May 22, 2021 Legislative Update

 

Well, for better or for worse, we’re finished for this year. The final action was, as usual, next year’s budget which begins July 1. It appears to show a staggering increase from two years ago, by more than a billion dollars – an increase of more than 16%.

But that number should sound familiar – it’s roughly the amount we’re received each of the past two years in emergency federal funds. So, the “real number” is much lower, and it’s important to understand the difference between our base budget and what we call “one-time” funds.

The base budget funds all of our ongoing budget for the operations of government. It increases based upon inflationary costs, pay increases, and any new programs intended to continue in future years. One-time appropriations are those that are for single-year expenses. They can create a future pressure because people want them to continue (at an increase to the base budget), but they come with no promise that will happen.

The base budget of state funds increased by 4.5 percent this year and 5.4 percent last year, so a 10% increase in the past two years -- from $4 billion to $4.2 billion to $4.4 billion. This includes the transportation and education budgets. The full base budget also includes hefty annual federal support, much of that coming through Medicaid funding. That has increased over the past two years from $2 billion to $2.2 billion to $2.3 billion. So federal funding is about a third of our total annual budget.

The most important question to many folks is whether the full budget reflects increases in our existing taxes, or requires an increase in tax rates or through new taxes. As has been true for several years back, this year’s budget does not require additional revenues; it reflects increased revenues from our existing tax base – including the “January surprise” -- a much healthier revenue flow than what was expected with the economic impact of COVID.

We added some 19 permanent state positions this year, and despite the fact that it did not require new taxes to cover them, it does concern me. This is the first time in many years that we have added this many new permanent positions. While the costs of these are included in the final, balanced budget, it locks in that cost. If we hit future tight budgets, it adds to the angst involved in potentially laying off staff.

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The competing needs in the state are always very difficult to balance, because there are many. No one can get every piece they want; compromises are necessary. I was comfortable with the bottom line, despite some choices I didn’t support, and I voted yes; the overall vote was unanimous. In a follow-up year-end update, I’ll list some of the key investments made through the federal rescue act funds along with other budget highlights.

I recognize some folks don’t believe any increases in the base budget should be considered, so I’m going to drill down on one example of need. The budget includes a 3% increase for our community mental health agencies. At the same time, the budget includes a 4.1% average increase to state staff. This difference happens year over year, so the disparity continues to grow more extreme. The result is that staff leave the community agencies in order to try to make a better living, and by most recent count, the agencies have 780 vacant positions.

One result is that children in mental health distress currently have a six-month wait to access counseling. Is it any surprise that their conditions get much worse? We are seeing increased numbers of children who live in our hospital emergency rooms for days, or occasionally even more than a week. The term used is “boarding.” They have a mental health crisis so severe that it needs inpatient care, and there are not enough beds. It many cases, it would have been avoided if they got care sooner.

Now there is a new impact as well. Private, for-profit businesses are opening up shop to compete for contracts with our schools for the mental health supports needed for students. Those businesses are pilfering community agency staff by paying higher salaries. They are turning around and offering contracts to schools that have less robust services, yet are more expensive.

Why would a school system choose a higher cost contract rather than through the local community agency (in our case, Washington County Mental Health)? Because the agencies have too many vacancies to supply the staff that the schools need. This downward spiral will cost more in school budgets while offering less support to students and increasing fiscal instability for our community agencies.

Salaries at community mental health agencies not eligible for federal rescue act funding. They are part of our competing base budget priorities.

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The budget isn’t the only place with competing interests in the same bill.

Three examples from last week: The housing bill includes crucial investments in affordable housing. It also creates a state rental housing registry (with five new state positions to run it) -- onerous because the cost would be borne by landlord fees that will be passed on in rent increases. I voted against the registry but when it was merged into one bill, I voted for the bill as a whole. The housing investments were too important. That bill remains awaiting Senate action.

Similarly, the unemployment bill made essential changes to how to maintain the Trust Fund but also prevent radical increases for business. It did this by discounting last year’s layoffs from the rating system that penalizes high layoff rates. It also included important investments to build our workforce. The same bill added $100 a month to unemployment benefits once the federal supplements end. There are a number of arguments against doing this as the crisis comes to an end, but for me the other parts of the bill outweighed the dispute over that issue, so I voted in support.

In terms of the cannabis bill, last year the House unanimously accepted my proposal that we not permit advertising when the new legal market begins. Legal sales with regulation are supposed to be about reducing the illicit market and increasing user safety through having potency and product purity standards. Identified priorities in the statute include not supporting increases in use. The Senate blocked the ban and we ended up with a bill with no advertising oversight at all, instead putting the issue off for negotiation this year.

When the advertising limits bill came out this year, I proposed a narrower addition that would prohibit advertising that was specifically targeted at increasing cannabis use. This time – in fear of Senate rejection of even that – the committee voted against it and it thus lost on the House floor, even though a number of Democrats joined Republicans in support. Despite that, I voted for the bill; without it, we would move ahead with no advertising restrictions at all.

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When off-season committees meet this summer and fall and the legislature returns next January, it will be in person. The only exception would be a return of emergency restrictions on capacity or distancing.

The resolution making that change added authority for the Joint Rules Committee to place limits on public access when legislative committees begin meeting back in the statehouse. I’m on the House Rules committee, and I objected vociferously. If we are in the statehouse, I will not abide by limits on public access.

So, it was revised into two parts. There can be conditions on public access if needed for safety, such as a face mask requirement. (Our air-handling equipment provides seriously inadequate ventilation.) However, access itself cannot be limited.

For indoor spaces, we have always had capacity limits. Public hearings, for example, often draw a large crowd that cannot safely enter the House chamber. An “overflow room” is set up, with audio-visual access. Thus, with my support, authority for limiting access for inside spaces remained in the resolution.

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As Rep. Goslant and I return to our regular “day jobs,” we remain available for questions or assistance. You can contact me at adonahue@leg.state.vt.us or Ken at kgoslant@leg.state.vt.us. All of my legislative updates for this year – and years past – can be accessed at representativeannedonahue.blogspot.com.

May 9, 2021 Legislative Update

 Let’s see if I can “write tight” and touch on a number of the items in play in the final two weeks of the session.

I am on the House Rules Committee, and we are in the middle of grappling with how to safely return to the statehouse next January. There are a number of competing interests. If we are in person, public access must be fully open as well. We are committed to that. But long before the pandemic, it was well known that the statehouse was an unhealthy place to be – and not just because of the bills being discussed!

The old air handling system is not adequate and in fact a few years ago a major mold problem developed in one wing, which had to be vacated for repairs. Because our processes are open, small committee rooms became stuffed with people – sometimes standing room only, clearly violating fire codes. It was a running joke about these rooms being winter virus incubators, and indeed, one bug or another often spread through a committee. So even if the state as a whole is “back to normal,” we need a new normal in the statehouse that is more health-conscious.

During our “Zoom” interim, there has also been an awareness of the increased transparency of live-streaming on YouTube and having those proceeding archived for later access. It has created greater access for public testimony without folks having to drive long distances. In returning to in-person, we don’t want to lose that, but it means IT system upgrades.

Though we’ve always had open meetings, the broader access and the archives have squelched some levels of committee interaction. Casual conversation or friendly jibing in front of 10 members of the public is one thing; it is more easily misinterpreted in the harsh light of video and people feel more compelled to be circumspect in what they say. Watching what you say isn’t a good thing for brainstorming and the free flow of ideas. Forgetting to watch what you say – something easy to do when the audience is invisible – can get you in trouble.

There is now a planning report that recommends some interim knocking down of walls for more committee space but less flow space in the building, thus restrictions on in-person public access. Most people agree that this would be totally not OK. An expanded building, however, would be several years away in planning and construction.

Should we stay on Zoom longer? It really does impair many levels of the lawmaking process, and it would not be a good public message, once the state of emergency ends, to be saying “everyone can go back to work, but we aren’t safe enough to do it ourselves yet.” This debate will extend over the next months.

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Voting

Coming up next week on the House floor will be the Senate-passed bill on making universal mail-in balloting permanent. While I do support the concept for maximizing easy voting for folks, I’m concerned about the cost trade-off. At a million dollars a pop so that people don’t have to put in a request for an absentee ballot – something that’s incredibly easy to do – it doesn’t feel like a good investment.

However, the part of the bill I’m most concerned about is the ballot correction process. The cover forms for mail-in ballots are sometimes filled out incorrectly. Some other states have a process to inform someone and allow them to correct the error instead of the ballot being trashed. This is a new work layer for town clerks, but if there is enough advance time and it just means sending out a postcard, it seems pretty reasonable.

But as often happens, our bill takes it too far. If there isn’t enough time left, the clerk is supposed to look for other ways to track the person down. And if the ballot then is sent back in with another error, the person must be contacted again, with a new chance to correct it. That last piece crosses the line of reasonableness for me, and I will be trying to get it removed from the bill. Two bites at the apple should be enough.

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‘Juveniles’

On the same day that the House approved Brattleboro’s charter change to allow 16- and 17-year-olds to vote on local budgets and hold office, we also approved a bill to re-enforce confidentiality protections for the newly created class of juveniles who go to Family Court: those up through age 19 if it isn’t a seriously violent crime. Does this seem, er, a little bit inconsistent?

The same teens whose arrests are confidential could run for office; voters would be shielded from the information that the youth had been stealing money from the store till when voting them onto the select board. It scares me to think of select board members or voters who are mostly completely protected from increased tax rates making decisions on increasing town services. (It is solely property taxes supporting town budgets, and you can’t even sign a lease before turning 18.) The ability to consider the balance between benefits and costs to the pocketbook is seriously impaired. Bad precedent; I voted no.

As far as extending the law to increase the number of secret arrests: there was a highly troubling aspect. Police can choose to disclose the information if they believe there is a public safety issue. There are absolutely no guidelines in the bill about what that means, so Berlin and Northfield could choose to set very different standards. It also creates a huge new loophole for actions based on unrecognized implicit bias. I fought this vigorously on the House floor and it was dispiriting to have to get legislative counsel to correct multiple errors that the member reporting the bill was making. He simply wasn’t prepared to explain it. But it passed.

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Equity and Past Harms

My committee’s health equity bill was revised slightly by the Senate but we signed off this past week and it is on its way to the governor. We used the recommended data from Vermont’s Health Department to create a new Commission to identify ways to increase equity for groups that are suffering worse outcomes because of historic biases in health care. That includes racial and ethnic groups, but also those with disabilities and those with differences in sexual orientation or gender affiliation. I am very conscious of some of these disparities as a person with a psychiatric disability. In this category, unconscious bias is called “diagnostic overshadowing.” A provider sees a medical history record, and looses focus on an unbiased assessment of the meaning of physical health symptoms. People have died from this.

Also last week, a Senate Committee passed the House resolution of apology for the state’s role in supporting eugenics in the first half of the 1900’s. It included sterilization for those deemed “unfit to procreate.” Those included people of diverse racial and ethnic backgrounds, in particular members of Abenacki tribes, as well as those in institutions for developmental or mental health disabilities. I first introduced this 10 years ago, so it was gratifying to see it finally pass.

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Budget Issues

The budget will be a mess this year. The House and Senate have started work on aligning our two versions, and the governor is being very public about his displeasure. Members like me are on the sidelines, waiting to see what the final package looks like.

It’s a demonstration of how having too much money to spend can be more difficult to address than having too little. There are some broad disagreements on the ways to decide on the investments we should make with the one-time bonanza of federal coronavirus relief funds – even though there is a lot of conceptual agreement on most of places where it should be invested. Those include housing, broadband and small business supports.

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Health Care

My committee is addressing policy language that the Senate included in its budget, and what recommendations we should give to our House Appropriations Committee in response.

One is easy. You may have never heard of Pharmacy Benefits Managers, PBMs for short, because they operate completely behind the scenes. They get contracts from insurance companies to negotiate deals with drug companies to save money, often in ways very damaging to independent pharmacies, such as Northfield’s. Cutting pharmacies’ tiny profit margin is where the PBMs make most of their money, and the non-negotiable contracts they create include “gag clauses” so that pharmacies are not able to tell anyone about the practices. One PBM began requiring a major new bureaucratic requirement on pharmacies this year. We – along with a number of other states – are jumping in to ban the practice.

We are also reviewing how the legislature should be involved in oversight of the state’s renegotiation of two special arrangements we have with federal health care funding. One is called the “global commitment,” a five-year agreement now up for renewal. It allows us to use Medicaid funding for new initiatives as long as we can show it is resulting in lower-than-otherwise-projected spending.

The second is the “All Payer Model,” which allows us to join the same accountable care organizations that were established through federal law to reform payment systems for Medicare, with our Medicaid program and with voluntary involvement of commercial payers. The concept is solid: if we all use the same mechanisms, we create a more uniform system and we save money. It hasn’t yet really taken off and proven itself yet. It’s a bit of chicken and egg: insurers don’t want to sign on until they see it working, but it won’t really work until enough people are signed on. That agreement is up for renewal next year. We want the two to be aligned, and we want to maximize opportunities that may result from new Biden administration policies.

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Forensic System

I will be reporting a bill on the floor next week that will initiative a deep dive into potential reforms to our current system for addressing people who may have committed violent crimes but can’t go to trial (or are found not guilty) because of a severe mental illness. We haven’t updated it in years, and other states are well ahead of us in best practices.

There is a great deal of public fear to contend with on the subject because of public misperceptions. First, people with a mental illness do not commit violent crimes at a higher rate than any other group. There is a different perception because of how these situations are publicly reported. In fact, of all psychiatric hospital admissions in Vermont, about one half of one percent are of people accused of a crime.

When fear drives reactions, however, the second factor is that policy is sometimes based on fear and we forget we are addressing people who have not been convicted of a crime and are constitutionally entitled to the presumption of innocence.

That doesn’t mean our system doesn’t need reform, or that we can disregard public safety in regards to individuals being held in a hospital instead of prison. But it is a complex area of law that can’t be undertaken hastily. That is what will be assessed, with an eye towards revising our current laws over the next several years.

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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.