March 27, 2021

 There were many major bills on the floor in the past week and I encourage folks to contact me or Rep. Ken Goslant if you want more background on any of them. 

We have passed on to the Senate this year’s annual budget, the two-year capital construction bill, and the transportation budget. We also passed the education tax rate bill, a major economic development bill, broadband build-out, and child care support reforms. Most of these bills had my support.

There was a bombshell regarding the review of options to address the crisis in the pension for state employees and teachers. Rather than crafting a joint bill as a committee, the chair and vice-chair released a detailed proposal that uses increases in employee contributions to addresses the shortfall from past state mismanagement. 

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The Budget

I voted for the budget with a fair amount of trepidation. The base budget of revenues and programs is balanced and reasonable. It exercises fiscal restraint, which is particularly important given the uncertainties as we pull ourselves out of a pandemic. In conjunction with the amounts for the economic development and workforce and the broadband bills, it appropriates $650 million from the new federal COVID-19 “rescue” fund.These were all solid and constrained to single-time investments – not building new programs that will then require ongoing future state budget expenditures. In addition to the items in the bills above, it includes clean water, higher education, and sate IT system investments.

My concern is that we are looking at a total federal influx of about double that -- $1.3 billion -- in money that can be spent over the next three years, and are making spending decisions on half of it without establishing a big picture on overall priorities and how the full pie should be divided up. It is a bit like spending half the money to build part your house without knowing what you need for the rest of it and whether you will have enough money left.

The base budget does include $360 million from our state funds to sustain our current pension obligations ($100 million more than what was required last year) plus – by moving the new federal money to backfill state funds -- $150 million in addition to address the current shortfall. But that is only a drop in the bucket compared to what is needed...

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The Pension Dilemma

I share in a strong desire to ensure that we don't back off our obligations based on our (as a state) prior mismanagement with the various state and teacher pension funds that have resulted in the $5.7 billion hole. I also agree that we should avoid decisions with a long-term impact, precipitously. Addressing those points have more complexity than may appear. 

The shortfall has built up over many years due in significant part to the state’s failure to fund its obligations, but is also based on acceptance of misguided actuarial assumptions without regular review of actual performance of investments. The boards making those decisions included employee representatives and included increases in benefits over the years – and, incomprehensively, different boards made benefit decisions from those making investment decisions. Revision of that structure is part of the reforms needed. Delay in action even for a year would have a huge impact on the ongoing exponential growth of the current shortfall. 

This past week was the first time that I and our caucus members were told about the plan presented by legislative leaders, so we hope there will be a great deal more testimony and input before a decision is made by the Government Operations Committee and brought to the House floor. When it reaches the floor, I will need to make a decision about whether a proposed resolution is fair and responsible. Once it leaves the House it goes to the Senate which will be able to change it as they see fit and then negotiate that with the House; it then goes to the Governor for his decision. So, we are still at a beginning phase. 

If you or anyone you know would like to send written testimony to the Government Operations Committee regarding specifics you should do so here: testimony@leg.state.vt.us. The details on the current proposals for change can be found at the legislative web site, legislature.vermont.gov by going to the committee web page and looking under Documents, date tab for March 24, under Chris Rupe. Two public hearing were scheduled but both filled quickly. You can watch the hearings on the same committee page; click on livestream and then on the archived YouTube link for the dates of March 26 and 29.

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Taxes: Education Fund

We voted out the base education property tax rate (the statewide one, which can shift locally based on town budget votes), which will go down next year by about 1.5 cents on the dollar. Before celebrating, we need to remember we’ve been in this place before, when costs continued to grow but tax increases were hidden because tax rates declined. Home sales are a hot market right now. The increased prices will drive up the grand list and thus revenues will increase while the rate stays the same or goes down. If your home value goes up on paper because other homes are being sold at higher prices, your taxes will go up even if the rate decreases. Increased spending doesn’t just vanish; we still pay for it.

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More on Taxes

We also raised a tax; one that appeared to place a small burden on very wealthy folks – those buying homes worth more than $1 million -- to help out those struggling just to buy a mobile home, by expanding the current tax credit that helps them. But recall the current increases in the market. This is resulting in major increases in the existing property transfer tax revenues. The mobile home tax credit can be increased without an added tax.

The property transfer tax also applies to far more than high-end homes. It applies to purchasers of rental properties, where costs will be passed on to low income tenants. It applies to businesses, which have been hit hard by the pandemic – and those costs will be passed on to the purchasers of goods and services. This is terrible timing. I voted no. Although several moderate Democrats joined most Republicans in opposition, the tax increase passed.

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Capital Bill

The only issue in contention in the capital bill was the construction of a new mental health facility that will replace a decrepit, temporary 7-bed building in Middlesex. The original was a set of trailers intended to last only a few years, set up after Tropical Storm Irene to replace state hospital beds that were used for a small group of patients who did not actually still need hospital-level care, but still did need a locked setting due to unresolved safety concerns. No one questioned the urgent need to replace that structure. 

The concern was about the expansion of more state, institutional beds (the new program will be 16 beds) without addressing the need for residential supports in the community for other Vermonters who are also remaining in hospitals because of lack of access to the post-hospital support they need. A shortage of community services feeds on the need to increase higher levels (and higher cost) care. Over the past ten years, utilization of hospital beds has nearly doubled, while access to community support has been stagnant. We added 12 highest-needs beds two years ago, which are just now about to open. That’s backwards, and the cost of running this new facility will suck more money away from the ability to support other Vermonters’ needs. 

My Health Care Committee, which is responsible for policy, took extensive testimony on this concern. We reached a compromise with the Institutions Committee, which is responsible for meeting the need for essential new state construction. That committee has been working for years to get this new facility built, and the construction will go forward.

Language from our committee that I drafted was added, however, to ensure flexibility in design to allow for future changes to address other needs. They also accepted policy language for a directive to the Department of Mental Health to identify community projects over the next nine months that might be able to be funded with the new federal infrastructure money. Operating costs then may be able to be addressed with the new federal bridge funding for several years, and then replaced by state funds saved as hospital levels are reduced. 

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Remote Vote Crisis

We had our first mini-crisis with remote voting. A thunderstorm rolling through briefly locked out several members from a vote, and when one member got up to ask if there was a way he could vote afterwards, he was told that House rules barred it. 

We started on a new bill, and I jumped up (figuratively) to call a point of order. Given our unique status in functioning from home computers, I felt we needed to find a way to preserve members’ ability to vote. A path forward was found by voting to suspend our own rules to allow a revote on the bill. The Rules Committee will be meeting to review this issue more broadly. 

After all, thunderstorm season is upon us...

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It is an honor to represent you. Please contact me (adonahue@leg.state.vt.us) or Ken (kgoslant@leg.state.vt.us) any time for questions. Remember that you can access any of my updates from the past on my blog representativeannedonahue.blogspot.com.

March 13, 2021 Update

 It’s been a busy week facing the deadline for bills to be voted out of committee if they are to be considered by the Senate this year, and these bills will be flooding the House floor for consideration in the next few weeks. Those that require money to implement must make a stop next in the Appropriations Committee, which much balance them against the overall needs and revenues of the state.

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Votes Last Week

Two controversial bills came up for House roll call votes this past week.

First was a Montpelier charter change to allow legal residents who are not citizens to vote on local Montpelier ballot items. Vermont law doesn’t allow towns to change their own charters without approval of the legislature. I felt this was a Montpelier voter decision about voting on Montpelier issues, which is not related to any state voting issues and sets no state precedent, so I voted yes. It passed 103-39.

The second makes it explicit in law that a judge can order a person to temporarily relinquish firearms prior to a court hearing when there is a domestic violence restraining order and it appears that there is a threat. Because there is no time for a hearing in advance, it is termed an “ex parte” order: the subject does not get to appear and give their side.

The primary opposition centered on whether a constitutional right should be suspended in this way based on the routine standard used in civil cases, which is call “preponderance of the evidence,” meaning that it is more probable than not, or weighs more than 50% on the scale of certainty. The higher standard requires a showing of “clear and convincing,” and criminal convictions require “beyond a reasonable doubt.”

There are rarely topics where I believe an issue is absolute, with no balancing of rights involved. I have opposed the overwhelming majority of bills placing restrictions on Second Amendment rights because I felt the rights were impacted in a significant way and the restriction was not something that would actually help reach the public safety goal that was articulated.

 This was an instance where I felt the balance fell towards allowing a temporary removal. The existing law permits even a child being taken from a parent “ex parte” based solely on preponderance of evidence of a claimed risk. There is urgency for these emergency orders, and the suspension of a right before the hearing can occurs is brief.

The vote on the bill was 101-41. (Everything is archived on YouTube now, so if you want to see my explanation on the House floor, you can check last Thursday’s video and go in to about the 1 hour, 46 minute spot.)

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Up Next Week

One of the bills on the calendar next week is on registration and certification of residential contractors. The purpose is to protect consumers. It applies to jobs that exceed $2,500 in cost. The registration would be mandatory; certification would be an option for those who want to be able to demonstrate to customers that they have qualifications that have been verified by the state. The registration requires a minimum level of liability coverage and the use of written contracts. 

I’m not generally in favor of the endless increase in the various occupations we put under state oversight. This bill does seem to make some sense, but it came out of the committee with a split vote, so I’ll be considering the reasons for opposition in the floor discussion.

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Health Care Bills

My committee passed four bills for the “crossover” deadline. Three were unanimous, and one was with one vote in opposition. 

Telehealth continues to be a major factor in our continuing virtual world, but providers must be licensed in Vermont to practice here, and “practice here” includes via telehealth. We had a bill proposed to approve telehealth practice by a mental health counselor who was licensed out of state but had an existing client who moved to Vermont. It turned out that there were a lot of complicating issues, plus a question about why we shouldn’t consider all medical professionals. We rewrote the bill to create a work group that will review all the issues and recommend legislation next year.

Sometimes it seems like we punt on a lot of subjects by setting up work groups. The reality is that if we were to do reasonable due diligence on every issue, we could easily take up half a session on one bill – or need to be a year-round legislature – so this avenue often makes sense.

A second bill addressed several mental health hospitalization topics. There is a lot of focus and oversight regarding people who are held involuntarily as a “danger to self or others,” and that’s appropriate because there are serious civil liberties at issue.

That obscures the fact that 90% of people admitted for psychiatric care are there voluntarily, just like the person who has sought admission because of a heart attack or to have a baby. Vermont’s small scale, however, means that our inpatient psychiatric units are not segregated to have locked units only for involuntary patients. This bill requires informed consent, so that someone seeking admission knows in advance that they will be in a locked unit, and may be stopped from leaving if they ask for discharge and are found to be at risk to self or others – and thus subject to the involuntary hospitalization law.

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Two With Money

 Our other two other bills will go to Appropriations first.

Dr. Dynasaur is the umbrella name for our Medicaid programs that cover children and pregnant moms from low income families. As a partially federally funded program, Medicaid is very limited in the coverage that is permitted for undocumented immigrants.

Do we want to leave children without protection (born or unborn) based on an immigration status? Note that urgent care is always provided, but we pay for it in more roundabout ways. A Mom who had no prenatal care and gives premature birth, with high costs for the preemie, will get the care. The parents might get hounded for payment but it will be swallowed up into the hospital’s “bad debt” which is then cost-shifted to everyone’s insurance premiums.

Investing in preventative care through a state-funded program is not only the humane thing to do (or, in the words of a colleague, “the Christian thing to do”), but it also saves money. About half of these folks are here legally but their full status is still being processed; most of the others are our migrant farmworker families. The estimate is that this will involve about 22 pregnancies and 100 children. Our committee was unanimous on a bipartisan basis in voting for this bill.

The second bill represents the major work of the session for our committee. 

We have been conscious for many years about the facts that there are groups of people who, on average, have significantly worse health outcomes than everyone else. COVID brought it to the forefront. The primary groups are “BIPOC” (Black, indigenous and people of color); LGBTQ, and people with disabilities.

The reasons include a wide range of historic inequities or discrimination carried over to current hidden biases, many of them listed with source citations in the bill’s findings section.  Here are just a few of the examples:

Vermont was part of the eugenics movement of the 1930s, where people were sterilized without consent because we believed they were inferior and needed to be prevented from having children. It was used against immigrants of the time (mostly French-Canadian) and those in state institutions. It was seen as a money-saver when it came to the cost of caring for future generations of those deemed to be “insane” or “imbeciles.” No group was hit as hard, though, as the Abenaki people. That deep wound at the hands of our society led to an ongoing fear and suspicion of our medical professions, and thus, less use of appropriate medical care.

Blacks held back by generations of discrimination by law face greater challenges in basic steps forward such as homeownership, better neighborhoods, or educational opportunities. With higher rates of poverty, crowded housing, environmental toxin exposures, and lack of access to healthier foods, it should not be a surprise that there are higher rates of the kinds of overlying health conditions that make any other illness – like COVID -- more severe.

There are also unrecognized biases by health providers themselves. One example is called “diagnostic overshadowing.”  It means that if a person comes in for care with the label of “mentally ill,” a provider may allow that label to overshadow the recognition of an underlying condition.

Our bill would create a broad Commission to develop standards for data collection and to make recommendations about creation of an Office of Health Equity within our Department of Health. The original bill came to us proposing the immediate creation of such an office, and I wasn’t sure that was the right direction. 

Changing the bill to bring in the voices of all those groups most affected by health disparities first is the right way to identify the best path forward on how to address them. We have an expression in the disability community: “nothing about us, without us.” In other words, don’t help us by deciding us what is best for us. Listen to us to learn what is needed.

The one committee member who voted against the bill was not opposed to its goals, but believed we should be working through existing state agencies, rather than setting up a Commission to develop a separate, new office within the Department of Health.

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Next for Us

Our committee’s next task is not a bill; it is a recommendation we need to make to the committee that handles the budget for new construction. The Department of Mental Health wants to move ahead with a new facility that will add nine beds as it replaces an existing, 7-bed locked step-down program for current patients in our highest security level of involuntary inpatient care. It believes this is the best way to address the ongoing problem of long delays in emergency rooms for patient in a mental health crisis, because if more current patients have a place to “step down,” inpatient beds will open up.

The Department’s own reports, however, show that we also have people who stay in the hospital longer than needed because of the lack of supported community housing, nursing home beds, or group homes. The Department also reports that community crisis teams are so short-staffed that they only respond to screen emergency room patients. They have no time to fulfil their intended function, which is to respond to a person in crisis to help avoid the need to go to the hospital.

When there are limited resources at every turn, the question we need to weigh is which steps we should prioritize.

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  It is an honor to represent you. Please contact me (adonahue@leg.state.vt.us) or Ken (kgoslant@leg.state.vt.us) anytime to share your input, ask questions, or raise concerns. My full archive of legislative updates can be found at representativeannedonahue.blogspot.com.