieu thereof a new subdivision to read as follows:

(11)(12)  ”Topical medicines” mean medicines applied to the surface of the body and include topical analgesics, anesthetics, antiseptics, scabicides, antifungals, antibacterials, and cryo-agents, and anti-inflammatory agents.

Ninth:  By adding a new section to be numbered Sec. 46 to read as follows:

Sec. 46.  OFFICE OF PROFESSIONAL REGULATION; BOARD OF FUNERAL SERVICE; STUDY

The office of professional regulation, in consultation with the board of funeral service, funeral consumers, providers of funeral services, and other stakeholders identified by the office, shall study the necessity of amending the statutes and administrative rules relating to funeral service in Vermont in the interest of public protection.  The study shall address the reorganization of the embalmer, crematory, and funeral services chapters of the Vermont Statutes Annotated, possible restructuring of the composition of the funeral board, continuing education requirements, and other amendments as deemed appropriate by the office and the board.  The office shall report to the house and senate committees on government operations with its recommendations no later than January 15, 2009.

And that the bill ought to pass in concurrence with such proposals of amendment.

Senator Ayer, for the Committee on Finance, to which the bill was referred, reported recommending that the bill ought to pass in concurrence when so amended.

Thereupon, the bill was read the second time by title only pursuant to Rule 43, and the proposal of amendment was agreed to.


Thereupon, pending the question, Shall the bill be read a third time?, Senator White moved to amend the Senate proposal of amendment by adding a new Sec. 47 to read as follows:

Sec. 47.  NURSING; MILITARY SERVICE; OFFICE OF PROFESSIONAL REGULATION; REPORT

By January 1, 2009, the office of professional regulation shall file a report with the general assembly that evaluates whether, and if so under what circumstances, an applicant for licensure to practice nursing should be eligible for licensure if he or she has received appropriate training and performed duties while enlisted in military service in lieu of satisfaction of a required educational program.  The office, as appropriate, shall consult with the Vermont state board of nursing, the military department, and the Vermont office of veterans’ affairs.

Which was agreed to.

Thereupon, third reading of the bill was ordered.

Rules Suspended; Bills Messaged

On motion of Senator Shumlin, the rules were suspended, and the following bills were ordered messaged to the House forthwith:

H. 558, H. 619, H. 894.

Recess

On motion of Senator Shumlin the Senate recessed until 1:00 P.M.

Called to Order

At 1:15 P.M. the Senate was called to order by the President.

Consideration Postponed

H. 881.

House bill entitled:

An act relating to the role of electric and gas utilities in facilitating the deployment of communications facilities throughout the state.

Was taken up.

Thereupon, without objection consideration of the bill was postponed until tomorrow.


House Proposal of Amendment Concurred In with Amendment

S. 226.

House proposal of amendment to Senate bill entitled:

An act relating to requiring the installation of photoelectric only smoke alarms.

Was taken up.

The House proposes to the Senate to amend the bill as follows:

First:  In Sec. 1, subdivision (a)(3), near the end, by striking out the word “is” and inserting in lieu thereof the word are in subdivision (a)(5), by striking out the following: “;” and inserting in lieu thereof the following: . in subdivision (a)(6), by striking out the word “are” and inserting in lieu thereof the word is by adding a new subdivision, to be subdivision (a)(10), to read as follows:

(10)  Photoelectric-type smoke detectors provide earlier detection and warning than ionization-type smoke detectors in smoldering fires by minutes or tens of minutes.  Ionization-type smoke detectors provide earlier detection and warning than photoelectric-type smoke detectors in flaming fires by seconds or tens of seconds.  Therefore, although this act requires photoelectric-only-type smoke detectors for the reasons set forth in these findings, the general assembly does not discourage the use of ionization-type smoke detectors and combination smoke detectors in addition to photoelectric-only-type smoke detectors.

     And by renumbering the remaining subdivisions to be numerically correct and in subsection (b), after the word “Therefore” by adding the following: ,

Second:  In Sec. 2, 9 V.S.A. § 2882(a) and (b), in both of the two instances, by striking out the following: “photoelectric type only” and inserting in lieu thereof the following: photoelectric-only-type

Third:  In Sec. 3, 9 V.S.A. § 2883(a) and (b), in both of the two instances, by striking out the following: “photoelectric type only” and inserting in lieu thereof the following: photoelectric-only-type

Fourth:  In Sec. 5 (Effective Date), in subsection (a), by striking out the following: “July 1, 2008” and inserting in lieu thereof the following “upon passage”; in subsection (b), by striking out the following: “single family” and inserting in lieu thereof the following: single-family and by striking out the following: “July 1, 2008” and inserting in lieu thereof the following: January 1, 2009 in subsection (c), by striking out the following: “Sec. 2. (b) and Sec. 3” and inserting in lieu thereof the following: Secs. 2(b) and 3 and in subsection (d), by striking out the following: ‘“photoelectric type only”’ and inserting in lieu thereof the following: photoelectric-only-type and after the following: “prohibit” and by inserting in lieu thereof the following: and does not discourage

And that after passage, the title of the bill is to be amended to read:

     AN ACT RELATING TO REQUIRING THE INSTALLATION OF PHOTOELECTRIC-ONLY-TYPE SMOKE DETECTORS.

     Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, Senator Illuzzi moved that the Senate concur in the House proposal of amendment with an amendment thereto:

     In Sec. 1, subsection (a) by striking out subdivision (10) in its entirety and inserting in lieu thereof a new subdivision (10) to read as follows:

(10)  Photoelectric-type smoke detectors provide earlier detection and warning than ionization-type smoke detectors in smoldering fires by minutes or tens of minutes.  Ionization-type smoke detectors provide earlier detection and warning than photoelectric-type smoke detectors in flaming fires by seconds or tens of seconds.  Therefore, although this act requires photoelectric-only-type smoke detectors for the reasons set forth in these findings, the general assembly does not discourage the use of separately powered ionization-type smoke detectors in addition to photoelectric-only-type smoke detectors required by this act.

Which was agreed to.

House Proposal of Amendment Concurred In

S. 271.

House proposal of amendment to Senate bill entitled:

An act relating to support for children with disabilities.

Was taken up.

The House proposes to the Senate to amend the bill by striking out Sec. 1 in its entirety and inserting a new Sec l to read as follows:

Sec. 1.  15 V.S.A. § 658(g) is added to read:

(g)  Upon motion, the court may extend child support up to the age of 22 for an individual found by the court to have significant physical, mental, or developmental disabilities.  The court shall consider the factors identified in section 659 of this title in making its decision.  The parent seeking the order shall provide the court with documentation of the child’s disability.

Thereupon, the question, Shall the Senate concur in the House proposal of amendment?, was decided in the affirmative.

House Proposal of Amendment Not Concurred In; Committee of Conference Requested; Committee of Conference Appointed

S. 301.

House proposal of amendment to Senate bill entitled:

An act relating to enhancing the penalties for assaulting a law enforcement officer and to the crime of assault with bodily fluids.

Was taken up.

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

Sec. 1.  13 V.S.A. § 1028 is amended to read:

§ 1028.  ASSAULT OF LAW ENFORCEMENT OFFICER, FIREFIGHTER, EMERGENCY ROOM PERSONNEL, OR EMERGENCY MEDICAL PERSONNEL MEMBER

A person convicted of a simple or aggravated assault against a law enforcement officer, firefighter, emergency room personnel, or member of emergency services personnel as defined in subdivision 2651(6) of Title 24 while the officer, firefighter, or emergency medical personnel member is performing a lawful duty, in addition to any other penalties imposed under sections 1023 and 1024 of this title, shall:

(1)  For the first offense, be imprisoned not more than one year;

(2)  For the second offense and subsequent offenses, be imprisoned not more than ten years.

And that after passage, the title of the bill is to be amended to read:

AN ACT RELATING TO ASSAULTS ON EMERGENCY ROOM PERSONNEL.

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, on motion of Senator Sears, the Senate refused to concur in the House proposal of amendment and requested a Committee of Conference.


Thereupon, pursuant to the request of the Senate, the President announced the appointment of

                                         Senator Mullin

                                         Senator Campbell

                                         Senator Nitka

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

Joint Resolution Adopted in Concurrence

J.R.H. 62.

Joint House resolution entitled:

Joint resolution commemorating the observance of 2008 Equal Pay Day.

Having been placed on the Calendar for action, was taken up and adopted in concurrence.

Rules Suspended; Proposal of Amendment; Bill Passed in Concurrence with Proposal of Amendment

H. 870.

Pending entry on the Calendar for action tomorrow, on motion of Senator Shumlin, the rules were suspended and House bill entitled:

An act relating to the regulation of professions and occupations.

Was taken up for immediate consideration.

Thereupon, on motion of Senator Shumlin, the rules were suspended and the bill was placed on all remaining stages of its passage in concurrence with proposals of amendment forthwith.

Thereupon, pending third reading of the bill, Senator Illuzzi moved to amend the Senate proposal of amendment by adding a new Sec. 47a to read as follows:

Sec. 47a.  EMERGENCY MEDICAL TECHNICIANS; MILITARY SERVICE; DEPARTMENT OF HEALTH; REPORT; COLLABORATION

(a)  The General Assembly finds that there is a critical shortage of nurses and emergency medical technicians in Vermont, hampering the ability of Vermonters to obtain affordable and timely and quality medical care.

(b)  By January 15, 2009, the commissioner of the Department of Health shall file a report with the House and Senate Government Operations that evaluates whether, and if so under what circumstances, an applicant for licensure as an emergency medical technician should be eligible for licensure, or exemption from licensure when employed by certain health care facilities, if he or she has received comparable training and performed duties while enlisted in military service in lieu of satisfaction of a required educational or testing program, or both.  The commissioner, as appropriate, shall consult with the executive director of the Vermont state board of nursing, the adjutant general, and the director of the Vermont office of veterans’ affairs.

(c)  The commissioner of health shall collaborate to the extent feasible with the director of the office of professional regulation regarding the comparable evaluation required by Sec. 47 of this Act for individuals with military service qualifying for licensing as nurses.

Which was agreed to.

Thereupon, the bill was read the third time and passed in concurrence with proposal of amendment.

Rules Suspended; House Proposal of Amendment Not Concurred In; Committee of Conference Requested; Committee of Conference Appointed

S. 107.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate bill entitled:

An act relating to mapping class four town highways and trails and mass discontinuances of unmapped town highways.

Was taken up for immediate consideration.

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

Sec. 1. 19 V.S.A. § 302(a)(6)(A) is amended to read:

(A) Unidentified corridors are town highways that:

(i) have been laid out as highways by proper authority through the process provided by law at the time they were created or by dedication and acceptance; and

(ii) do not, as of July 1, 2009 2010, appear on the town highway map prepared pursuant to section 305 of this title; and

(iii) are not otherwise clearly observable by physical evidence of their use as a highway or trail; and

(iv) are not legal trails.

Sec. 2.  19 V.S.A. § 305(h) is amended to read:

(h) Notwithstanding the provisions of subchapter 7 of chapter 7 of this title, on or before July 1, 2009 2010, a municipality's legislative body may vote to discontinue all town highways that are not included as such on the sworn certificate of the description and measurement of town highways filed with the town clerk on February 10 of that year pursuant to subsection (b) of this section. For the purposes of this section, a town highway shall be deemed to be included on the sworn certificate of the description and measurement of town highways if:

* * *

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, on motion of Senator White, the Senate refused to concur in the House proposal of amendment and requested a Committee of Conference.

Thereupon, pursuant to the request of the Senate, the President announced the appointment of

                                         Senator White

                                         Senator Flanagan

                                         Senator Doyle

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

Rules Suspended; House Proposal of Amendment Concurred In

S. 201.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate bill entitled:

An act relating to state employee whistleblower protection.

Was taken up for immediate consideration.

The House proposes to the Senate to amend the bill as follows:

First:  In Sec. 1, 3 V.S.A. § 972(4), after the following: “promotion,” and before the following: “or involuntary transfer” by inserting the following: imposition of a performance warning period,

Second:  In Sec. 1, 3 V.S.A. § 975(b), in the first sentence, by striking out the word “raises” and inserting in lieu thereof the word files and by striking out the following: “under a grievance procedure or similar process available to the employee” and inserting in lieu thereof the following: with the Vermont labor relations board

Third:  In Sec. 1, 3 V.S.A. § 975(b), by striking out the second sentence in its entirety

Fourth:  In Sec. 1, 3 V.S.A. § 975(c), by striking out the word “raises” and inserting in lieu thereof the word files

Thereupon, the question, Shall the Senate concur in the House proposal of amendment?, was decided in the affirmative.

Rules Suspended; House Proposal of Amendment Not Concurred In; Committee of Conference Requested; Committee of Conference Appointed

S. 283.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate bill entitled:

An act relating to managed care organizations and the blueprint for health.

Was taken up for immediate consideration.

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

Sec. 1.  18 V.S.A. § 9414(a)(1), (b), and (e) are amended to read:

(a)  The commissioner shall have the power and responsibility to ensure that each managed care organization provides quality health care to its members, in accordance with the provisions of this section.

(1)  In determining whether a managed care organization meets the requirements of this section, the commissioner shall annually review and examine, in accordance with subsection (e) of this section, the organization’s administrative policies and procedures, quality management and improvement procedures, utilization management, credentialing practices, members' rights and responsibilities, preventive health services, medical records practices, grievance and appeal procedures, member services, financial incentives or disincentives, disenrollment, provider contracting, and systems and data reporting capacities.  The commissioner may establish, by rule, specific criteria to be considered under this section.

(b)(1)  A managed care organization shall assure that the health care services provided to members are consistent with prevailing professionally recognized standards of medical practice. 

(2)  A managed care organization shall establish a chronic care program as needed to implement the blueprint for health established in chapter 13 of this title.  The program shall include:

(A)  appropriate benefit plan design;

(B)  informational materials, training, and follow-up necessary to support members and providers; and

(C)  payment reform methodologies.

(3)  Each managed care organization shall have procedures to assure availability, accessibility and continuity of care, and ongoing procedures for the identification, evaluation, resolution, and follow-up of potential and actual problems in its health care administration and delivery.

(e)  The commissioner shall evaluate review a managed care organization's performance under the requirements of this section at least once every three years and more frequently as the commissioner deems proper.  If upon review the commissioner determines that the organization’s performance with respect to one or more requirements warrants further examination, the commissioner shall conduct a comprehensive or targeted examination of the organization’s performance.  The commissioner may designate another organization to conduct any evaluation under this subsection.  Any such independent designee shall have a confidentiality code acceptable to the commissioner, or shall be subject to the confidentiality code adopted by the commissioner under subdivision (f)(3) of this section.  In conducting an evaluation under this subsection, the commissioner or the commissioner's designee shall employ, retain, or contract with persons with expertise in medical quality assurance.

Sec. 2.  8 V.S.A. § 4088f is added to read:

§ 4088f.  HEALTH INSURANCE AND THE BLUEPRINT FOR HEALTH

(a)  A health insurance plan shall be offered, issued, and administered consistent with the blueprint for health established in chapter 13 of Title 18, as determined by the commissioner.

(b)  As used in this section, “health insurance plan” means any individual or group health insurance policy, any hospital or medical service corporation or health maintenance organization subscriber contract, or any other health benefit plan offered, issued, or renewed for any person in this state by a health insurer, as defined in section 9402 of Title 18.  The term shall include the health benefit plan offered by the state of Vermont to its employees and any health benefit plan offered by any agency or instrumentality of the state to its employees.  The term shall not include benefit plans providing coverage for specific disease or other limited benefit coverage unless so directed by the commissioner.

Sec. 3.  SUPPORT OF BLUEPRINT integrated early implementation PILOT Programs

(a)  As used in this section, “health insurer” means a health insurance company doing business in Vermont whose individual share of the commercially insured Vermont market, as measured by covered lives, comprises at least five percent of the commercially insured Vermont market.

(b)  The blueprint director shall establish a pilot design and evaluation committee to assist with design, implementation, and evaluation of the integrated early implementation pilot programs, as defined in section 7 of No. 71 of the Acts of 2007.  The committee shall:

(1)  work collaboratively with the blueprint director to accomplish the provisions in subsections (c) through (g) of this section; and

(2)  include a representative of each of the participating health insurers; a participating provider from each pilot community; a representative of the Vermont department of health; a representative of the office of Vermont health access; a representative of the department of banking, insurance, securities, and health care administration; a naturopathic physician; a representative of the business community; and a representative of the Vermont Medical Society.

(c)  Implementation of the first pilot program shall begin no later than July 1, 2008.  Implementation of the second pilot program shall begin no later than October 1, 2008.  Implementation of the third pilot program shall begin no later than January 1, 2009.

(d)  No later than May 31, 2008, health insurers and the office of Vermont health access shall commit in writing to participation in the three integrated early implementation pilot projects as described in section 7 of No. 71 of the Acts of 2007 and as further specified by the provisions of this section.  Such commitment shall include agreement to:

(1)  provide financial support for a five-member community care team in each of the three integpilrated early implementation pilot program communities established pursuant to subsection 7(f) of No. 71 of the Acts of 2007.  The department of health, health insurers, and the office of Vermont health access shall each contribute equal shares of such financial support for the community care teams, with the exception that MVP Healthcare shall contribute one half of that share;

(2)  provide financial support for payment reform for providers in practices that are participating as part of the three integrated early implementation pilot programs as referenced in subsections 7(e) and 7(g) of No. 71 of the Acts of 2007;

(3)  provide claims data-sharing for evaluation of the effectiveness of these integrated pilot programs as referenced in subsections 7(c) and 7(e) of Act 71 of No. 71 of the Acts of 2007; and

(4)  actively participate in program design, implementation, and evaluation activities.

(e)  No later than May 31, 2008, the blueprint director shall adopt designs for the financial support models in subdivisions (d)(1) and (d)(2) of this section and for the plan to evaluate healthcare process quality, including targets for key outcomes to be achieved by the pilots.

(f)  By January 1, 2010, as part of the blueprint annual report, the blueprint director shall include a report on integrated pilot program implementation and preliminary evaluation findings.

(g)  No later than six months after the third integrated pilot has completed 12 months of clinical operations, the blueprint director and the pilot design and evaluation committee shall assess whether there is sufficient clinical and financial gain from these types of programs to move forward with statewide implementation.

(1)  The blueprint director shall provide a final evaluation report to the senate committee on health and welfare, the house committee on health care, and the commission on health care reform.

(2)  If evidence supports statewide implementation, the final evaluation report shall include recommendations to achieve this goal.

(h)  If the commissioner of banking, insurance, securities, and health care administration determines that a health insurer is not participating in an adequate and appropriate manner, as determined by the commissioner, in the activities described in this section, the commissioner, in addition to any other remedy or sanction provided for by law, may order the health insurer to participate in such blueprint initiatives and take such other actions as the commissioner determines necessary to carry out the purposes of this section.

Sec. 4.  REPEAL

Sec. 3 of this act, relating to blueprint integrated early implementation pilot programs, shall be repealed on July 1, 2012.


Sec. 5.  18 V.S.A. § 1120 is amended to read:

§ 1120.  DEFINITIONS

As used in this subchapter,:

(1)  “Child care facility” means a child care facility or family day care home licensed or registered under chapter 35 of Title 33, unless exempted by rule adopted under section 1123 of this title.

(2)  “school” “School” means a public or independent prekindergarten, kindergarten, elementary or secondary school or any postsecondary school as defined in 16 V.S.A. § 176(b), unless exempted by rule adopted pursuant to section 1123 of this title.

Sec. 6.  18 V.S.A. § 1121 is amended to read:

§ 1121.  IMMUNIZATIONS REQUIRED PRIOR TO ATTENDING SCHOOL AND CHILD CARE FACILITIES

(a)  No person may enroll as a student in a Vermont school, regardless of whether the student has been enrolled in the school during a previous school year, unless the appropriate school official has received a record or certificate of immunization issued by a licensed physician health care practitioner or a health clinic that the person has received required immunizations appropriate to age as specified by the Vermont department of health.

(b)  No person may enroll or retain a child in a child care facility, regardless of whether the child has been enrolled in the facility during a previous year, unless the facility has received a record or certificate of immunization issued by a licensed health care practitioner or a health clinic that the child has received required immunizations in the prior 12-month period appropriate to age as specified by the Vermont department of health.

Sec. 7.  18 V.S.A. § 1122 is amended to read:

§ 1122.  EXEMPTIONS

(a)  A person may remain in school or in the child care facility without a required immunization:

(1)  If the person, or in the case of a minor the person’s parent or guardian presents a written statement from a licensed physician health care practitioner, health clinic, or nurse that the person is in the process of being immunized.  The person may continue to attend school or the child care facility as long as the immunization process is being accomplished;

(2)  If a physician health care practitioner, licensed to practice in Vermont, certifies in writing that a specific immunization is or may be detrimental to the person’s health or is not appropriate;

(3)  If the person, or in the case of a minor the person’s parent or guardian states in writing that the person, parent, or guardian has religious beliefs or moral philosophical convictions opposed to immunization.

(b)  The health department may provide by rule for further exemptions to immunization based upon sound medical practice.

Sec. 8.  18 V.S.A. § 1123 is amended to read:

§ 1123.  IMMUNIZATION RULES AND REGULATIONS

The health department shall adopt rules for administering this subchapter.  Such rules shall be developed in consultation with the department of education shall establish rules for administering this subchapter with respect to immunization requirements for Vermont schools, and in consultation with the department for children and families with respect to immunization requirements for child care facilities.  Such rules shall establish which immunizations shall be required and the manner and frequency of their administration, and may provide for exemptions as authorized by this subchapter.

Sec. 9.  18 V.S.A. § 1124 is amended to read:

§ 1124.  ACCESS TO RECORDS

Appropriate health personnel, including school nurses, shall have access to student immunization records of anyone enrolled in Vermont schools or child care facilities, when access is required in the performance of official duties related to the immunizations required by this subchapter.  Access to student immunization records shall only be provided with the prior written consent of parents and students as required by the Family Educational Rights and Privacy Act, 20 U.S.C. § 1232g, and any regulations adopted thereunder.

Sec. 10.  18 V.S.A. § 1126 is amended to read:

§ 1126.  NONCOMPLIANCE

The school board of each district, or the board of trustees of each independent school, or the chief executive officer of each post-secondary postsecondary school, or the director of each child care facility shall exclude from school or a child care facility any person not otherwise exempted under this subchapter who fails to comply with its provisions.  No person shall be excluded for failure to comply with the provisions of this subchapter unless there has been a notification by the appropriate school or child care facility authority to the person, or in the case of a minor to the person’s parent or guardian of the noncompliance with this subsection, and of their rights under section 1122 of this title.  In the event of exclusion, school officials or the director of the child care facility shall notify the department of health and contact the parents or guardians in an effort to secure compliance with the requirements of this subchapter so that the person may attend school or the child care facility.

Sec. 11.  18 V.S.A. § 1129 is amended to read:

§ 1129.  CHILDHOOD IMMUNIZATION REGISTRY

(a)  A health care provider shall report to the department all data regarding required immunizations of adults and of children under the age of 18 within seven days of the immunization, provided that required reporting of immunizations of adults shall commence within one month after the health care provider has established an electronic health records system and data interface pursuant to the e-health standards developed by the Vermont information technology leaders.  A health insurer shall report to the department all data regarding immunizations of adults and of children under the age of 18 at least quarterly.  The All data required pursuant to this subsection shall be reported in a form required by the department.

(b)  The department may use the data to create a registry of childhood immunizations.  Registry information regarding a particular adult shall be provided, upon request, to the adult, the adult’s health care provider, and the adult’s health insurer.  A minor child’s record also may be provided, upon request, to school nurses, and upon request and with written parental consent, to licensed day care providers, to demonstrate document compliance with Vermont immunization laws.  Registry information regarding a particular child shall be provided, upon request, to the child after the child reaches the age of majority and to the child’s parent, guardian, health insurer, and health care provider.  Registry information shall be kept confidential and privileged and may be shared only in summary, statistical, or other form in which particular individuals are not identified.

Sec. 12.  EFFECTIVE DATE

This act shall take effect July 1, 2008, except that Sec. 3 and this section shall take effect upon passage.

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, on motion of Senator Racine, the Senate refused to concur in the House proposal of amendment and requested a Committee of Conference.

Thereupon, pursuant to the request of the Senate, the President announced the appointment of


                                         Senator Racine

                                         Senator Mullin

                                         Senator Lyons

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

Rules Suspended; House Proposal of Amendment; Consideration Postponed

S. 313.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate bill entitled:

An act relating to a license to store and ship wine.

Was taken up for immediate consideration.

The House proposes to the Senate to amend the bill by striking out Sec. 1 and inserting in lieu thereof the following:

Sec. 1.  7 V.S.A. § 68 is added to read:

§ 68.  VINOUS BEVERAGE STORAGE AND SHIPPING LICENSE

The liquor control board may grant to a person who operates a climate-controlled storage facility in which vinous beverages owned by another person are stored for a fee a license that allows the licensee to store and transport vinous beverages on which all applicable taxes already have been paid.  A vinous beverage storage facility may also accept shipments from any licensed in-state or out-of-state vinous manufacturer that has an in-state or out‑of‑state consumer shipping license pursuant to section 66 of this title.  Vinous beverages stored may be transported only for shipment to the owner of the beverages or to another licensed vinous beverage storage facility, and the beverages shall be shipped only by common carrier in compliance with subsection 66(f) of this title.  The licensee shall pay a fee pursuant to subdivision 231(a)(20) of this title.   A license under this section shall be issued pursuant to rules adopted by the board.  A person granted a license pursuant to this section may not sell or resell any vinous beverages stored at the storage facility. 

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, on motion of Senator Shumlin, consideration was postponed until tomorrow.

Rules Suspended; House Proposal of Amendment; Consideration Postponed

S. 322.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate bill entitled:

An act relating to a license to store and ship wine.

Was taken up for immediate consideration.

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

Sec. 1.  FINDINGS AND INTENT

(a)  The general assembly finds:

(1)  A viable agricultural sector in Vermont represents part of a secure regional food supply, which leads to energy and economic efficiencies.

(2)  The general public is increasingly interested in locally produced food.

(3)  Livestock raised on-farm for meat offers profit potential and economic opportunity for Vermont producers.

(4)  Meat from livestock raised on Vermont farms has an excellent reputation for quality and flavor.

(5)  In recent years, there has been increasing interest in the on-farm slaughter of animals for use by households for economic, ethnic, and humane reasons.

(6)  There are limited options for livestock slaughter in Vermont.

(7)  Historically, meat raised on Vermont farms has been safe and healthy; Vermont’s slaughtering and processing practices have excellent safety records.

(8)  The sustainability of Vermont’s local food systems depends on the relationship between the producer and the consumer.  Key aspects of such successful relationships include the producer’s integrity and the consumer’s interest in and knowledge of how the food is raised, harvested, and processed.

(9)  Community-supported agriculture programs can serve as models for meat producers interested in marketing directly to consumers.

(10)  Raising meat, fruits, and vegetables as close as possible to the kitchens of the end-user minimizes the carbon footprint of the entire food system.

(11)  The dairy promotion council should be required to report annually to the legislature, as well as the governor, on its activities, the amount of money received, and the expenditures thereof.

(b)  It is therefore the intent of the general assembly in enacting this legislation to:

(1)  Assure the continuance of a safe, local food supply.

(2)  Maintain the Vermont meat inspection service’s “at least equal to” status with the federal government’s USDA food safety inspection service.

(3)  Provide for collective ownership of animals raised and slaughtered on Vermont farms where the meat is distributed only to the owners.

(4)  Better understand the rules for building approved slaughter and processing facilities in Vermont and compare Vermont’s meat inspection regulations to other states.

(5)  Determine ways to build cost-effective slaughter and processing facilities and the feasibility of cooperative ownership.

(6)  Promote and encourage growth in Vermont’s livestock industry and the production of meat for local consumption by allowing for more on-farm slaughter and processing of livestock, creating opportunity for the development of more commercial slaughter and processing facilities, and by supporting those currently in the industry.

(7)  Provide more opportunities for Vermont livestock farmers and the supporting slaughter and processing industry to meet the growing demand for animals to be slaughtered and processed by ethnic and religious groups in accordance with their practices and beliefs.

* * * Dairy Promotion Council * * *

Sec. 2.  6 V.S.A. § 2972(b) is amended to read:

(b)  Included among the powers of the council in connection with the enforcement of this chapter are the powers to require reports from any person subject to this chapter; to adopt, rescind, modify, and amend all proper and necessary rules, regulations and orders to administer this chapter, which rules, regulations and orders shall be promulgated by publication in the manner prescribed therefor by the council and shall have the force and effect of law when not inconsistent with existing laws; to administer oaths, subpoena witnesses, take depositions, and certify to official acts; to require any dealer to keep such true and accurate records and to make such reports covering purchases, sales, and receipts of dairy products and related matters as the council deems reasonably necessary for effective administration, which records shall be open to inspection by the secretary of agriculture, food and markets at any reasonable time and as often as may be necessary, but information thus obtained shall not be published or be open to public inspection in any manner revealing any individual dealer’s identity, except as required in proceedings to enforce compliance; to keep accurate books, records, and accounts of all of its dealings, and to make annually a full report of its doings to the house and senate committees on agriculture and the governor, which shall show the amount of money received and the expenditures thereof.  The report shall be submitted annually on or before January 15.  The Vermont agency of agriculture, food and markets shall perform the administrative work of the council as directed by the council.  The council shall reimburse the agency of agriculture, food and markets for the cost of services performed by the agency.

Sec. 3.  LIVESTOCK STUDY

The legislative council shall consult with local producers, the Vermont congressional delegation, the agency of agriculture, food and markets, and the department of education and develop proposals for a Vermont locally produced meat-in-schools program.  The goals shall be to use existing resources to procure locally produced food products processed in Vermont and inspected by the Vermont agency of agriculture, food and markets to bolster the safety of the food in schools while supporting the Vermont agricultural industry.

Sec. 4.    AGENCY OF AGRICULTURE, FOOD AND MARKETS; SLAUGHTER ON PREMISES STUDY

In consultation with interested parties the agency of agriculture, food and markets shall study and recommend actions to meet the objectives set forth in Sec. 1(b) of this act.  The results of such study and any actions recommended shall be included in a report to the house and senate committees on agriculture on or before January 15, 2009.

Sec. 5.  6 V.S.A. § 3306(f) is amended to read:

(f)  Itinerant custom slaughterers, who slaughter solely at a person’s home or farm and who do not own, operate or work at a slaughtering plant shall be exempt from the licensing provisions of this section.  An itinerant custom slaughterer may slaughter livestock owned by an individual who has entered into a contract with a person to raise the livestock on the farm where it is intended to be slaughtered.


Sec. 6.  9 V.S.A. § 2465a is added to read:

§ 2465a.  DEFINITION OF LOCAL AND LOCALLY GROWN

For the purposes of this chapter and rules adopted pursuant to subsection 2453(c) of this chapter, “local,” “locally grown,” and any substantially similar term shall mean that the goods being advertised originated within Vermont or 30 miles of the place where they are sold, measured directly, point to point, except that the term “local” may be used in conjunction with a specific geographic location, such as “local to New England,” or a specific mile radius, such as “local–within 100 miles,” as long as the specific geographic location or mile radius appears as prominently as the term “local,” and the representation of origin is accurate.

Sec. 7.  EFFECTIVE DATE

This act shall take effect upon passage, except Sec. 5 which shall take effect April 15, 2009.

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, on motion of Senator Shumlin, consideration was postponed until tomorrow.

Rules Suspended; Proposal of Amendment; Third Reading Ordered

H. 887.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House bill entitled:

An act relating to health care reform.

Was taken up for immediate consideration.

     Senator Racine, for the Committee on Health and Welfare, to which the bill was referred, reported recommending that the Senate propose to the House to amend the bill by striking out all after the enacting clause and inserting in lieu thereof the following:

* * * Expanding Affordable Coverage * * *

Sec. 1.  8 V.S.A. § 4080a(h)(2)(B) is amended to read:

(B)  The commissioner’s rules shall permit a carrier, including a hospital or medical service corporation and a health maintenance organization, to establish rewards, premium discounts, split benefit designs, rebates, or otherwise waive or modify applicable co-payments, deductibles, or other cost‑sharing amounts in return for adherence by a member or subscriber to programs of health promotion and disease prevention.  The commissioner shall consult with the commissioner of health, the director of the blueprint for health, and the director of the office of Vermont health access in the development of health promotion and disease prevention rules that are consistent with the Blueprint for Health.  Such rules shall:

* * *

(iii)  provide that the reward under the program is available to all similarly situated individuals and shall comply with the nondiscrimination provisions of the federal Health Insurance Portability and Accountability Act of 1996; and

* * *

Sec. 2.  EXPEDITED RULEMAKING

No later than January 1, 2009 and notwithstanding the provisions of chapter 25 of Title 3, the department of banking, insurance, securities, and health care administration shall adopt rules to implement the healthy lifestyle insurance discount and split benefit design established in subsection 4080a(h) of Title 8.  The rules for the split benefit design shall include provisions that promote good health, prevent disease, and encourage healthier lifestyles without penalizing individuals due to disability, poor health, or socioeconomic status.  The department shall adopt the rules pursuant to the following expedited rulemaking process:

(1)  After publication in three daily newspapers with the highest average circulation in the state of a notice of the rules to be adopted pursuant to this process and at least a 14-day public comment period following publication, the department shall file final proposed rules with the legislative committee on administrative rules.

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

(3)  The department may adopt a properly filed final proposed rule:

(A)  after the passage of 14 days from the date of filing final proposed rules with the legislative committee on administrative rules;

(B)  after receiving notice of approval from the committee; or

(C)  if the department has received a notice of objection from the legislative committee on administrative rules, after having responded to the objection from the committee pursuant to section 842 of Title 3.

(4)  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 by the department with the secretary of state pursuant to this section shall be deemed to be in full compliance with section 843 of Title 3 and shall be accepted by the secretary of state if filed with a certification by the commissioner of banking, insurance, securities, and health care administration that the rule is required to meet the purposes of this section.

Sec. 3.  EXPANDING ACCESS TO CATAMOUNT HEALTH

(a)  No later than March 1, 2009, the secretary of human services shall apply to the federal Centers for Medicare and Medicaid Services for a waiver amendment to allow Vermont to lower the waiting period for coverage under Catamount Health and the Vermont health access plan to six months from the current 12 months.  Within 60 days following approval of the waiver, the secretary of administration shall submit to the commission on health care reform created pursuant to section 901 of Title 2 a recommendation on whether to proceed with reducing the waiting period.  Upon receipt of the secretary’s recommendation, the commission on health care reform shall consider:

(1)  the availability of resources;

(2)  issues surrounding implementation; and

(3)  potential benefits to the health care system.

(b)  The commission on health care reform shall make a recommendation to the senate committees on health and welfare and on appropriations and the house committees on health care and on appropriations on whether to proceed with or delay implementation of the reduction in the waiting period.  The committees shall present their recommendations to the general assembly, which shall make a determination whether to proceed with implementation of the reduced waiting period.

Sec. 4.  8 V.S.A. § 4080f(a)(9) is amended to read: 

(9)  “Uninsured” means an individual who does not qualify for Medicare, Medicaid, the Vermont health access plan, or Dr. Dynasaur, and:  who had no private insurance or employer-sponsored coverage that includes both hospital and physician services within 12 months prior to the month of application,; who has had a nongroup health insurance plan with an annual deductible of no less than $10,000.00 for an individual or an annual deductible of no less than $20,000.00 for two‑person or family coverage for at least six months; or who lost private insurance or employer-sponsored coverage during the prior 12 months for the following reasons:

(A)  the individual’s private insurance or employer-sponsored coverage ended because of:

(i)  loss of employment, including a reduction in hours that results in ineligibility for employer-sponsored coverage, unless the employer has terminated its employees or reduced their hours for the primary purpose of discontinuing employer-sponsored coverage and establishing their eligibility for Catamount Health;

(ii)  death of the principal insurance policyholder;

(iii)  divorce or dissolution of a civil union;

(iv)  no longer qualifying receiving coverage as a dependent under the plan of a parent or caretaker relative; or

(v)  no longer receiving COBRA, VIPER, or other state continuation coverage; or

(B)  college- or university-sponsored health insurance became unavailable to the individual because the individual graduated, took a leave of absence, decreased enrollment below a threshold set for continued coverage, or otherwise terminated studies.

Sec. 5.  33  V.S.A. § 1983 is amended to read: 

§ 1983.  Eligibility

(a)(1)  Except as provided in subdivisions (3), and (4), and (5) of this subsection, an individual shall be eligible for Catamount Health assistance if the individual is an uninsured Vermont resident without access to an approved employer-sponsored insurance plan under section 1974 of this title.

* * *

(5)  An individual shall not be eligible for Catamount Health assistance for the first 12 months of coverage if the individual is solely eligible under the high deductible standard outlined in 8 V.S.A. § 4080f(a)(9).

Sec. 6.  33 V.S.A. § 1973(e) is amended to read: 

(e)  For purposes of this section, “uninsured” means:

(1)  an individual with household income, after allowable deductions, at or below 75 percent of the federal poverty guideline for households of the same size;

(2)  an individual who had no private insurance or employer-sponsored coverage that includes both hospital and physician services within 12 months prior to the month of application; or

(3)  an individual who lost private insurance or employer-sponsored coverage during the prior 12 months for the following reasons:

(A)  the individual’s coverage ended because of:

(i)  loss of employment, including a reduction in hours that results in ineligibility for employer-sponsored coverage, unless the employer has terminated its employees or reduced their coverage for the primary purpose of discontinuing employer-sponsored coverage and establishing their eligibility for Catamount Health;

(ii)  death of the principal insurance policyholder;

(iii) divorce or dissolution of a civil union;

(iv)  no longer qualifying receiving coverage as a dependent under the plan of a parent or caretaker relative; or

(v)  no longer receiving COBRA, VIPER, or other state continuation coverage; or

(B)  college- or university-sponsored health insurance became unavailable to the individual because the individual graduated, took a leave of absence, decreased enrollment below a threshold set for continued coverage, or otherwise terminated studies.

(4)  An individual who was eligible for Catamount Health solely under the high deductible standard outlined in 8 V.S.A. § 4080f(a)(9) shall not be eligible for VHAP for the first 12 months of coverage.

Sec. 7.  33 V.S.A. § 1974 is amended to read: 

* * *

(b) VHAP-eligible premium assistance.

* * *

(6)  An individual shall not be eligible for premium assistance for the first 12 months of coverage if the individual is solely eligible under the high deductible standard outlined in 8 V.S.A. § 4080f(a)(9).

* * *

(c)  Uninsured individuals; premium assistance.

(1)  For the purposes of this subsection:

* * *

(B)  “Uninsured” means an individual who does not qualify for Medicare, Medicaid, the Vermont health access plan, or Dr. Dynasaur, and had no private insurance or employer-sponsored coverage that includes both hospital and physician services within 12 months prior to the month of application, or lost private insurance or employer-sponsored coverage during the prior 12 months for the following reasons:

(i)  the individual’s private insurance or employer-sponsored coverage ended because of:

(I)  loss of employment, including a reduction in hours that results in ineligibility for employer-sponsored coverage, unless the employer has terminated its employees or reduced their hours for the primary purpose of discontinuing employer-sponsored coverage and establishing their eligibility for Catamount Health;

(II)  death of the principal insurance policyholder;

(III)  divorce or dissolution of a civil union;

(IV)  no longer qualifying receiving coverage as a dependent under the plan of a parent or caretaker relative; or

(V)  no longer receiving COBRA, VIPER, or other state continuation coverage; or

(ii)  college- or university-sponsored health insurance became unavailable to the individual because the individual graduated, took a leave of absence, decreased enrollment below a threshold set for continued coverage, or otherwise terminated studies.

* * *

(3) The premium assistance program under this subsection shall provide a subsidy of premiums or cost-sharing amounts based on the household income of the eligible individual, with greater amounts of financial assistance provided to eligible individuals with lower household income and lesser amounts of assistance provided to eligible individuals with higher household income. Until an approved employer-sponsored plan is required to meet the standard in subdivision (4)(B)(ii) of this subsection, the subsidy shall include premium assistance and assistance to cover cost-sharing amounts for chronic care health services covered by the Vermont health access plan that are related to evidence-based guidelines for ongoing prevention and clinical management of the chronic condition specified in the blueprint for health in section 702 of Title 18. Notwithstanding this subsection, an individual shall not be eligible for premium assistance for the first 12 months of coverage if the individual is solely eligible under the high deductible standard outlined in 8 V.S.A. § 4080f(a)(9).

* * *

Sec. 8.  33 V.S.A. § 1982(2) is amended to read: 

(2)  “Uninsured” means an individual who does not qualify for Medicare, Medicaid, the Vermont health access plan, or Dr. Dynasaur, and had no private insurance or employer‑sponsored coverage that includes both hospital and physician services within 12 months prior to the month of application or lost private insurance or employer‑sponsored coverage during the prior 12 months for the following reasons:

(A)  the individual’s private insurance or employer‑sponsored coverage ended because of:

(i)  loss of employment, including a reduction in hours that results in ineligibility for employer-sponsored coverage, unless the employer has terminated its employees or reduced their hours for the primary purpose of discontinuing employer‑sponsored coverage and establishing their eligibility for Catamount Health;

(ii)  death of the principal insurance policyholder;

(iii)  divorce or dissolution of a civil union;

(iv)  no longer qualifying receiving coverage as a dependent under the plan of a parent or caretaker relative; or

(v)  no longer receiving COBRA, VIPER, or other state continuation coverage; or

(B)  college- or university-sponsored health insurance became unavailable to the individual because the individual graduated, took a leave of absence, decreased enrollment below a threshold set for continued coverage, or otherwise terminated studies.

* * * Preexisting Conditions under Catamount Health * * *

Sec. 9.  8 V.S.A. § 4080f(e) is amended to read:

(e)(1)  For a 12‑month period from the effective date of coverage earliest date of application, a carrier offering Catamount Health may limit coverage of preexisting conditions which existed during the 12‑month period before the effective date of coverage earliest date of application, except that such exclusion or limitation shall not apply to chronic care if the individual is participating in a chronic care management program, nor apply to pregnancy.  A carrier shall waive any preexisting condition provisions for all individuals and their dependents who produce evidence of continuous creditable coverage during the previous nine months.  If an individual has a preexisting condition excluded under a subsequent policy, such exclusion shall not continue longer than the period required under the original contract or 12 months, whichever is less.  The carrier shall credit prior coverage that occurred without a break in coverage of 63 days or more.  A break in coverage shall be tolled after the earliest date of application, subject to reasonable time limits, as defined by the commissioner, for the individual to complete the application process.  For an eligible individual, as such term is defined in Section 2741 of Title XXVII of the Public Health Service Act the Health Insurance Portability and Accountability Act of 1996, a carrier offering Catamount Health shall not limit coverage of preexisting conditions.

(2)  Notwithstanding subdivision (1) of this subsection, a carrier offering Catamount Health shall not limit coverage of preexisting conditions for subscribers who apply before November 1, 2008.  This subdivision (2) shall not apply to claims incurred prior to the effective date of this section.

* * * 75 Percent Rule * * *

Sec. 10.  8 V.S.A. § 4080a(l) is amended to read:

(l)(1)  A registered small group carrier which is not a nonprofit health maintenance organization shall may require that at least 75 percent or less of the employees or members of a small group with more than 10 employees participate in the carrier’s plan, provided that if a nonprofit health maintenance organization provides a small group plan to more than 25 percent of the employees or members of the small group, a registered small group carrier may offer or continue to provide its small group plan to the remaining employees or members.  A registered small group carrier may require that 50 percent or less of the employees or members of a small group with 10 or fewer employees or members participate in the carrier’s plan.  A small group carrier’s rules established pursuant to this subsection shall be applied to all small groups participating in the carrier’s plans in a consistent and nondiscriminatory manner.

(2)  For purposes of this requirement the requirements set forth in subdivision (1) of this subsection (l), the a registered small group carrier shall not include in its calculation an employee or member who is already covered by another group health benefit plan as a spouse or dependent or who is enrolled in Catamount Health, Medicaid, the Vermont health access plan, or Medicare.  Employees or members of a small group who are enrolled in the employer’s plan and receiving premium assistance under chapter 19 of Title 33 shall be considered to be participating in the plan for purposes of this section.  If the small group is an association, trust, or other substantially similar group, this the participation requirement requirements shall be calculated on an employer-by-employer basis.

(3)  A small group carrier may not require recertification of compliance with the participation requirements set forth in this section more often than annually at the time of renewal.  If, during the recertification process, a small group is found not to be in compliance with the participation requirements, the small group shall have 120 days to become compliant prior to termination of the plan.

* * * Preventing Chronic Conditions Through Healthy Lifestyles * * *

Sec. 11.  COMMUNITY PLANS

The commissioner of health, through the 12 district health offices, shall work with communities in each region to develop comprehensive plans that identify and prioritize community needs relating to wellness and healthy living.  The 12 district health offices shall involve schools, worksites, and other stakeholders interested in improving community health and shall consult existing sources of community‑level population health data.  In drafting the plans, the commissioner shall work with community stakeholders to develop an inventory of policy and environmental supports related to wellness and healthy living.  Such plans shall be made available to the public. 

Sec. 12.  18 V.S.A. § 104b is amended to read:

§ 104b.  COMMUNITY HEALTH AND WELLNESS GRANTS

(a)  The commissioner shall establish a program for awarding competitive, substantial, multi-year grants to comprehensive community health and wellness projects.  Successful projects must:

* * *

(4)  use strategies that have been demonstrated to be effective in reaching the desired outcome; and

(5)  provide data for evaluating and monitoring progress;

(6)  include a plan for ensuring that all food vending machines located in public buildings within the control of the grant recipient contain foods and portion sizes consistent with the Vermont nutrition and fitness policy guidelines or other relevant science-based resources; and

(7)  address socioeconomic or other barriers that stand in the way of fit and healthy lifestyles in their communities.

(b)  The commissioner, through the 12 district health offices, shall assist communities by:

(1)  providing technical assistance to support communities in following a consistent and coordinated approach to planning and implementation, including practices such as needs assessment, defined priorities, action plans, and evaluation;

(2)  providing access to best and promising practices and approved public policies;

(3)  providing assistance to help communities develop public awareness materials and communication tools with well-researched and well-coordinated messaging;

(3) (4)  helping projects communities obtain and maximize funding from all applicable sources; and

(4)(5)  providing other assistance as appropriate.

* * *

(e)  By January 15 1 of each year, the commissioner shall report on the status of the program to the general assembly, the senate committee on health and welfare, and the house committees on human services and on health care by including a section on prevention grants in the annual report of the Blueprint for Health.

* * *

Sec. 13.  INVENTORY OF COORDINATED SCHOOL HEALTH PROGRAMS

The commissioner of health, in collaboration with the commissioner of education and the secretaries of agriculture, food and markets and of transportation, shall compile an inventory of all programs both inside and outside the agencies and departments that award grants or similar funding and that provide technical assistance to supervisory unions and school districts to address issues such as nutrition and physical activity (both indoor and outdoor) for students and staff, obesity, tobacco use, and substance abuse.  The inventory shall include for each program a description of the program purposes, priorities, and any restrictions on the use of funds or technical assistance.  The inventory shall be accompanied by recommendations on how state agencies and other state funding sources may improve coordination of grant awards and technical assistance for school health initiatives and how to work with school districts with a more comprehensive and coordinated approach to planning and implementation, including practices such as needs assessment, defined priorities, action plans, and evaluations and the involvement of school health teams and school health coordinators in community planning efforts.  The recommendations shall also propose a coordinated process for awarding grants to support school health, such as coordination or integration with the community grants process in section 104b of Title 18.  The inventory and recommendations must be submitted to the senate committees on health and welfare and education, the house committees on health care, on human services, and on education, and made available on the internet for review by town offices and school districts, no later than January 15, 2009.

Sec. 14.  NUTRITION GUIDELINES FOR COMPETITIVE FOOD AND BEVERAGE SALES IN SCHOOLS

(a)  The commissioner of education shall collaborate with the commissioner of health and the secretary of agriculture, food and markets to update the current Vermont nutrition policy guidelines applicable to competitive foods and beverages sold outside the federally reimbursable school nutrition programs.  The revised guidelines shall rely on science-based nutrition standards recommended by the alliance for a healthier generation, the institute of medicine, and other relevant science-based resources and shall be available to school districts before the 2008–2009 school year.

(b)  By January 15, 2009, the commissioners of education and of health shall report to the house committees on agriculture, on education, on health care, and on human services, and the senate committees on health and welfare and on education regarding the number of school districts that have and have not adopted a nutrition policy that is substantially the same as the Vermont nutrition policy guidelines applicable to competitive foods and beverages as revised in accordance with subsection (a) of this section.  The report shall include specific information about how policies adopted by the school boards may differ from the Vermont nutrition policy guidelines and include recommendations on how to ensure that all Vermont school districts will meet the state school nutrition guidelines by July 1, 2011.

Sec. 15.  32 V.S.A. § 3802(6) is amended to read:

(6)  Buildings, land and personal property owned and occupied by a Young Men’s Christian Association or a Young Women’s Christian Association for the purposes of its work, the income of which is entirely used for such purposes; or owned and occupied by a health, recreation, and fitness organization, exempt under Section 501(c)(3) of the Internal Revenue Code, for the purposes of its work and the income of which is entirely used for its exempt purpose, and designated by a hospital, as defined in 18 V.S.A. § 9402,  to promote exercise and healthy lifestyles for the community.  A hospital may designate no more than one health, recreation, and fitness facility under this subdivision, and this exemption shall apply, notwithstanding the provisions of subdivision 3832(7) of this title.

Sec. 16.  HEALTHY COMMUNITY DESIGN AND ACCESS TO HEALTHY FOODS

(a)  The commissioner of health, in consultation with the secretaries of agriculture, foods and markets and of transportation, the commissioners of the departments of education, of housing and community affairs, and of forests, parks, and recreation, and the regional planning association, shall make recommendations on how to strengthen strategies for environmental and policy change to increase healthy choices in Vermont communities and how to enhance coordination among existing programs and funding.  In addition, the commissioner, through the 12 district health offices, shall work with communities to support efforts in planning, implementation, and obtaining funding from applicable sources.  Recommended environmental and policy change strategies shall include ways to:

(1)  Promote and support opportunities for physical activity at the community level through increasing access to walking and bicycle paths, bicycle lanes, safe routes to schools, indoor and outdoor recreational facilities, and parks and other recreational areas;

(2)  Increase access to healthy foods in Vermont communities, including local foods, through strategies such as food pricing and economic approaches, food and beverage marketing and promotion, improving access to affordable healthy foods in low income communities, and other promising food‑related policy and environmental strategies; and

(3)  Promote the goals of physical activity, nutrition, and healthy living in planning processes that involve zoning and land use, growth centers, and downtown revitalization.

(b)  The commissioner shall make recommendations in a consolidated report on healthy living initiatives to the senate committee on health and welfare and the house committees on health care and on human services on priorities and recommendations no later than January 15, 2009.

Sec. 17.  HEALTHY WORKSITES

(a)(1)  The commissioner of health shall convene a work group to identify priorities and develop recommendations to enhance collaborative learning and interactive sharing of best practices in worksite wellness and employee health management, through approaches such as statewide or regional worksite wellness conferences, web‑enhanced resources and seminars, and the worksite recognition awards of the governor’s council on physical fitness and sports.

(2)  The work group should examine best practices in Vermont and other states that include:

(A)  Use of premium discounts, reduced cost sharing, or other financial incentives to encourage employee participation in wellness and health promotion activities;

(B)  Strategies to spread the adoption of workplace policies and practices that support breastfeeding for mothers;

(C)  Strategies to reach out to small employers and their employees who lack access to worksite wellness programs, such as the use of the VT 2‑1‑1 information and referral service as an information resource for healthy diet and physical activity, and the use of hospital‑based programs offering classes and one-to-one counseling similar to hospital-based tobacco use prevention programs; and

(D)  Use of financial incentives (such as small grants or tax credits) for small employers to establish worksite wellness programs, and the feasibility of group‑purchasing arrangements to help small employers gain access to worksite wellness products at a lower cost.

(b)  The commissioner shall make recommendations in a consolidated report on healthy living initiatives to the senate committee on health and welfare and the house committees on health care and on human services on priorities and recommendations no later than January 15, 2009.

Sec. 18.  PROMOTING HEALTHY WEIGHT THROUGH PRIMARY CARE

(a)  The commissioner of health shall coordinate with the Blueprint for Health director on practice‑based pilot projects to promote effectiveness in implementing evidence-based recommendations for the promotion of healthy weight and for the assessment, prevention, and treatment of obesity in primary care settings, in consultation with the Vermont child health improvement program and the area health education centers program.  The pilot projects shall focus on best practices in implementation by working with members of the medical practice to design, test, and evaluate strategies for changing office systems to better support efforts to promote healthy weight and prevent obesity in children and adults. 

(b)(1)  The commissioner shall convene a work group comprising the three major insurance carriers in Vermont, the office of Vermont health access, self‑insured employers, school health personnel and students, and health care providers to review recommended best practices in primary care settings for the promotion of healthy weight and for the for the assessment, prevention, and treatment of child and adolescent eating disorders, overweight, and obesity and to recommend changes in coverage and payment policies as needed to support best practices that have a high health impact and cost-effectiveness.  As part of its review, the work group should:

(A)  Review models of successful obesity prevention and care strategies developed by insurance carriers and primary care practices in Vermont and other states;

(B)  Identify the respective roles of health practitioners shown to be most effective and cost-effective in the promotion of healthy weight and the assessment, prevention, and treatment of obesity, including physicians, dieticians, nonmedical counselors, self‑management groups, weight management programs, physical activity counselors, and others;

(C)  Review models for standard third party payment of breastfeeding education and support services;

(D)  Develop a plan for promoting measurement and tracking of the body mass index (BMI) percentile for children and adolescents, such as through the collection of data relating to BMI, lack of physical exercise, and inappropriate diet and eating habits using the ICD‑9‑DM V‑codes in the ninth edition of International Classification of Disease Codes;

(E)  Include in the tracking plan guidelines for how such information will be coordinated and shared in order to maintain reasonable expectations of privacy; and 

(F)  Identify ways that payment policies might encourage stronger relationships among primary care practices, public health supports (such as WIC clinics for children under the age of six years), and school health personnel.

(2)  The commissioner shall make recommendations in a consolidated report on healthy living initiatives to the senate committee on health and welfare and the house committees on health care and on human services on priorities and recommendations no later than January 15, 2009.

Sec. 19.  18 V.S.A. § 11 is amended to read: 

§ 11.  CARDIOVASCULAR HEALTH: COALITION FOR HEALTHY ACTIVITY, MOTIVATION, AND PREVENTION PROGRAMS (CHAMPPS)/FIT AND HEALTHY Advisory Council

The department of health shall:

* * *

(6)  Convene a CHAMPPS/Fit and healthy advisory council chaired by the commissioner of health or designee and composed of state agencies and private sector partners which shall advise the commissioner on developing, implementing, and coordinating initiatives to increase physical activity and improve nutrition and reduce overweight and obesity. 

(A)  The functions and duties of the council shall include:

(i)  Recommending ways that the department of health and other state agencies can reach out to communities, schools, worksites, and municipal and regional planners to assist them in creating environments and policies conducive to healthy living for all Vermonters; and

(ii)  Assessing available resources and funding streams, recommending how best to coordinate those initiatives and resources across state agencies and private sector organizations for the greatest impact, and recommending new initiatives and priorities utilizing data and best-practice guidelines. 

(B)  The department of health shall review the fit and healthy Vermonters prevention plan and the status of its major initiatives with the advisory council at least every three years.  The advisory council shall advise and make recommendations to the department of health as the department develops an annual work plan setting forth prioritized strategies to implement a three-year prevention plan.

Sec. 20.  FOODS CONTAINING ARTIFICIAL TRANS FAT AND MENU LABELING

The Vermont department of health, in collaboration with the Vermont hospitality council, the American Heart Association, and representatives of the food service industry in Vermont, shall develop proposed labeling that will inform consumers of the presence of trans fats in food service facilities.  The department of health shall also recommend methods for making Vermont free of artificial trans fats in prepared foods by 2012.  Recommendations shall be presented to the senate committee on health and welfare and the house committee on health care by January 15, 2009.

Sec. 21.  16 V.S.A. § 133(c) is added to read: 

(c)  Vermont school districts may include a module within the secondary school health class curricula relating to cervical cancer and the human papillomavirus.  The department of education shall work with relevant medical authorities to update the current model module to reflect up-to-date information and practices for health education in this area.


Sec. 22.  AHEC COUNTER DETAILING PROJECT

(a)  The Vermont area health education centers (AHEC) shall establish an evidence‑based prescription drug education program for health care professionals designed to provide information and education to physicians, pharmacists, and other health care professionals on the therapeutic and cost‑effective utilization of prescription drugs.  The program shall use the evidence-based standards developed by the Blueprint for Health, and AHEC shall collaborate with other states that are working on similar programs.  AHEC shall share information that would potentially strengthen programs or leverage limited resources and shall notify prescribers about commonly used brand-name drugs for which the patent has expired within the past 12 months or will expire in the coming 12 months.  The Vermont department of health and the office of Vermont health access shall collaborate in issuing notices.  To the extent permitted by funding, the program may include the distribution of vouchers for samples of generic medicines.

(b)  The sum of $70,000.00 is appropriated from the general fund to AHEC in fiscal year 2009 to support the counter-detailing project, provided that such appropriation shall expire upon collection of the first dollar of the manufacturer fee established in section 2004 of Title 33 and all funds remaining from this appropriation redeposited in the general fund. 

* * * Supporting Health Information Technology * * *

Sec. 23.  22 V.S.A. § 903 is amended to read:

§ 903.  health information technology

* * *

(c)(1)  The commissioner shall contract enter into a grant agreement with the Vermont information technology leaders (VITL), a broad‑based health information technology advisory group that includes providers, payers, employers, patients, health care purchasers, information technology vendors, and other business leaders, to develop the health information technology plan, including applicable standards, protocols, and pilot programs.  In carrying out their responsibilities under this section, members of VITL shall be subject to conflict of interest policies established by the commissioner to ensure that deliberations and decisions are fair and equitable.

(2)  VITL shall be designated in the plan to operate the exclusive statewide health information exchange network for this state, notwithstanding the provisions of subsection (g) of this section requiring the recommendation of the commissioner and the approval of the general assembly before the plan can take effect.  To the extent of its involvement with the operation of the network, VITL shall be immune from civil, criminal, or administrative liability as a result of any action made in good faith; but nothing in this section shall be construed to establish immunity for the failure to exercise due care.  Nothing in this section shall impede local community providers from the exchange of electronic medical data. 

* * *

(g)  On or before January 1, 2007, VITL shall submit to the commission on health care reform, the secretary of administration, the commissioner of information and innovation, the commissioner of banking, insurance, securities, and health care administration, the director of the office of Vermont health access, the senate committee on health and welfare, and the house committee on health care a preliminary health information technology plan for establishing a statewide, integrated electronic health information infrastructure in Vermont, including specific steps for achieving the goals and objectives of this section. A final plan shall be submitted July 1, 2007.  The plan shall include also recommendations for self-sustainable funding for the ongoing development, maintenance, and replacement of the health information technology system.  Upon recommendation by the commissioner of information and innovation and approval by the general assembly, the plan shall serve as the framework within which certificate of need applications for information technology are reviewed under section 9440b of Title 18 by the commissioner.  VITL shall update the plan annually to reflect emerging technologies, the state’s changing needs, and such other areas as VITL deems appropriate and shall submit the updated plan to the commissioner.  Upon approval by the commissioner, VITL shall distribute the updated plan to the commission on health care reform; the secretary of administration; the commissioner of banking, insurance, securities, and health care administration; the director of the office of Vermont health access; the senate committee on health and welfare; the house committee on health care; affected parties; and interested stakeholders.

* * *

(h)  Beginning January 1, 2006, and annually thereafter, VITL shall file a report with the commission on health care reform, the secretary of administration, the commissioner, the commissioner of banking, insurance, securities, and health care administration, the director of the office of Vermont health access, the senate committee on health and welfare, and the house committee on health care.  The report shall include an assessment of progress in implementing the provisions of this section, recommendations for additional funding and legislation required, and an analysis of the costs, benefits, and effectiveness of the pilot program authorized under subsection (e) of this section, including, to the extent these can be measured, reductions in tests needed to determine patient medications, improved patient outcomes, or reductions in administrative or other costs achieved as a result of the pilot program.  In addition, VITL shall file quarterly progress reports with the secretary of administration and the health access oversight committee and shall publish minutes of VITL meetings and any other relevant information on a public website.

* * *

Sec. 24.  E‑PRESCRIBING STUDY

(a)  The director of the commission on health care reform and the VITL project review committee shall conduct a planning and feasibility study to determine the impact of implementing a statewide e‑prescriber program. 

(b)  The study shall address:

(1)  a consideration of the best methods of access to e‑prescribing, including the use of freestanding handheld devices, web-based options, and e‑prescribing modules integrated with electronic medical records; 

(2)  identification of an appropriate business model, including incentives to encourage provider participation;

(3)  an inventory of current e-prescribing activities and existing capacity for e-prescribing in this state;

(4)  a cost-benefit analysis of creating a statewide e-prescriber program;

(5)  the ability of an e-prescriber program to ensure the privacy and security of prescription data, including controls over data-mining;

(6)  state and national studies and reports on data-mining in e-prescribing and the appropriate use of e-prescription information;

(7)  the use of practice management systems and electronic claims data sources through the Vermont health information exchange;

(8)  existing state and national initiatives such as the National e-Prescribing Patient Safety Initiative and Massachusetts’s Partners Health Care; and

(9)  an assessment of the readiness of pharmacies to participate in e‑prescribing and the impact on independent pharmacies.

(c)  No later than January 15, 2009, the director of the commission on health care reform shall report on the findings of the study to the commission on health care reform, the house committee on health care, and the senate committee on health and welfare.


* * * Investing in Vermont’s Health Care System and Workforce * * *

Sec. 25.  HEALTH IMPROVEMENT APPROPRIATIONS

The amount of $60,000.00 is appropriated from the general fund to the Vermont department of health for the child psychiatry division in the Vermont Center for Children, Youth, and Families (VCCYF) to support child tele-psychiatry pilots in community health centers that will: 

(1)  Pair Vermont health centers’ medical, nursing, social work, and psychology staff with the UVM VCCYF child psychiatric consultative team;

(2)  Provide monthly training and education resources for health center staff by UVM faculty;

(3)  Help strengthen and expand the newly established UVM child psychiatry fellowship program; and

(4)  Provide critical child psychiatry assessment and consulting services across the state that will establish relationships to help recruit and retain new child psychiatrists for Vermont.

* * * Fair Standards for Provider Contracts with Insurers * * *

Sec. 26.  18 V.S.A. § 9418 is amended to read:

§ 9418.  payment for health care services

* * *

(i)  If In addition to any other remedy provided by law, if the commissioner finds that a health plan has engaged in a pattern and practice of violating this section, the commissioner may impose an administrative penalty against the health plan of no more than $500.00 for each violation, and may order the health plan to cease and desist from further violations and order the health plan to remediate the violation.  In determining the amount of penalty to be assessed, the commissioner shall consider the following factors:

(1)  The appropriateness of the penalty with respect to the financial resources and good faith of the health plan.

(2)  The gravity of the violation or practice.

(3)  The history of previous violations or practices of a similar nature.

(4)  The economic benefit derived by the health plan and the economic impact on the health care facility or health care provider resulting from the violation.

(5)  Any other relevant factors.

(j)  A health plan in this state shall not impose on any provider any retrospective denial of a previously paid claim or any part of that previously paid claim, unless: 

(1)  The health plan has provided at least 30 days’ notice of any retrospective denial or overpayment recovery or both in writing to the provider.  The notice must include:

(A)  the patient’s name;

(B)  the service date;

(C)  the payment amount;

(D)  the proposed adjustment; and

(E)  a reasonably specific explanation of the proposed adjustment.

(2)  The time that has elapsed since the date of payment of the previously paid claim does not exceed 12 months. 

(k)  The retrospective denial of a previously paid claim shall be permitted beyond 12 months from the date of payment for any of the following reasons: 

(1)  The plan has a reasonable belief that fraud or other intentional misconduct has occurred;

(2)  The claim payment was incorrect because the provider of the insured was already paid for the health services identified in the claim;

(3)  The health care services identified in the claim were not delivered by the provider; 

(4)  The claim payment is the subject of adjustment with another health insurer; or

(5)  The claim payment is the subject of legal action.

(l) Notwithstanding this section, a health plan may not retroactively deny or recoup a pharmacy point-of-sale payment except in the circumstances of fraud, intentional misconduct, a member not receiving the prescription, or error in the processing of the claim. 

(m)  Nothing in this section shall be construed to prohibit a health plan from applying payment policies that are consistent with applicable federal or state laws and regulations, or to relieve a health plan from complying with payment standards established by federal or state laws and regulations, including rules adopted by the commissioner pursuant to section 9408 of this title relating to claims administration and adjudication standards, and rules adopted by the commissioner pursuant to section 9414 of this title and section 4088f of Title 8 relating to pay for performance or other payment methodology standards.

(n)  The provisions of this section shall not apply to stand-alone dental plans.

Sec. 27.  18 V.S.A. § 9418a is added to read:

§ 9418a.  PROCESSING CLAIMS, DOWNCODING, AND ADHERENCE TO CODING RULES

(a)  As used in this section:

(1)  “Claim” means any claim, bill or request for payment for all or any portion of provided health care services that is submitted by:

(A)  A health care provider or a health care facility pursuant to a contract or agreement with the health plan; or

(B)  A health care provider, a health care facility or a patient covered by the health plan.

(2)  “Contest” means the circumstance in which the health plan was not provided with:

(A)  Sufficient information needed to determine payer liability; or

(B)  Reasonable access to information needed to determine the liability or basis for payment of the claim.

(3)  “Health plan” means a health insurer, disability insurer, health maintenance organization, medical or hospital service corporation, or a workers’ compensation policy of a casualty insurer licensed to do business in Vermont, but does not include a stand-alone dental plan.  “Health plan” also includes a health plan that requires its medical groups, independent practice associations, or other independent contractors to pay claims for the provision of health care services.

(b)  Health plans shall accept and initiate the processing of all health care claims submitted by a health care provider pursuant to and consistent with the current version of the American Medical Association’s current procedural terminology (CPT) codes, reporting guidelines and conventions; the Centers for Medicare and Medicaid Services health care common procedure coding system (HCPCS); the National Correct Coding Initiative; the National Council for Prescription Drug Programs coding; or other appropriate standards, guidelines, or conventions approved by the commissioner. 

(c)  Nothing in this section shall preclude a health plan from determining that any such claim is not eligible for payment in full or in part, based on a determination that: 

(1)  The claim is contested as defined in subdivision 9418(a)(3) of this title;

(2)  The service provided is not a covered benefit under the contract, including a determination that such service is not medically necessary or is experimental or investigational;

(3)  The insured did not obtain a referral, prior authorization, or precertification, or satisfy any other condition precedent to receiving covered benefits from the health care provider;

(4)  The covered benefit exceeds the benefit limits of the contract;

(5)  The person is not eligible for coverage or is otherwise not compliant with the terms and conditions of his or her coverage agreement;

(6)  The health plan has a reasonable belief that fraud or other intentional misconduct has occurred; or

(7)  The health plan determines through coordination of benefits that another health insurer is liable for the claim.  

(d)  Nothing in this section shall be deemed to require a health plan to pay or reimburse a claim, in full or in part, or to dictate the amount of a claim to be paid by a health plan to a health care provider. 

(e)  No health plan shall automatically reassign or reduce the code level of evaluation and management codes billed for covered services (downcoding), except that a health plan may reassign a new patient visit code to an established patient visit code based solely on CPT codes, CPT guidelines, and CPT conventions. 

(f)  Notwithstanding the provisions of subsection (c) of this section, and other than the edits contained in the conventions in subsection (b) of this section, health plans shall continue to have the right to deny, pend, or adjust claims for covered services on other bases and shall have the right to reassign or reduce the code level for selected claims for covered services based on a review of the clinical information provided at the time the service was rendered for the particular claim or a review of the information derived from a health plan’s fraud or abuse billing detection programs that create a reasonable belief of fraudulent or abusive billing practices, provided that the decision to reassign or reduce is based primarily on a review of clinical information. 

(g)  Every health plan shall publish on its provider website and in its provider newsletter the name of the commercially available claims editing software product that the health plan utilizes and any significant edits, as determined by the health plan, added to the claims software product after the effective date of this section, which are made at the request of the health plan.  The health plan shall also provide such information upon written request of a health care provider who is a participating member in the health plan’s provider network. 

(h)  In addition to any other remedy provided by law, if the commissioner finds that a health plan has engaged in a pattern and practice of violating this section, the commissioner may impose an administrative penalty against the health plan of no more than $500.00 for each violation, and may order the health plan to cease and desist from further violations and order the health plan to remediate the violation.  In determining the amount of penalty to be assessed, the commissioner shall consider the following factors:

(1)  The appropriateness of the penalty with respect to the financial resources and good faith of the health plan.

(2)  The gravity of the violation or practice.

(3)  The history of previous violations or practices of a similar nature.

(4)  The economic benefit derived by the health plan and the economic impact on the health care facility or health care provider resulting from the violation.

(5)  Any other relevant factors.

(i)  Nothing in this section shall be construed to prohibit a health plan from applying payment policies that are consistent with applicable federal or state laws and regulations, or to relieve a health plan from complying with payment standards established by federal or state laws and regulations, including rules adopted by the commissioner pursuant to section 9408 of this title relating to claims administration and adjudication standards, and rules adopted by the commissioner pursuant to section 9414 of this title and section 4088f of Title 8 relating to pay for performance or other payment methodology standards.

Sec. 28.  18 V.S.A. § 9418b is added to read:

§ 9418b.  PRIOR AUTHORIZATION

(a)  As used in this section:

(1)  “Claim” means any claim, bill or request for payment for all or any portion of provided health care services that is submitted by:

(A)  A health care provider or a health care facility pursuant to a contract or agreement with the health plan; or

(B)  A health care provider, a health care facility or a patient covered by the health plan.

(2)  “Health plan” means a health insurer, disability insurer, health maintenance organization, medical or hospital service corporation or a workers’ compensation policy of a casualty insurer licensed to do business in Vermont, but does not include a stand-alone dental plan.  “Health plan” also includes a health plan that requires its medical groups, independent practice associations or other independent contractors to pay claims for the provision of health care services.

(b)  Health plans shall pay claims for health care services for which prior authorization was required by and received from the health plan, unless:

(1)  The insured was not a covered individual at the time the service was rendered;

(2)  The insured’s benefit limitations were exhausted;

(3)  The prior authorization was based on materially inaccurate information from the health care provider;

(4)  The health plan has a reasonable belief that fraud or other intentional misconduct has occurred; or 

(5)  The health plan determines through coordination of benefits that another health insurer is liable for the claim.

(c)  Notwithstanding the provisions of subsection (b) of this section, nothing in this section shall be construed to prohibit a health plan from denying continued or extended coverage as part of concurrent review, denying a claim if the health plan is not primarily obligated to pay the claim, or applying payment policies that are consistent with an applicable law, rule, or regulation. 

(d)  A health plan shall furnish, upon request from a health care provider, a current list of services and supplies requiring prior authorization. 

(e)  A health plan shall post a current list of services and supplies requiring prior authorization to the insurer’s website. 

(f)  In addition to any other remedy provided by law, if the commissioner finds that a health plan has engaged in a pattern and practice of violating this section, the commissioner may impose an administrative penalty against the health plan of no more than $500.00 for each violation, and may order the health plan to cease and desist from further violations and order the health plan to remediate the violation.  In determining the amount of penalty to be assessed, the commissioner shall consider the following factors:

(1)  The appropriateness of the penalty with respect to the financial resources and good faith of the health plan.

(2)  The gravity of the violation or practice.

(3)  The history of previous violations or practices of a similar nature.

(4)  The economic benefit derived by the health plan and the economic impact on the health care facility or health care provider resulting from the violation.

(5)  Any other relevant factors.

(g)  Nothing in this section shall be construed to prohibit a health plan from applying payment policies that are consistent with applicable federal or state laws and regulations, or to relieve a health plan from complying with payment standards established by federal or state laws and regulations, including rules adopted by the commissioner pursuant to section 9408 of this title relating to claims administration and adjudication standards, and rules adopted by the commissioner pursuant to section 9414 of this title and section 4088f of Title 8 relating to pay for performance or other payment methodology standards.

Sec. 29.  18 V.S.A. § 9408a is amended to read: 

§ 9408a.  uniform provider credentialing

* * *

(d)  An insurer or a A hospital shall notify a provider concerning the status of the provider’s completed credentialing application not later than:

(1)  Sixty days after the insurer or hospital receives the completed credentialing application form; and

(2)  Every 30 days after the notice is provided under subdivision (1) of this subsection, until the hospital makes a final credentialing determination concerning the provider. 

* * *

(f)  An insurer shall act upon and finish the credentialing process of a completed application submitted by a provider within 60 calendar days of receipt of the application.  An application shall be considered complete once the insurer has received all information and documentation necessary to make its credentialing determination as provided in subsections (b) and (c) of this section. 

Sec. 30.  FAIR CONTRACTING STANDARDS STUDY

The Vermont medical society, in collaboration with the department of banking, insurance, securities, and health care administration; the Vermont association of hospital and health systems; insurers; practice managers; and other interested parties, shall work to address the following issues and report to the house committee on health care and the senate committee on health and welfare or before January 15, 2009:

(1)  Fair and transparent contracting standards for providers participating in health insurance plans;

(2)  Categories of coverage;

(3)  Rental networks; and

(4)  Most favored nation clauses. 

Sec. 31.  RESTRICTIVE COVENANTS STUDY

The Vermont medical society, in collaboration with the department of health, the area health education centers program, and the Vermont association of hospitals and health systems, shall work to address the issue of the use of restrictive covenants in employment contracts of health care professionals and the impact of restrictive covenants on recruitment and retention of health care professionals in Vermont and shall report to the senate committee on health and welfare and the house committee on health care on or before January 15, 2009. 

Sec. 32.  WORKERS’ COMPENSATION STUDY

The Vermont medical society, in collaboration with the Vermont association of hospitals and health systems; the department of banking, insurance, securities, and health care administration; the department of labor; workers’ compensation carriers; practice managers; and other interested parties, shall work to address the following issues and shall report to the senate committees on health and welfare and on economic development, housing and general affairs and the house committees on health care and on commerce on or before January 15, 2009:

(1)  Timely payment of workers’ compensation claims;

(2)  Notification and resolution process for contested claims;

(3)  Enforcement of timely payment, including assessment of interest and penalties;

(4)  Charges for examinations, reviews, and investigations in connection with workers’ compensation claims;

(5)  Filing of carriers’ written claims processing practices with the department of labor; and 

(6)  Development of online claim processing and claim tracking systems accessible to health care providers. 


* * * Phase Out of the Health Insurance Safety Net * * *

Sec. 33.  8 V.S.A. § 4080c is amended to read:

§ 4080c.  HEALTH INSURANCE SAFETY NET

(a)  Upon payment of the required premium, the secretary of administration shall make health insurance available for the following:

(1)  Individuals in the nongroup market as of April 1, 1992 and individuals in the small group market as of July 1, 1992 who lose coverage for any of the following reasons:

(A)  Their insurer withdraws from the marketplace in Vermont.

(B)  Their insurer fails to register as of July 1, 1993 as a carrier qualified to provide nongroup insurance coverage.

(2)  Individuals in the group market who prior to December 31, 2008 are terminated, laid off, or otherwise separated from employment and who are not subsequently covered or eligible for coverage under another group health insurance plan.  Eligibility for coverage under this subdivision shall commence at the end of any health insurance continuation right provided by state or federal law.

(3)  Eligibility under subdivisions (1) and (2) of this subsection shall terminate on December 31, 2008.

(b)  Notwithstanding any provision of law to the contrary, coverage under this section shall be offered by nonprofit hospital and medical service corporations chartered in Vermont pursuant to chapters 123 and 125 of Title 8 at substantially similar terms and prices for the period beginning April 1, 1992 and ending when universal access is implemented by the general assembly on December 31, 2011.  The secretary may make coverage available under this section from any other insurer or health maintenance organization licensed to do business in Vermont.  The provisions of section 5115 of this title, relating to the duty of health maintenance organizations, shall not apply to coverage made available under this section.  No person may offer a health benefit plan or insurance policy under this section as a means of circumventing the requirements of section 4080b of this title, and the commissioner shall adopt, by rule, standards and a process to carry out the provisions of this prohibition.

* * *

(d)  Any surplus income realized by a carrier through participation in the program established by this section shall be applied to reduce or mitigate increases in premiums paid by other nongroup policyholders.  As used in this subsection, “surplus income” means a carrier’s premium income, less the carrier’s claims paid and incurred and the carrier’s reasonable administrative costs of no more than eight percent.

(e)  The commissioner shall by rate authorization provide for the phased adjustment of the prices provided in subsection (c) of this section so that for policies or contracts renewing on or after January 1, 2012, rates under this section shall be identical to rates provided in other nongroup policies or contracts offered or issued to individuals, with attention to making such rate adjustment as smooth as practicable over the years 2009, 2010, and 2011.  A nongroup carrier required to offer safety net coverage may withdraw all safety net products for policies or contracts renewing on or after January 1, 2012.

(f)  No later than October 1, 2008, the commissioner shall issue guidelines for the development and approval of a plan for the reasonable phase-out by December 31, 2011 of the separate safety net risk pool established in this section.  On or after October 1, 2008, a nongroup carrier covering lives in the safety net pool may propose a phase-out plan to the commissioner together with such information necessary to review the plan adequately.  The commissioner shall approve the plan if he or she finds that the plan will carry out the purposes of this section, provides adequate protection for lives covered in the safety net pool, and allows former safety net subscribers to choose coverage with any nongroup carrier or purchase any other health insurance product for which they are eligible.  The plan shall be deemed approved within 60 days of an adequate filing, as determined by the commissioner, unless sooner approved, disapproved, or approved subject to such conditions as the commissioner determines are necessary to carry out the purposes of this section and to provide adequate protection for lives covered in the safety net pool.

(g)  This section is repealed as of December 31, 2011, except that such repeal shall not affect the rate authorizations required under subsection (e) of this section or the ability of a nongroup carrier to withdraw safety net rates and forms for policies and contracts renewing on or after January 1, 2012.

Sec. 34.  8 V.S.A. § 4080b(h) is amended to read:

(h)(1)  A registered nongroup carrier shall use a community rating method acceptable to the commissioner for determining premiums for nongroup plans.  Except as provided in subdivision (2) of this subsection, the following risk classification factors are prohibited from use in rating individuals and their dependents:

(A)  demographic rating, including age and gender rating;

(B)  geographic area rating;

(C)  industry rating;

(D)  medical underwriting and screening;

(E)  experience rating;

(F)  tier rating; or

(G)  durational rating.

(2)(A)  The Notwithstanding any provision in sections 4516, 4588, and 5115 of this title, the commissioner shall, by rule, adopt standards and a process for permitting registered nongroup carriers to use one or more risk classifications in their community rating method, provided that the premium charged shall not deviate above or below the community rate filed by the carrier by more than 20 percent, and provided further that the commissioner’s rules may not permit any medical underwriting and screening and shall give due consideration to the need for affordability and accessibility of health insurance.  The commissioner in applying such rule shall not discriminate between or among nongroup carriers.

* * *

Sec. 35.  8 V.S.A. § 4516 is amended to read:

§ 4516.  ANNUAL REPORT TO COMMISSIONER

Annually, on or before March 15, a hospital service corporation shall file with the commissioner of banking, insurance, securities, and health care administration a statement sworn to by the president and treasurer of the corporation showing its condition on December 31.  The statement shall be in such form and contain such matters as the commissioner shall prescribe.  To qualify for the tax exemption set forth in section 4518 of this title, the statement shall include a certification that the hospital service corporation operates on a nonprofit basis for the purpose of providing an adequate hospital service plan to individuals of the state, both groups and nongroups, without discrimination based on age, gender, geographic area, industry, and medical history, except as allowed by subdivisions 4080a(h)(2)(B) and 4080b(h)(2)(B) 4080b(h)(2) of this title. 

Sec. 36.  8 V.S.A. § 4588 is amended to read:

§ 4588.  ANNUAL REPORT TO COMMISSIONER

Annually, on or before March 15, a medical service corporation shall file with the commissioner of banking, insurance, securities, and health care administration a statement sworn to by the president and treasurer of the corporation showing its condition on December 31, which shall be in such form and contain such matters as the commissioner shall prescribe.  To qualify for the tax exemption set forth in section 4590 of this title, the statement shall include a certification that the medical service corporation operates on a nonprofit basis for the purpose of providing an adequate medical service plan to individuals of the state, both groups and nongroups, without discrimination based on age, gender, geographic area, industry, and medical history, except as allowed by subdivisions 4080a(h)(2)(B) and 4080b(h)(2)(B) 4080b(h)(2) of this title. 

Sec. 37.  8 V.S.A. § 5115 is amended to read:

§ 5115.  DUTY OF NONPROFIT HEALTH MAINTENANCE ORGANIZATIONS

Any nonprofit health maintenance organization subject to this chapter shall offer nongroup plans to individuals in accordance with section 4080b of this title without discrimination based on age, gender, industry, and medical history, except as allowed by subdivisions 4080a(h)(2)(B) and 4080b(h)(2)(B) 4080b(h)(2) of this title. 

Sec. 38.  INAPPLICABILITY TO CATAMOUNT HEALTH

The provisions of Secs. 33 through 37 of this act shall not apply to products or coverage offered under Catamount Health pursuant to section 4080f of Title 8.

Sec. 39.  EFFECTIVE DATES

This act shall take effect on passage, except that Sec. 15 of this act shall apply to grand lists of April 1, 2009 and thereafter. 

Senator Kitchel, for the Committee on Appropriations, to which the bill was referred, reported recommending that the bill ought to pass in concurrence, with proposal of amendment.

Thereupon, the bill was read the second time by title only pursuant to Rule 43, and pending the question, Shall the Senate propose to the House to amend the bill as recommended by the Committee on Health and Welfare?, Senator Cummings, on behalf of the Committee on Finance, moved to amend the proposal of amendment of the Committee on Health and Welfare by striking out Sec. 15 in its entirety, and in Sec. 39, by striking out the following: “, except that Sec. 15 of this act shall apply to grand lists of April 1, 2009 and thereafter

Thereupon, pending the question, Shall the proposal of amendment of the Committee on Health and Welfare be amended as recommended by Senator Cummings, on behalf of the Committee on Finance?, Senator Racine moved to substitute a proposal of amendment for the proposal of amendment of Senator Cummings, on behalf of the Committee on Finance, as follows:

     By striking out Sec. 15 in its entirety, and in Sec. 39, by striking out the following: “, except that Sec. 15 of this act shall apply to grand lists of April 1, 2009 and thereafter” and by inserting  in lieu thereof a new Sec. 15 to read:

Sec. 15.  HEALTH CARE REFORM PROPERTY TAX EXEMPTION

     In fiscal years 2009 and 2010 only, the following property shall be exempt from education property tax under chapter 135 of Title 32:  Buildings and land owned and occupied by a health, recreation, and fitness organization which is exempt under Section 501(c)(3) of the Internal Revenue Code, the income of which is entirely used for its exempt purpose, and which is designated by a hospital, as defined in 18 V.S.A. § 9402,  to promote exercise and healthy lifestyles for the community.  A hospital may designate no more than one health, recreation, and fitness facility under this section, and this exemption shall apply notwithstanding the provisions of subdivision 3832(7) of Title 32.

Thereupon, pending the question, Shall the proposal of amendment of Senator Cummings, on behalf of the Committee on Finance, be substituted as proposed by Senator Racine?, Senator Racine requested and was granted leave to withdraw the proposal of amendment.

Thereupon, the recurring question, Shall the proposal of amendment of the Committee on Health and Welfare be amended as recommended by Senator Cummings on behalf of the Committee on Finance?, was decided in the affirmative.

     Thereupon, pending the question, Shall Senate propose to the House to amend the bill as recommended by the Committee on Health and Welfare, as amended?, Senator Racine, moved to amend the proposal of amendment of the Committee Health and Welfare, as amended, as follows:

First:  In Sec. 26, 18 V.S.A. § 9418, in subsection (n), by inserting “or to a workers’ compensation policy of a casualty insurer licensed to do business in Vermont” following “dental plans

Second:  In Sec. 27, 18 V.S.A. § 9418a, in the first sentence of subdivision (a)(3), by inserting “or” before “medical or hospital service corporation”; by striking “or a workers’ compensation policy of a casualty insurer licensed to do business in Vermont,” before “, but does not include”; and by inserting “or a workers’ compensation policy of a casualty insurer licensed to do business in Vermont” following “dental plan

Third:  In Sec. 28, 18 V.S.A. § 9418b, in the first sentence of subdivision (a)(2), by inserting “or” before “medical or hospital service corporation”; by striking “or a workers’ compensation policy of a casualty insurer licensed to do business in Vermont,” before “, but does not include”; and by inserting “or a workers’ compensation policy of a casualty insurer licensed to do business in Vermont” following “dental plan

Fourth:  In Sec. 32, by striking “and” following “department of labor;” in subdivision (5), striking the period following “health care providers” in subdivision (6) and inserting in lieu thereof “; and”, and adding a subdivision (7) to read:

(7)  Uniform claims processing standards for workers’ compensation insurers.

Fifth:  By striking Sec. 38 in its entirety and renumbering the remaining sections to be numerically correct

Which was agreed to.

Thereupon, the pending question, Shall the Senate propose to the House to amend the bill as recommended by the Committee on Health and Welfare, as amended?, was decided in the affirmative.

Thereupon, third reading of the bill was ordered.

Rules Suspended; House Proposal of Amendment Not Concurred In; Committee of Conference Requested; Committee of Conference Appointed

S. 171.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate bill entitled:

An act relating to discharge of a mortgage by an attorney.

Was taken up for immediate consideration.

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

Sec. 1.  27 V.S.A. § 470 is added to read:

§ 470.  VALIDATION OF MORTGAGE DISCHARGE ON ONE-TO-FOUR-FAMILY RESIDENTIAL PROPERTY

(a)  Subject to the provisions of subsection (b) of this section, a mortgage discharge executed on behalf of a banking or lending institution with respect to a mortgage encumbering a one-to-four-family residential real property, including a residential unit in a condominium or in a common interest community as defined in Title 27A, that is not valid because it is not executed by or is not issued by or in the name of the record holder of the mortgage, shall be valid as if it had been issued or executed by the record holder of the mortgage if:

(1)  No person has within three years after the discharge is recorded brought an action challenging the validity of the discharge and recorded a copy of the complaint in the land records of the town where the discharge is recorded; and

(2)  An affidavit is recorded that is dated more than three years after the recording date of the mortgage discharge and contains the following:

(A)  A statement that the affiant has been the record owner of the real property described in the mortgage for at least two years prior to the date of the affidavit.

(B)  The recording information for the mortgage, any assignments, and the release.

(C)  A statement that, since the date of the recording of the release, the affiant has received no demand for payment of all or any portion of the debt secured by the mortgage and has received no notice or communication that would indicate that all or any portion of the mortgage debt remains due or owing.

(D)  A statement that, to the best of the affiant’s knowledge and belief, the mortgage has been paid in full.

(b)  The provisions of this section shall not apply to any release obtained by fraud or forgery.

Sec. 2.  27 V.S.A. § 141 is amended to read:

§ 141.  EXECUTION AND ACKNOWLEDGMENT OF CONVEYANCE

(a)  A homestead or an interest therein shall not be conveyed by the owner thereof, if married, except by way of mortgage for the purchase money thereof given at the time of such purchase, unless the wife or husband joins in the execution and acknowledgment of such conveyance.  A conveyance thereof, or of an interest therein, not so made and acknowledged, shall be inoperative so far only as relates to the homestead provided for in this chapter.

(b)  When a mortgagee takes an accruing mortgage, the only debt which shall be secured thereby or become a lien upon the property described therein shall be the debt described in the mortgage and existing at the time of its execution, and any subsequent direct indebtedness of the mortgagor to such mortgagee; provided, that when the mortgage includes a homestead, the written consent of the wife or husband of the mortgagor to the creation of such subsequent direct indebtedness shall be required.

(c)  If a mortgaged property includes a homestead, any amendment to the mortgage which increases the amount of the indebtedness secured thereby or extends the date of maturity thereof, shall be executed and acknowledged by both spouses.  The failure to obtain the written spousal consent shall not affect the validity or priority of such amendment, but the lien created thereby shall be inoperative so far only as relates to the rights of homestead of such spouse in the mortgaged premises under chapter 3 of this title, provided the amendment is challenged by such spouse before his or her homestead interest is otherwise extinguished.

(d)  Notwithstanding anything to the contrary in this section, a spouse or civil union partner may convey his or her respective homestead interest to the other spouse or civil union partner prior to the time the homestead right vests, thereby divesting the grantor of any homestead interest in the property.  A conveyance of homestead property between spouses or civil union partners shall be deemed to include a conveyance of any homestead interest.  This section shall apply retroactively, except that it shall not affect a suit begun or pending as of July 1, 2008.

Sec. 3.  27 V.S.A. § 348 is amended to read:

§ 348.  INSTRUMENTS CONCERNING REAL PROPERTY LACKING STATEMENT OF CONSIDERATION, OR WITNESSES OR ACKNOWLEDGMENTS, VALIDATED

(a)  When an instrument of writing shall have been on record in the office of the clerk in the proper town for a period of 15 years, and there is a defect in the instrument because it omitted to state any consideration therefor or was not sealed, witnessed, acknowledged, validly acknowledged, or because a license to sell was not validly issued or is defective, the instrument shall, from and after the expiration of 15 years from the filing thereof for record, be valid.  Nothing herein shall be construed to affect any rights acquired by grantees, assignees or encumbrancers under the instruments described in the preceding sentence, nor shall this section apply to conveyances or other instruments of writing, the validity of which is brought in question in any suit now pending in any courts of the state.

(b)  Notwithstanding subsection (a) of this section, any deed, mortgage, lease, power of attorney, release, discharge, assignment, or other instrument made for the purpose of conveying, leasing, mortgaging, or affecting any interest in real property which contains any one or more of the following errors is valid unless, within three years after the instrument is recorded, an action challenging its validity is commenced, and a copy of the complaint is recorded in the land records of the town where the instrument is recorded:

(1)  The instrument contains a defective acknowledgment.

(2)  In the case of a conveyance by a corporation, limited liability company, partnership, limited partnership, or limited liability partnership, or by any other entity authorized to hold and convey title to real property within this state, the instrument designated such entity as the grantor but was signed or acknowledged by an individual in the individual capacity of such person, or fails to disclose the authority of the individual who executes and acknowledges the instrument.

(3)  The instrument contains an incorrect statement of the date of execution, or contains an execution date or other date that is later than the date of the recording.  In case of such conflict the date of recording prevails.

(4)  The instrument does not contain a statement of consideration.

(c)  Notwithstanding the provisions of subsection (a) of this section, any deed, mortgage, lease, power of attorney, release, discharge, assignment, or other instrument made for the purpose of conveying, leasing, mortgaging, or affecting any interest in real property which is executed pursuant to a recorded power of attorney and contains one or more of the following errors or omissions is valid as if it had been executed without the error or omission:

(1)  The instrument was executed by an attorney-in-fact but was signed or acknowledged by the attorney-in-fact without reference to his or her capacity.

(2)  The instrument was executed by an attorney-in-fact but does not reference the power of attorney.

(3)  The power of attorney was effective at the time the instrument was executed but is recorded after the instrument is recorded.

(d)  A release, discharge, or assignment of mortgage interest executed by a commercial lender with respect to a one-to-four-family residential real property, including a residential unit in a condominium or in a common interest community as defined in Title 27A, which recites authority to act on behalf of the record holder of the mortgage under a power of attorney but where the power of attorney is not of record, shall have the same effect as if executed by the record holder of the mortgage unless, within two years after the instrument is recorded, an action challenging the release, discharge or assignment is commenced and a copy of the complaint is recorded in the land records of the town where the release, discharge, or assignment is recorded. This subsection shall not apply to releases, discharges, or assignments obtained by fraud or forgery.


Sec. 4.  9 V.S.A. § 4005a is added to read:

§ 4005a.  FUND HELD IN TRUST; COMMINGLING; NO EFFECT ON TITLE TO REAL PROPERTY

(a)  For the purposes of this section:

(1)  “Claim” means any valid claim for materials furnished or services rendered in the construction, repair, remodeling, improvement, or renovation of any building or structure for which the claimant has a lien or the right to claim a lien.

(2)  “Express trust” means funds that have been paid by an owner, for or in connection with services, labor, or materials used in an improvement of real property, which are to be held by a contractor or subcontractor, in express trust, for those services, labor, or materials.  Any such contractor or subcontractor who accepts money from any owner or contractor shall become the trustee of the express trust that is created pursuant to this section.  The amounts received by such contractor or subcontractor under or in connection with each building project shall be a separate trust and the contractor or subcontractor, or any successor or assign or both of such contractor or subcontractor that hold such trust funds, shall be a trustee thereof.  These funds are not required to be held in any separate account by a contractor or subcontractor.  Such trust shall be effective against and shall have priority over any unsecured interest of a party seeking payment from such contractor or subcontractor for claims other than those that are due and owing by reason of the specific building project for which the trust was created, whether such creditors are foreign attachment or other judicial lien creditors, a trustee in bankruptcy or similar creditors or representatives or creditors of the contractor or subcontractor.

(b)  Funds held in express trust are not required to be held in any separate account by a contractor or subcontractor.

(c)  No express trust shall be required for a federal, state, or municipal project.

(d)  The amount payable to any contractor or subcontractor under any contract for the construction, repair, remodeling, improvement, or renovation of any building or structure shall, upon receipt by such contractor or subcontractor, be held in express trust by such contractor or subcontractor for the payment of all claims that are due and owing, or to become due and owing, by such contractor or subcontractor by reason of such construction, repair, remodeling, improvement, or renovation.

(e)  Any amount required to be held in express trust under this section shall be applied to the payment of the corresponding claims specified in this section.

(f)  Nothing herein shall be construed to create a lien on real property.  The existence of an express trust under this section shall not prohibit the filing or enforcement of a lien against the affected real property pursuant to chapter 51 of Title 9 by any claimant.  A priority lien of a secured lender shall not be subordinate to an express trust.

(g)  In the case of an express trust which is not held by a corporation, limited liability partnership, or limited liability company, liability for sums due under this section shall only attach to the principal or head of the company which holds the funds under the express trust.

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment?, on motion of Senator Sears, the Senate refused to concur in the House proposal of amendment and requested a Committee of Conference.

Thereupon, pursuant to the request of the Senate, the President announced the appointment of

                                         Senator Campbell

                                         Senator Hartwell

                                         Senator Illuzzi

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

Rules Suspended; House Proposal of Amendment to Senate Proposal of Amendment Not Concurred In; Committee of Conference Requested; Committee of Conference Appointed

H. 748.

Pending entry on the Calendar for notice, on motion of Senator Shumlin, the rules were suspended and House proposal of amendment to Senate proposal of amendment to Senate bill entitled:

An act relating to permitting students to possess and self-administer emergency medication.

Was taken up for immediate consideration.

The House proposes to the Senate to amend the proposal of amendment as follows:

First:  In Sec. 1, § 1387(a), by striking out the words “during the school day” and inserting in lieu thereof the words at school

Second:  In Sec. 1, § 1387(b)(2), by striking out subdivision (D) in its entirety.

Third:  In Sec. 1, § 1387(c), by striking out the following: “shall:  (1)  Develop” and inserting in lieu thereof the following: shall develop and by striking out subdivision (2) in its entirety, and immediately following the sentence “The written plan shall prominently state that the medication is solely for the use of the student covered by the plan.” by adding two new sentences to read as follows:  The parties developing the plan of action shall determine both to whom the plan, or notification of the plan, shall be given and the person or persons responsible for doing so.  The plan may include a requirement that the student notify a school employee or agent after self-administering emergency medication. 

Thereupon, pending the question, Shall the Senate concur in the House proposal of amendment to the Senate proposal of amendment?, on motion of Senator Collins, the Senate refused to concur in the House proposal of amendment and requested a Committee of Conference.

Thereupon, pursuant to the request of the Senate, the President announced the appointment of

                                         Senator Nitka

                                         Senator Giard

                                         Senator Doyle

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

Committees of Conference Appointed

H. 615.

An act relating to juvenile judicial proceedings.

Was taken up.  Pursuant to the request of the House, the President announced the appointment of

                                         Senator Nitka

                                         Senator Kitchel

                                         Senator Sears

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

H. 709.

An act relating to campgrounds.

Was taken up.  Pursuant to the request of the House, the President announced the appointment of


                                         Senator Illuzzi

                                         Senator Miller

                                         Senator Carris

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

H. 889.

An act relating to the State’s transportation program.

Was taken up.  Pursuant to the request of the House, the President announced the appointment of

                                         Senator Mazza

                                         Senator Scott

                                         Senator Kitchel

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

H. 891.

An act making appropriation for the support of government.

Was taken up.  Pursuant to the request of the House, the President announced the appointment of

                                         Senator Bartlett

                                         Senator Sears

                                         Senator Snelling

as members of the Committee of Conference on the part of the Senate to consider the disagreeing votes of the two Houses.

Message from the House No. 59

     A message was received from the House of Representatives by Ms. Wrask, its Second Assistant Clerk, as follows:

Mr. President:

I am directed to inform the Senate the House has considered Senate bills of the following titles:

S. 114.  An act relating to enhancing mental health parity.

S. 336.  An act relating to juvenile judicial proceedings.

S. 354.  An act relating to public agency deferred compensation plans.

And has passed the same in concurrence with proposals of amendment in the adoption of which the concurrence of the Senate is requested.

     The House has considered Senate proposals of amendment to House bill of the following title:

     H. 94.  An act relating to retail sales and taxing of specialty beers.

And has concurred therein with proposals of amendment in the adoption of which the concurrence of the Senate is requested.

The House has considered Senate proposals of amendment to House bills of the following titles and has refused to concur therein and asks for Committees of Conference upon the disagreeing votes of the two Houses to which the Speaker has appointed as members of such Committees on the part of the House:

H. 11.  An act relating to the commissioner of health.

                                         Rep. Donahue of Northfield

                                         Rep. McAllister of Highgate

                                         Rep. Andrews of Rutland City

H. 290.  An act relating to underground utility damage prevention system.

                                         Rep. Livingston of Manchester

                                         Rep. Consejo of Sheldon

                                         Rep. Shand of Weathersfield

H. 432.  An act relating to Juneteenth National Freedom Day.

                                         Rep. Pearson of Burlington

                                         Rep. Jerman of Essex

                                         Rep. Grenier of St. Johnsbury

H. 515.  An act relating to the collection and disposal of mercury-added thermostats.

                                         Rep. McCullough of Williston

                                         Rep. Randall of Troy

                                         Rep. Martin of Springfield

H. 617.  An act relating to guardianships.

                                         Rep. Jewett of Ripton

                                         Rep. Gervais of Enosburg

                                         Rep. Flory of Pittsford


H. 711.  An act relating to agricultural, forestry, and horticultural education.

                                         Rep. Godin of Milton

                                         Rep. Stevens of Shoreham

                                         Rep. Peltz of Woodbury

H. 806.  An act relating to public water systems.

                                         Rep. Randall of Troy

                                         Rep. Lewis of Derby

                                         Rep. McCullough of Williston

The House has considered Senate proposal of amendment to House proposal of amendment to Senate bill of the following title:

S. 290.  An act relating to agricultural water quality financing.

And has refused to concur therein and asks for a Committee of Conference upon the disagreeing votes of the two Houses;

And the Speaker has appointed as members of such Committee on the part of the House

                                         Rep. Lawrence of Lyndon

                                         Rep. Spengler of Colchester

                                         Rep. Browning of Arlington

Adjournment

On motion of Senator Shumlin, the Senate adjourned until eleven o’clock in the morning.

 



Published by:

The Vermont General Assembly
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Montpelier, Vermont


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