The inner dynamics of a legislative body is fascinating, and I get a window into it by being a committee vice-chair and a member of the House Rules Committee. It’s a window into, but not membership, in the power-brokering that occurs with the Speaker and committee chairs. For this special session to finish the budget work and further allocate federal relief funds (work that was too risky to do in June when so much was unknown), those two items remain the priority. However, if there is time before the budget is passed, each chair has been told that he or she can prioritize one other bill in their committee to try to get across the finish line.
Health Care Priorities
My Health Care Committee chair and I have agreed that our priority is the passage of a health care workforce development bill that we had completed in February but that is being considered by the Senate. Assuming the Senate makes no changes to it so it doesn’t need to come back to us, the priority bill will become our hospital price transparency bill. The Senate is making changes to that one, so we will need to use our limited committee time to review that work and decide if we can agree in order to get it through.
Our health care work force was in crisis long before the pandemic, and we took testimony early in the session to dig deeper into it. We concluded that the most urgent gaps were in nursing at all levels and in primary care physicians, and that one opportunity would be through scholarship assistance for those two fields. We identified money towards these scholarships through accessing some that had been left partially unused from reserved funds from a court settlement.
Hospital price transparency is another really important issue. We got stakeholder consensus on a path forward to enable consumers to identify in advance what the actual costs to them would be for different procedures and among different hospitals. While many states have done similar things, the catch is that creating a user-friendly data base can be really expensive.
Our Senate counterparts like that bill, but want to add some new components – some things that are actually a new topic that would normally be a separate bill. So, if we want our bill to pass, we’ll need to take testimony from those affected in the small amount of remaining time. There are other bills we have received from the Senate, each of which would similarly require review time. The Senate says this new one is its priority, so it will be those others that are put off to be restarted next year.
Mental Health Crises
Speaking of needing “to take testimony from those affected,” which I think is a critical part of our job, our committee was asked by the Speaker to taken on the review of another topic that came a bit out of the blue. The governor’s budget arrived in the House three weeks ago with a proposal to add seven positions for mental health workers “embedded” in state police barracks. It was in the Department of Public Safety budget, so under the division of labor among committees, it didn’t come to our health care committee for review.
There is pretty widespread consensus that we’ve been asking police to be all things to all people, which had contributed to some of the current need for policing reforms. “Jack of all trades, master of none.” We can expect abilities to de-escalate and stabilize crisis situations, but we can’t expect every officer to be a mental health counsellor or expert on top of the myriad other responsibilities we place upon them. We are really pleased that the governor recognized this as a sufficient priority to find funds in a tight budget to expand mental health support. (On Friday, the governor also announced a number of other policing reform initiatives the administration is implementing in advance of any pending legislation.)
A few weeks ago, an increase in funding for mental health outreach was selected as the most important priority for policing reform in a survey completed by 1,446 people in Vermont. In all, 62 percent of those responding said it was “extremely important,” the highest ranking of any of 10 suggested reform initiatives. More than one item could be selected in the survey. The next highest rankings were for increased training in de-escalation skills (54%) and requiring the use of body cameras (53%).
So, this is a critical initiative, but it also needs to be done right. Neither the Department of Public Service, in drafting the proposal, nor the Senate members who were pushing for it, actually talked with those who would be affected: neither with the clinical community, nor those who are part of the community of people who have experienced mental illness, like myself. Many years ago, when I was still dealing with significant symptoms, I was involved in two different situations where police were part of intervention. One was superbly handled; the other was significantly mishandled. So, I know this topic up front and personal.
We need the mental health-law enforcement collaboration, but there are many different models for how to achieve it. A core question: should this be a mental health system program that responds to assist police, or should it be a police department program that incorporates mental health staff as an arm of its own organizational structure? When the expansion proposal was discovered buried in the Public Safety budget there was some immediate concern about the model and why others weren’t involved in the planning. So, the Speaker intervened to ask our committee to rapidly dive in to take broad-based testimony and make a recommendation to the Appropriations Committee by the end of this coming week. The House budget will be finished this Tuesday, so there was “placeholder” language included to reserve the funding while our committee does its review.
The budget includes one specific proposal from our committee on further use of the remaining federal coronavirus relief funds. In the June allocations, we had asked for $1,000,000 to be put into special support for Vermonters who are members of “health disparity groups” who might need specific intervention – supports outside of what the general population needs. This included three groups where the particular concern was the higher risks from imposed social isolation: elders, people with disabilities, and LGBTQ youth. It also included groups with disproportionate rates of COVID-19 due to systemic health disparities: people of color and immigrant or migrant groups. The Health Department said they already had some emergency federal funds for that purpose, so our request was cut in half to $500,000.
Last week we heard what’s been done to date, and it was clear that although good work had happened, many of the groups we felt needed to be addressed had not received attention. We asked for an additional coronavirus relief fund appropriation of $1,000,000, including more explicit instructions about who to reach out to for identifying the specific needs, and the Appropriations Committee has added that to the budget.
One bill that moved forward last week will allow Efficiency Vermont some flexibility in the use of the money raised through our electric bill surcharges. This highly successful program (it is a 4-to-1 return on investment) was created to focus on reducing electricity use. This bill will allow EV to strategically use $2 million of its $60 million budget to address efficiencies in heating and transportation. It does raise or spend any new money, but allows an added range of use. Coming up this week, it is expected that the Senate changes to the Climate Solutions Act will be coming to the House floor for final approval.
The marijuana tax-and-regulate bill was locked in a conference committee standoff between House and Senate, but each made major concessions last Friday afternoon. It appears that the final area of disagreement is solvable, so this bill is likely to move forward. The House has passed bills numerous times to make seat belt use a matter of “primary enforcement” (you can be pulled over for that alone; currently, there has to be another reason for the stop before you can get a seat belt ticket). Each time, the Senate has killed it. So, under the umbrella of the highway safety components of the marijuana bill, the House added seat belt enforcement. On Friday, the House agreed to drop that piece.
The saliva test in the House version (with the requirement of a warrant) has the purpose of screening drivers for drug use, similar to alcohol. The problem is that it isn’t remotely as accurate. It only detects presence of a substance, which could include marijuana legally used days ago. The Senate was adamantly opposed but has now agreed to it. The final big split was about whether towns have to hold a vote before a sales outlet can open in their community, or whether outlets are presumed to be permitted unless a town has a vote to prohibit. The Senate has now accepted the “opt-in” requirement.
That leaves only the disagreement over a tax structure component regarding how towns that permit sales outlets can share in financial benefits.
Please feel free to contact Rep. Ken Goslant (firstname.lastname@example.org) or me (email@example.com) at any time with your inquiries or input. It is an honor to serve you. You can see all of my past updates at representativeannedonahue.blogspot.com