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Senate CalendarTUESDAY, APRIL 18, 2006

106th DAY OF ADJOURNED SESSION

TABLE OF CONTENTSPage No.

UNFINISHED BUSINESS OF THURSDAY, APRIL 6, 2006House Proposal of Amendment

S. 22 Off label use of prescription drugs for cancer..............................1489Sen. Leddy amendment..............................................................1493

UNFINISHED BUSINESS OF TUESDAY, APRIL 11, 2006Third Reading

H. 384 Medical ins. for seasonal emp. of Dept. of Forests, Parks & Rec.1493H. 860 Vermont’s participation in the regional greenhouse gas initiative1493

Sen. Coppenrath amendment.....................................................1493H. 876 Relating to management of exposure to mercury.........................1494

UNFINISHED BUSINESS OF WEDNESDAY, APRIL 12, 2006House Proposal of Amendment

S. 117 Relating to state recognition of the Abenaki People.....................1493

UNFINISHED BUSINESS OF THURSDAY, APRIL 13, 2006Second Reading

FavorableH. 874 Relating to sentencing for first and second degree murder...........1496

Judiciary Committee Report......................................................1496

UNFINISHED BUSINESS OF FRIDAY, APRIL 14, 2006Third Reading

H. 677 Standards board and licensing hearing panels for educators........1496

Second ReadingFavorable

H. 882 Amendments to the charter of the town of Richmond..................1496Government Operations Committee Report..............................1497

Favorable with Proposal of AmendmentH. 615 Public records & application of deliberative process privilege....1497

Government Operations Committee Report..............................1497

H. 766 Real estate transfer pursuant to foreclosure..................................1498Judiciary Committee Report......................................................1498

H. 794 Relating to military service and professional regulation..............1498Government Operations Committee Report..............................1498

H. 877 Funding regional technical center school district.........................1499Education Committee Report.....................................................1500

House Proposal of AmendmentS. 262 Expanding employer access to applicants’ criminal records........1500

House Proposal of Amendment to Senate Proposal of AmendmentS. 27 Safe haven defense to the crime of abandoning a baby................1506

Report of Committee of ConferenceH. 404 Access to mental health and substance abuse providers...............1506

NEW BUSINESS

Second ReadingFavorable with Proposal of Amendment

H. 480 Relating to precursor drugs of methamphetamine........................1507Judiciary Committee Report......................................................1507

H. 871 Relating to professions and occupations.......................................1510Government Operations Committee Report..............................1510

House Proposal of Amendment to Senate Proposal of AmendmentH. 33 Relating to the uniform mediation act..........................................1512

House Proposals of AmendmentS. 103 Lawsuits arising from exercise of right to freedom of speech......1513S. 182 Immigration consequences of pleading guilty to criminal offense1513S. 310 Relating to common sense initiatives in health care.....................1514

NOTICE CALENDAR

Favorable with Proposal of AmendmentH. 150 Relating to insurance fraud...........................................................1556

Judiciary Committee Report......................................................1556H. 253 Establishing energy efficiency standards for certain appliances. .1559

Natural Resources and Energy Committee Report....................1559H. 294 Relating to groundwater management..........................................1568

Natural Resources and Energy Committee Report....................1568H. 602 An act relating to agricultural energy and fuel production...........1572

Agriculture Committee Report..................................................1573H. 817 Relating to stormwater management............................................1573

Natural Resources and Energy Committee Report....................1573

H. 884 Vermont Municipal Employees Retirement System.....................1575Government Operations Committee Report..............................1576

House Proposal of AmendmentS. 106 Beverage container handler’s fee/bottle redemption system........1576

House Proposal of Amendment to Senate Proposal of AmendmentH. 538 Parents/students rights & responsibilities under state & fed. law.1577

ORDERED TO LIES. 112 Relating to the practice of optometry............................................1577S. 157 Relating to rulemaking for Vermont origin..................................1577S. 315 Relating to creation of the Vermont Land Bank program............1577S. 316 Relating to access to broadband services throughout Vermont....1577S. 319 Relating to expanding the scope of the net metering program.....1577

ORDERS OF THE DAY

ACTION CALENDAR

UNFINISHED BUSINESS OF THURSDAY, APRIL 6, 2006

House Proposal of Amendment

S. 22

An act relating to off-label use of prescription drugs for cancer.

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. 8 V.S.A. chapter 107, subchapter 9 is added to read:

Subchapter 9. Off-Label Use of Prescription Drugs for Cancer

§ 4100e. REQUIRED COVERAGE FOR OFF-LABEL USE

(a) A health insurance plan that provides coverage for prescription drugs shall provide coverage for off-label use in cancer treatment in accordance with the following:

(1) A health insurance plan contract may not exclude coverage for any drug used for the treatment of cancer on grounds that the drug has not been approved by the federal Food and Drug Administration, provided the use of the drug is a medically accepted indication for the treatment of cancer.

(2) Coverage of a drug required by this section also includes medically necessary services associated with the administration of the drug.

(3) This section shall not be construed to require coverage for a drug when the federal Food and Drug Administration has determined its use to be contraindicated for treatment of the current indication.

(4) A drug use that is covered under subdivision (1) of this subsection may not be denied coverage based on a “medical necessity” requirement except for a reason unrelated to the legal status of the drug use.

(5) A health insurance plan contract that provides coverage of a drug as required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles, and exclusions to the same extent these provisions are applicable to coverage of all prescription drugs and are not inconsistent with the requirements of this section.

(b) As used in this section, the following terms have the following meanings:

(1) “Health insurance plan” means a health benefit plan offered, administered, or issued by a health insurer doing business in Vermont.

(2) “Health insurer” is defined by subdivision 9402(9) of Title 18. As used in this subchapter, the term includes the state of Vermont and any agent or instrumentality of the state that offers, administers, or provides financial support to state government, including Medicaid, the Vermont health access plan, the VScript pharmaceutical assistance program, or any other public health care assistance program.

(3) “Medically accepted indication” includes any use of a drug that has been approved by the federal Food and Drug Administration and includes another use of the drug if that use is prescribed by the insured’s treating oncologist and supported by medical or scientific evidence. For purposes of this subchapter, “medical or scientific evidence” means one or more of the following sources:

(A) peer-reviewed scientific studies published in or accepted for publication by medical journals that meet nationally recognized requirements for scientific manuscripts and that submit most of their published articles for review by experts who are not part of the editorial staff.

(B) peer-reviewed literature, biomedical compendia, and other medical literature that meet the criteria of the National Institutes of Health’s National Library of Medicine for indexing in Index Medicus, Excerpta Medicus (EMBASE), Medline, and MEDLARS database Health Services Technology Assessment Research (HSTAR).

(C) medical journals recognized by the federal Secretary of Health and Human Services, under Section 1861(t)(2) of the federal Social Security Act.

(D) the following standard reference compendia: the American Hospital Formulary Service-Drug Information, the American Medical Association Drug Evaluation, and the United States Pharmacopoeia-Drug Information.

(E) findings, studies, or research conducted by or under the auspices of federal government agencies and nationally recognized federal research institutes, including the Agency for Health Care Policy and Research, National Institutes of Health, National Cancer Institute, National Academy of Sciences, Center for Medicare and Medicaid Services, and any national board

recognized by the National Institutes of Health for the purpose of evaluating the medical value of health services.

(F) peer-reviewed abstracts accepted for presentation at major medical association meetings.

(4) “Off-label use” means the prescription and use of drugs for medically accepted indications other than those stated in the labeling approved by the federal Food and Drug Administration.

(c) A determination by a health insurer that an off-label use of a prescription drug under this section is not a medically accepted indication supported by medical or scientific evidence is eligible for review under section 4089f of this title.

Sec. 2. 8 V.S.A. § 4089f(b)(3) is amended to read:

(b) An insured who has exhausted all applicable internal review procedures provided by the health benefit plan shall have the right to an independent external review of a decision under a health benefit plan to deny, reduce or terminate health care coverage or to deny payment for a health care service. The independent review shall be available when requested in writing by the affected insured, provided the decision to be reviewed requires the plan to expend at least $100.00 for the service and the decision by the plan is based on one of the following reasons:

* * *

(3) The health care treatment has been determined to be experimental, investigational or an off-label drug. A health benefit plan that denies use of a prescription drug for the treatment of cancer as not medically necessary or as an experimental or investigational use shall treat any internal appeal of such denial as an emergency or urgent appeal, and shall decide such appeal within the time frames applicable to emergency and urgent internal appeals under regulations adopted by the commissioner.

Sec. 3. APPLICATION

(a) Sec. 1 of this act shall apply to all health insurance plans issued or offered on and after October 1, 2006 and to all other health insurance plans on and after October 1, 2006 upon renewal or their anniversary date, whichever is sooner, but in no event later than October 31, 2007.

(b) Sec. 2 of this act is intended to clarify existing administrative regulations and shall apply to all appeals subject to 8 V.S.A. § 4089f (independent external review of health care service decisions) pending on and after the effective date of this act.

* * * Wholesale Drug Distributors: Accreditation; Pedigrees * * *

Sec. 4. 26 V.S.A. § 2068 is amended to read:

§ 2068. REQUIREMENTS; APPLICANTS; LICENSES

An applicant shall satisfy the board that it has, and licensees shall maintain, the following:

* * *

(10) Compliance with standards and procedures which the board shall adopt by rule concerning provisions for initial and periodic on-site inspections, criminal and financial background checks, ongoing monitoring, reciprocity for out-of-state wholesale drug distributors inspected by a third party organization recognized by the board or inspected and licensed by a state licensing authority with legal standards for licensure that are comparable to the standards adopted by the board pursuant to this subdivision, protection of a wholesale drug distributor’s proprietary information, and any other requirements consistent with the purposes of this subdivision. The board rules may recognize third party accreditation in satisfaction of some or all of the requirements of this subdivision.

Sec. 5. ELECTRONIC PEDIGREE STUDY

The board of pharmacy shall study the feasibility of an electronic pedigree system that would verify the chain of distribution for all prescription drugs. The board shall report its findings and recommendations to the general assembly not later than January 15, 2007. The study shall include consultation with drug manufacturers, wholesale drug distributors, and pharmacies responsible for the sale and distribution of prescription drugs and consideration of any relevant national standards or initiatives. The board shall include a proposed implementation date in the study.

* * * Drug and Medical Supply Repository Program: Study * * *

Sec. 6. DRUG AND MEDICAL SUPPLY REPOSITORY STUDY

The department of health, in consultation with the office of Vermont health access, the board of pharmacy, the department of disabilities, aging, and independent living, and the board of medical practice, shall study the feasibility of creating a repository program through which licensed facilities, wholesale drug distributors, and drug manufacturers can donate unused, unopened prescription drugs and medical supplies to pharmacies, hospitals, and clinics in order to dispense such drugs and supplies, for only a handling fee, to persons who are income - eligible or uninsured. The study shall include findings and recommendations concerning the cost the department would incur in creating and overseeing such a program, including any costs related to

consultation with experts, the benefits of a repository program, and any other standards or procedures necessary for the development and implementation of the program. The department of health shall report its findings and recommendations to the general assembly not later than January 15, 2007.

AMENDMENT TO S. 22 TO BE OFFERED BY SENATOR LEDDY ON BEHALF OF THE COMMITTEE ON HEALTH AND WELFARE

Senator Leddy, on behalf of the Committee on Health and Welfare, moves that the Senate concur in the House proposal of amendment with the following proposal of amendment thereto:

First: In Sec. 5 (electronic pedigree study), in the first sentence, after the words "study the feasibility of an electronic pedigree system", by inserting the words or any other system

Second: In Sec. 6 (drug and medical supply repository study), in the first sentence, after the words "the board of pharmacy,", by inserting the words the department of public safety,

UNFINISHED BUSINESS OF TUESDAY, APRIL 11, 2006

Third Reading

H. 384

An act relating to medical insurance for seasonal employees of the department of forests, parks and recreation.

H. 860

An act relating to Vermont’s participation in the regional greenhouse gas initiative.

PROPOSAL OF AMENDMENT TO H. 860 TO BE OFFERED BY SENATOR COPPENRATH BEFORE THIRD READING

Senator Coppenrath moves that the Senate propose to the House to amend the bill in Sec. 1, 30 V.S.A., § 254(c)(2) by striking out subparagraph (F) in its entirety and inserting in lieu thereof a new subparagraph (F) to read as follows:

(F) ensure that carbon credits allocated under this program and revenues associated with their sale remain power system assets managed for the benefit of electric consumers. To that end, at least 50% of the revenues shall be used to directly mitigate electricity ratepayer impacts by reducing electric rates paid by consumers, and the remaining credits may be used for investments in energy efficiency and other low-cost, low-carbon power system investments;

H. 876

An act relating to management of exposure to mercury.

UNFINISHED BUSINESS OF WEDNESDAY, APRIL 12, 2006


S. 117

An act relating to state recognition of the Abenaki People.

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

Sec. 1. 1 V.S.A. chapter 23 is added to read:

CHAPTER 23. ABENAKI PEOPLE

§ 851. FINDINGS

The general assembly finds that:

(1) At least 1,700 Vermonters claim to be direct descendants of the several indigenous Native American peoples, now known as Western Abenaki tribes, who originally inhabited all of Vermont and New Hampshire, parts of western Maine, parts of southern Quebec, and parts of upstate New York for hundreds of years, beginning long before the arrival of Europeans.

(2) There is ample archaeological evidence that demonstrates that the Missisquoi Abenaki were indigenous to and farmed the river floodplains of Vermont at least as far back as the 1100s A.D.

(3) The Western Abenaki, including the Missisquoi, have a very definite and carefully maintained oral tradition that consistently references the Champlain valley in western Vermont.

(4) Many contemporary Abenaki families continue to produce traditional crafts and intend to continue to pass on these indigenous traditions to the younger generations. In order to create and sell Abenaki crafts that may be labeled as Indian- or Native American-produced, the Abenaki must be recognized by the state of Vermont.

(5) Federal programs may be available to assist with educational and cultural opportunities for Vermont Abenaki and other Native Americans who reside in Vermont.

§ 852. VERMONT COMMISSION ON NATIVE AMERICAN AFFAIRS ESTABLISHED; AUTHORITY

(a) In order to recognize the historic and cultural contributions of Native Americans to Vermont, to protect and strengthen their heritage, and to address

their needs in state policy, programs, and actions, there is hereby established the Vermont commission on Native American affairs (the “commission”).

(b) The commission shall comprise seven members appointed by the governor for two-year terms from a list of candidates compiled by the division for historic preservation. The governor shall appoint a chair from among the members of the commission. The division shall compile a list of candidates’ recommendations from the following:

(1) Recommendations from the Missisquoi Abenaki and other Abenaki and other Native American regional tribal councils and communities in Vermont.

(2) Applicants who apply in response to solicitations, publications, and website notification by the division of historical preservation.

(c) The commission shall have the authority to assist Native American tribal councils, organizations, and individuals to:

(1) Secure social services, education, employment opportunities, health care, housing, and census information.

(2) Permit the creation, display, and sale of Native American arts and crafts and legally to label them as Indian- or Native American - produced as provided in 18 U.S.C. § 1159(c)(3)(B) and 25 U.S.C. § 305e(d)(3)(B).

(3) Receive assistance and support from the federal Indian Arts and Crafts Board, as provided in 25 U.S.C. § 305 et seq.

(4) Become eligible for federal assistance with educational, housing, and cultural opportunities.

(5) Establish and continue programs offered through the U.S. Department of Education Office on Indian Education pursuant to Title VII of the Elementary and Secondary Education Act established in 1972 to support educational and cultural efforts of tribal entities that have been either state or federally recognized.

(d) The commission shall meet at least three times a year and at any other times at the request of the chair. The agency of commerce and community development and the department of education shall provide administrative support to the commission.

(e) The commission may seek and receive funding from federal and other sources to assist with its work.

§ 853. RECOGNITION OF ABENAKI PEOPLE

(a) The state of Vermont recognizes the Abenaki people and recognizes all Native American people who reside in Vermont as a minority population.

(b) Recognition of the Native American or Abenaki people provided in subsection (a) of this section shall be for the sole purposes specified in subsection 852(c) of this title and shall not be interpreted to provide any Native American or Abenaki person with any other special rights or privileges that the state does not confer on or grant to other state residents.

(c) This chapter shall not be construed to recognize, create, extend, or form the basis of any right or claim to land or real estate in Vermont for the Abenaki people or any Abenaki individual and shall be construed to confer only those rights specifically described in this chapter.

Sec. 2. EFFECTIVE DATE; APPOINTMENTS TO COMMISSION

(a) This act shall take effect on passage.

(b) The governor shall make appointments to the commission no later than 90 days after the effective date of this act.

UNFINISHED BUSINESS OF THURSDAY, APRIL 13, 2006

Second Reading

Favorable

H. 874

An act relating to sentencing for first and second degree murder.

Reported favorably by Senator Wilton for the Committee on Judiciary.

(Committee vote: 6-0-1)

(No House amendments)

UNFINISHED BUSINESS OF FRIDAY, APRIL 14, 2006

Third Reading

H. 677

An act relating to a standards board and licensing hearing panels for professional educators.

Second Reading

Favorable

H. 882

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

Reported favorably by Senator Condos for the Committee on Government Operations.

(Committee vote: 5-0-1)

(No House amendments)

Favorable with Proposal of Amendment

H. 615

An act relating to the public records act and application of the deliberative process privilege.

Reported favorably with recommendation of proposal of amendment by Senator White for the Committee on Government Operations.

The Committee recommends that the Senate propose to the House to amend the bill by adding a new section to be Sec. 4 to read as follows:

Sec. 4. LEGISLATIVE COUNCIL STUDY

The legislative council, in consultation with the state archivist, the public records specialists in the department of buildings and general services, the agency of administration, the division of vital records in the department of health, the Vermont league of cities and towns, the Vermont municipal clerks and treasurers association, and other interested parties, shall study the public records law of the state of Vermont as set forth in chapter 5 of Title 1, 3 V.S.A. § 218, and the numerous exemptions to the public records requirements throughout the Vermont statutes. On or before January 15, 2007, the legislative council shall report to the house and senate committees on government operations. The report shall include:

(1) A summary of the statutory requirements and organization of the state public records requirements;

(2) An analysis of the ease of access and use of public records under the existing state public records requirements and any recommendations to improve use of and access to public records;

(3) An analysis of the need and justification for each of the existing exemptions in statute to the inspection and review requirements of the public records act;

(4) A review of the management and administration of public records requirements by the department of buildings and general services, other state agencies, and municipalities;

(5) A summary of the pending federal regulations for the administration, issuance, and inspection of vital records and a review of how such regulations will impact Vermont public records management and inspection;

(6) A summary of the enforcement of public records requirements in the state, including the ability of an aggrieved person to appeal a decision of a public agency, and a summary of public records enforcement and appellate authority in other states; and

(7) Proposed legislation to amend, reorganize, and simplify the public records requirements of the state of Vermont.

(Committee Vote: 5-0-1)

(For House amendments, see House Journal for February 17, 2006, page 341; February 21, 2006, page 357.)

H. 766

An act relating to real estate transfer pursuant to strict foreclosure not voidable as fraudulent conveyance.

Reported favorably with recommendation of proposal of amendment by Senator Illuzzi for the Committee on Judiciary.

The Committee recommends that the Senate propose to the House to amend the bill by adding a new section to be Sec. 6 to read as follows:

Sec. 6. EFFECTIVE DATE

This act shall take effect on passage.

and that after passage, the title be amended to read as follows: “AN ACT RELATING TO STRICT FORECLOSURE”


(For House amendments, see House Journal for March 3, 2006, page 546.)

H. 794

An act relating to military service and professional regulation.

Reported favorably with recommendation of proposal of amendment by Senator Giard for the Committee on Government Operations.

The Committee recommends 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:

Sec. 1. 20 V.S.A. § 368 is added to read

§ 368. ACTIVATION OR DEPLOYMENT OF NATIONAL OR STATE GUARD OR RESERVE MEMBERS; PROFESSIONS AND OCCUPATIONS; STATE REGULATION

Notwithstanding any provision of law to the contrary, a member of the national guard, state guard, or reserve component, whose profession or occupation is regulated by an agency of the state and who holds a valid license, certification or registration to practice that profession or occupation at the time of activation or deployment shall be entitled to:

(1) an extension of the period of active licensure or certification through the duration of and up to sixty days following the person’s return from activation or deployment provided that maintenance of active licensure or certification is required by the military during the time of such activation or deployment. In order to qualify for the extension, the person shall:

(A) notify the agency of his or her activation or deployment at any time prior to the scheduled expiration of the current license or certification; and

(B) certify that the circumstances of the activation or deployment impede good faith efforts to make timely application for renewal of the license or certification.

(2) a reasonable opportunity to meet the terms or conditions of licensure or certification following the person’s return from activation or deployment if military service in any way interferes with a good faith effort to complete a term or condition of licensure, regardless of whether the military requires the person to maintain the license or certification during the time of activation or deployment.


This act shall take effect upon passage and shall apply to any person who

meets the requirements of this section on July 1, 2005 or thereafter.


(For House amendments, see House Journal for February 2, 2006, page 212.)

H. 877

An act relating to funding of regional technical center school district

Reported favorably with recommendation of proposal of amendment by Senator Collins for the Committee on Education.

The Committee recommends that the Senate propose to the House to amend the bill in Sec. 1, 16 V.S.A. § 1578a(a), following the words "technical center" by inserting the word school


(No House amendments.)


S. 262

An act relating to expanding employer access to applicants’ criminal records.

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. 20 V.S.A. § 2056b(a) is amended to read:

(a) The Vermont criminal information center may provide Vermont criminal history records as defined in section 2056a of this title to bona fide persons conducting research related to the administration of criminal justice, subject to conditions approved by the commissioner of public safety to assure the confidentiality of the information and the privacy of individuals to whom the information relates.

Sec. 2. 20 V.S.A. § 2056c is amended to read:

§ 2056c. DISSEMINATION OF CRIMINAL HISTORY RECORDS TO EMPLOYERS

(a) As used in this section:

(1) “Applicant” means an individual seeking or being sought for employment or, a volunteer position with an employer, or admission to a course of instruction offered by the Vermont criminal justice training council.

(2) “Criminal conviction record” means the record of convictions in Vermont and convictions in other jurisdictions.

(3) “Employer” means any individual, organization, or governmental body, including partnership, association, trustee, estate, corporation, joint stock company, insurance company, or legal representative, whether domestic or foreign, or the receiver, trustee in bankruptcy, trustee or successor thereof, and any common carrier by mail, motor, water, air, or express company doing business in or operating within this state, which has one or more individuals performing services for it within this state; and

(A) the employer is a qualified entity that provides care or services to vulnerable classes as provided in 42 U.S.C. §§ 5119a and 5119c; or

(B) the employer is a postsecondary school with student residential facilities or an authorized agent.

(4) “The center” means the Vermont crime criminal information center.

(5) “Vulnerable classes” means children, the elderly, and persons with disabilities as defined in 42 U.S.C. § 5119c.

(b)(1) An employer may obtain from the center a Vermont criminal conviction record and an out-of-state criminal record for any applicant who has given written authorization on a release form provided by the center, provided that the employer has filed a user’s agreement with the center. The user’s agreement shall require the employer to comply with all statutes, rules, and policies regulating the release of criminal conviction records and the protection of individual privacy. The user’s agreement shall be signed and kept current by the employer.

(2) An individual, organization, or governmental body doing business in Vermont which has one or more individuals performing services for it within this state and which is a qualified entity that provides care or services to children, the elderly, or persons with disabilities as defined in 42 U.S.C. § 5119c may obtain from the center an out-of-state criminal conviction record for any applicant who has given written authorization on a release form provided by the center, provided that the employer has filed a user’s agreement with the center and complies with all other provisions of this section.

(c)(1) The employer may obtain the a criminal conviction record only:

(A) after the applicant has been given an offer of employment conditioned on the record check or;

(B) after a volunteer has been offered a position conditioned on the record check.

(2) The Vermont criminal justice training council may obtain a criminal conviction record only after an applicant has been accepted into a course of instruction offered by the Vermont criminal justice training council conditioned on the record check.

(3) An organization that receives a criminal conviction record pursuant to this section shall provide a free copy of such record to the record subject within ten days of receipt of the record.

(4) An organization entitled to receive a criminal conviction record pursuant to this section shall not require an applicant to obtain or submit

personally a copy of his or her criminal conviction record for purposes of employment or acceptance into a course offered by the Vermont criminal justice training council.

(d)(1) Postsecondary school employers may obtain criminal records only for applicants who apply for employment or volunteer positions that provide access to student residential facilities. Employers shall be provided with informational material by the center prior to authorization to request criminal conviction records. The materials shall address the following topics:

(A) Requirements of the user agreement.

(B) How to obtain criminal conviction records from the center.

(C) How to interpret criminal conviction records.

(D) How to obtain source documents summarized in the criminal conviction records.

(E) Misuse of criminal conviction records.

(2) Employers shall certify on the user agreement that they have read and understood the materials prior to receiving authorization to request records from the center.

(e) The release form shall contain the applicant’s name, signature, date of birth, place of birth, and the signature as attested to by a notary public. The release form shall state that the applicant has the right to appeal the findings to the center, pursuant to rules adopted by the commissioner of public safety.

(f) No (1) Except as otherwise authorized by this chapter, no person shall confirm the existence or nonexistence of criminal conviction record information to any person who would not be eligible to receive the information pursuant to this subchapter or disclose the contents of a criminal conviction record without the record subject’s permission to any person other than the applicant and properly designated employees of the employer who have a documented need to know the contents of the record.

(2) An employer who receives criminal conviction records pursuant to this section shall maintain a confidential log of all record requests as specified by the center. The employer shall confidentially retain records relating to requests for criminal conviction records for a period of three years. At the end of the retention period, if logs and records are to be destroyed, they shall be shredded.

(g) A person who violates the provisions of this section with respect to unauthorized disclosure of confidential criminal history record information obtained from the center under the authority subsection (f) of this section shall

be fined assessed a civil penalty of not more than $5,000.00. Each unauthorized disclosure shall constitute a separate civil violation. The office of the attorney general shall have authority to enforce this section.

(h) The center shall provide notice of the penalty for unauthorized disclosure on a form accompanying any report of a criminal conviction record to an employer. The notice shall include, in boldface print, the following statements: THE REQUESTOR AGREES TO USE CRIMINAL CONVICTION RECORD INFORMATION RECEIVED FROM THE VERMONT CRIME CRIMINAL INFORMATION CENTER FOR THE PURPOSES INTENDED BY LAW. THE REQUESTOR AGREES NOT TO DISCLOSE THE CONTENTS OF ANY CRIMINAL CONVICTION RECORD INFORMATION WITHOUT THE APPLICANT’S PERMISSION TO ANY PERSON OTHER THAN THE APPLICANT AND PROPERLY DESIGNATED EMPLOYEES WHO HAVE A DOCUMENTED NEED TO KNOW THE CONTENTS OF THE RECORD. A VIOLATION MAY RESULT IN A FINE CIVIL PENALTY OF UP TO $5,000.00. EACH UNAUTHORIZED DISCLOSURE SHALL CONSTITUTE A SEPARATE CIVIL VIOLATION.

(i) Nothing in this section shall create a statutory duty for an employer to perform a criminal conviction record check on every job applicant hired by the employer. An employer’s failure to obtain a criminal conviction record on an employee who subsequently commits a criminal offense shall not be the sole factor in determining civil or criminal liability unless otherwise authorized by law.

Sec. 3. 20 V.S.A. § 2056d(a) is amended to read:

(a) Statewide criminal history records shall be released only by the Vermont criminal information center.

Sec. 4. 20 V.S.A. § 2056f is added to read:

§ 2056f. DISSEMINATION OF CRIMINAL HISTORY RECORDS AND CRIMINAL CONVICTIONS RECORDS TO AN INDIVIDUAL

A person may obtain a copy of his or her own criminal history record as defined in section 2056a of this title or criminal conviction record as defined in section 2056c of this title or a statement that no record exists from the Vermont criminal information center. Copies of a person’s criminal history record and criminal conviction record may be obtained by making a personal appearance at the center during regular business hours or by written request. Written requests shall be on a form specified by the center and shall contain the person’s name, date of birth, place of birth, and signature as attested to by a notary public. A raised seal must be affixed to the form.


§ 2063. CRIMINAL HISTORY RECORD FEES; CRIMINAL HISTORY RECORD CHECK FUND

(a) Except as otherwise provided for in this section, the cost of each check for a criminal history check record as defined in section 2056a of this title or a criminal conviction record as defined in section 2056c of this title based on name and date of birth shall be $10.00. Out-of-state criminal history record checks shall include any additional fees charged by the state from which the record is requested.

(b) Requests made by criminal justice agencies for criminal justice purposes or other purposes authorized by state or federal law shall be exempt from all record check fees. The following types of requests shall be exempt from the Vermont criminal record check fee:

(1) Requests made by governmental agencies or entities regulated by governmental agencies in accordance with local, state or federal law or regulation which requires a criminal record check for employment or licensing any individual, organization, or governmental body doing business in Vermont which has one or more individuals performing services for it within this state and which is a qualified entity that provides care or services to children, the elderly, or persons with disabilities as defined in 42 U.S.C. § 5119c.

(2) Requests made by researchers approved by the Vermont criminal information center to conduct research related to the administration of criminal justice. A fee, however, may be charged by the center which shall reflect the cost of generating the requested information.

(3) Requests made by individuals to review their own record at the Vermont criminal information center; however, copies of the individual’s record are not exempt from the record check fee.

(c) The criminal history record check fund is established and shall be managed by the commissioner of public safety in accordance with the provisions of Title 32, chapter 7, subchapter 5 of chapter 7 of Title 32. All fees paid under this section shall be placed in the fund and used for personnel and equipment related to the processing, maintenance, and dissemination of criminal history records. The commissioner of finance and management may draw warrants for disbursements from this fund in anticipation of receipts.

(d) The department of public safety shall have the authority, with the approval of the secretary of administration, to establish limited service positions as are necessary to provide criminal record checks in a timely

manner, provided that there are sufficient funds in the criminal history record check fund to pay for the costs of these positions.

Sec. 6. DATA COLLECTION

The Vermont criminal information center shall report to the house and senate committees on judiciary on or before January 15, 2007 on the following:

(1) All individuals, organizations, or governmental bodies entitled to obtain criminal record information from the center and the legal authority for such access.

(2) The record information that is released to those identified by subdivision (1) of this section.

(3) The number of record requests by a group of requestors.

(4) The number of record requests without release forms.

(5) An assessment of the cost of the criminal record check program compared to the revenues generated from record requests.

(6) Any additional data that will assist the committees in engaging in a comprehensive review of access to statewide criminal record information.

Sec. 7. REPORT

(a) There is established an access to criminal history record information committee for the purpose of making findings and recommendations regarding public access to statewide criminal history records from the Vermont crime information center and the dissemination of electronic criminal case record information by the court. The committee shall consider what information should be released, by what method and to whom, in a manner that is consistent, reliable, and sensitive to privacy issues.

(b) The committee shall consist of the following members:

(1) A judge or justice appointed by the chief justice of the Vermont supreme court.

(2) The director of the Vermont crime information center.

(3) The executive director of the Vermont bar association or his or her designee.

(4) The executive director of the American Civil Liberties Union.

(5) Two former legislators appointed jointly by the speaker of the house and the senate committee on committees.

(c) The judge or justice shall be the chair of the committee.

(d) The Vermont crime information center and the judiciary shall provide the committee with information and assistance necessary to accomplish its charge.

(e) Former legislative members of the committee shall be entitled to per diem compensation and reimbursement for expenses in the same manner as current legislative members in accordance with 2 V.S.A. § 406.

(f) The committee shall report its findings and recommendations to the house and senate committees on judiciary on or before January 15, 2007.

Sec. 8. DISSEMINATION OF ELECTRONIC CASE RECORDS

The judiciary shall not permit public access via the internet to criminal case records or family court case records prior to June 1, 2007. The court may permit criminal justice agencies, as defined in 20 V.S.A. § 2056a, internet access to criminal case records for criminal justice purposes, as defined in section 2056a.

Proposal of Amendment to Senate Proposal of Amendment to House Proposal of Amendment

S. 27

An act relating to a safe haven defense to the crime of abandoning a baby.

The House has concurred in the Senate proposal of amendment to the House proposal of amendment, with a further amendment as follows:

In Sec. 1, 13 V.S.A. § 1303(b)(1), by striking out subparagraph (B) in its entirety and inserting in lieu thereof a new subparagraph (B) to read as follows:

(B) An employee, staff member, or volunteer at a fire station, police station, place of worship, or an entity that is licensed or authorized in this state to place minors for adoption.

Report of Committee of Conference

H. 404

An act relating to access to mental health and substance abuse providers.

To the Senate and House of Representatives:

The Committee of Conference to which were referred the disagreeing votes of the two Houses upon House Bill entitled:

H. 404. An act relating to access to mental health and substance abuse providers.

Respectfully report that they have met and considered the same and recommend that the House concur with the Senate proposal of amendment.

Sen. Claire AyerSen. Jeannette WhiteSen. Hull Maynard

Committee on the part of the Senate

Rep. Michael FisherRep. Anne DonahueRep. Sandy Haas

Committee on the part of the House

NEW BUSINESS

Second Reading


H. 480

An act relating to precursor drugs of methamphetamine.

Reported favorably with recommendation of proposal of amendment by Senator Wilton for the Committee on Judiciary.



§ 1102. JUDICIAL BUREAU; JURISDICTION

(a) A judicial bureau is created within the judicial branch under the supervision of the supreme court.

(b) The judicial bureau shall have jurisdiction of the following matters:

* * *

(10) violations under subdivision 658(c)(1) of Title 7, relating to an employee of a second class licensee selling alcohol to a minor during a compliance check.;

(11) violations of 18 V.S.A. § 4234b(b), relating to selling and dispensing ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers.

* * *

Sec. 2. 18 V.S.A. § 4234b is added to read:

§ 4234b. EPHEDRINE AND PSEUDOEPHEDRINE

(a) Possession.

(1) No person shall knowingly and unlawfully possess a drug product containing ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers, with the intent to use the product as a precursor to manufacture methamphetamine or another controlled substance.

(2)(A) Except as provided in subdivision (2)(B) of this subsection, there shall be a permissive inference that a person who possesses a drug product containing nine or more grams of ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers, intends to use the product as a precursor to methamphetamine or another controlled substance.

(B) The permissive inference established by subdivision (2)(A) of this subsection shall not apply to the following persons lawfully possessing drug products in the course of legitimate business:

(i) A bona fide retailer of drug products.

(ii) A wholesale distributor of drug products or its agents licensed by the board of pharmacy.

(iii) A manufacturer of drug products, or its agents, licensed by the board of pharmacy.

(iv) A pharmacist licensed by the board of pharmacy.

(v) A licensed health care professional possessing the drug products in the course of carrying out his or her profession.

(3) A person who violates this subsection shall:

(A) if the offense involves possession of less than nine grams of ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers, be imprisoned not more than one year or fined not more than $2,000.00, or both;

(B) if the offense involves possession of nine or more grams of ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers, be imprisoned not more than five years or fined not more than $100,000.00, or both.

(b) Selling and dispensing.

(1) A drug product containing ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers, shall not be distributed at retail to the general public unless it is maintained in a locked display case or behind the counter out of the public’s reach.

(2)(A) A retail establishment shall not knowingly dispense to a person within a 30 - day period any drug product or combination of drug products containing a total of nine or more grams of ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers.

(B) A retail establishment shall not knowingly dispense to a person within a 24-hour period any drug product or combination of drug products containing a total of more than 3.6 grams of ephedrine, pseudoephedrine, or phenylpropanolamine, or their salts, isomers, or salts of isomers.

(C) This subdivision shall not apply to drug products dispensed pursuant to a valid prescription.

(3) A person or business which violates this subdivision shall:

(A) for a first violation be assessed a civil penalty of not more than $100.00.

(B) for a second and subsequent violation be assessed a civil penalty of not more than $500.00.

(d) This section shall not apply to a manufacturer which has obtained an exemption from the Attorney General of the United States under section 711(d) of the federal Combat Methamphetamine Epidemic Act of 2005.

(e) As used in this section:

(1) “Commissioner” means the commissioner of health.

(2) “Distributor” means a person, other than a manufacturer or wholesaler, who sells, delivers, transfers, or in any manner furnishes a drug product to any person who is not the ultimate user or consumer of the product.

(3) “Knowingly” means having actual knowledge of the relevant facts.

(4) “Manufacturer” means a person who produces, compounds, packages, or in any manner initially prepares a drug product for sale or use.

(5) “Readily retrievable” means available for inspection without prior notice at the registration address if that address is within the state of Vermont. If the registration address is in a state other than Vermont, it means records must be furnished within three working days.

(6) “Wholesaler” means a person, other than a manufacturer, who sells, transfers, or in any manner furnishes a drug product to any other person for the purpose of being resold.


This act shall take effect on September 1, 2006.



H. 871

An act relating to professions and occupations.

Reported favorably with recommendation of proposal of amendment by Senator Kitchel for the Committee on Government Operations.

The Committee recommends that the Senate propose to the House to amend the bill as follows:

First: By adding four new sections to be numbered Secs. 4a, 4b, 4c, and 4d to read as follows:

Sec. 4a. 13 V.S.A. § 2901 is amended to read:

§ 2901. PUNISHMENT FOR PERJURY

A person who, being lawfully required to depose the truth in a proceeding in a court of justice or in a contested case before a state agency pursuant to chapter 25 of Title 3, commits perjury shall be imprisoned not more than fifteen 15 years and fined not more than $10,000.00, or both.

Sec. 4b. 13 V.S.A. § 2901a is amended to read:

§ 2901a. PERJURY BY INCONSISTENT STATEMENTS

A person is also guilty of perjury and may be sentenced under section 2901 of this title if in one or more proceedings before or ancillary to a court or grand jury or in a contested case before a state agency pursuant to chapter 25 of Title 3:

(1) he or she knowingly makes two or more statements under oath or affirmation which are material in the proceedings;

(2) the statements are inconsistent to the degree that the person necessarily believed one of them to be false; and

(3) both statements were made within the period of the statute of limitations.

Sec. 4c. 13 V.S.A. § 2906 is amended to read:

§ 2906. INFORMATION AND INDICTMENT FOR PERJURY

It shall be sufficient in an information or indictment for perjury or subornation of perjury to set forth the substance of the offense charged, by what court or state agency and by whom the oath was administered, and that such court, state agency, or person had competent authority to administer the same, without setting forth, other than aforesaid, the record or other proceedings, or the commission or authority of such court, state agency, or person before whom the perjury was committed.

Sec. 4d. 13 V.S.A. § 3015 is amended to read:

§ 3015. OBSTRUCTION OF JUSTICE

Whoever corruptly, or by threats or force, or by any threatening letter or communication, intimidates or impedes any witness, grand or petit juror, or officer in or of any court or agency of the state of Vermont, or causes bodily injury to such person or intentionally damages the property of such person on account of such person's attendance at, deliberation at, or performance of his or her official duties in connection with a matter already heard, presently being heard or to be heard before any court or agency of the state of Vermont, or corruptly or by threats or force or by any threatening letter or communication, obstructs or impedes, or endeavors to obstruct or impede the due administration of justice, shall be imprisoned not more than five years or fined not more than $5,000.00, or both. For the purposes of this section, “agency” shall have the meaning set forth in subsection 801(b) of Title 3.

Second: In Sec. 9, 26 V.S.A. § 851, by striking out the following: “$25.00” and inserting in lieu thereof the following: the initial application fee

Third: By striking out Secs. 15 and 16 in their entirety and inserting in lieu thereof new Secs. 15 and 16 to read as follows:

Sec. 15. 26 V.S.A. § 1724a is added to read:

§ 1724a. FORMULARY; DIRECTOR OF THE OFFICE OF PROFESSIONAL REGULATION

At least annually, the director, with the advice of the board of optometry and in consultation with the commissioner of health, shall review and update the formulary of prescription medicines optometrists may use in a manner consistent with the optometry scope of practice and training. The director shall establish written protocols designed to ensure both meaningful and timely consultation with the board and the commissioner of health and other experts whose input the director finds useful.

Sec. 16. 26 V.S.A. § 1728c is amended to read:

§ 1728c. USE OF ORAL THERAPEUTIC PHARMACEUTICAL AGENT; COMMUNICATION WITH PRIMARY CARE PROVIDER

A licensee who employs an oral therapeutic pharmaceutical agent, as identified by the formulary committee established in section 1724 1724a of this title, which might prove to have significant systemic adverse reactions or systemic side effects shall, in a manner consistent with Vermont law, ascertain the risk of systemic side effects through either a case history or by communicating with the patient’s primary care provider. The licensee shall also communicate with the patient’s primary care provider, or with a physician skilled in diseases of the eye, when in the professional judgment of the licensee, it is medically appropriate. The communication shall be noted in the patient’s permanent record. The methodology of communication shall be determined by the licensee.

Fourth: In Sec. 17, 26 V.S.A. § 2032(f), in the first sentence, by striking out the following: “one year” and inserting in lieu thereof the following: two years

Fifth: By striking out Sec. 53 in its entirety.


(For House amendments, see House Journal for March 14, 2006, page 626; March 15, 2006, page 646.)

House Proposal of Amendment to Senate Proposal of Amendment

H. 33

An act relating to the uniform mediation act.

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

In Sec. 1, 12 V.S.A. § 5717, by striking out subsection (b) in its entirety and inserting in lieu thereof a new subsection (b) to read as follows:

(b) There is no privilege under section 5715 of this title if a court, administrative agency, or arbitration panel finds, after a hearing in camera, that the party seeking discovery or the proponent of the evidence has shown that the evidence is not otherwise available, that there is a need for the evidence that substantially outweighs the interest in protecting confidentiality, and the mediation communication is sought or offered in:

(1) a criminal proceeding in district court;

(2) a child protection proceeding under chapter 49 or chapter 55 of Title 33;

(3) a protection proceeding involving a vulnerable adult under chapter 69 of Title 33; or

(4) a proceeding to prove a claim to rescind or reform, or a defense to avoid liability on, a contract arising out of the mediation, except as otherwise provided in subsection (c) of this section.


S. 103

An act relating to lawsuits arising from exercise of right to freedom of speech or to petition government for redress of grievances.


First: In Sec. 2, subdivision (e)(1)(A), after the words “factual support” by striking out the word “or” and inserting in lieu thereof and

Second: In Sec. 2, subsection (g), after the words “shall be appealable” by adding the words in the same manner

Third: In Sec. 2, subsection (h), after the words “enforcement action” by adding the words or criminal proceeding


S. 182

An act relating to advisement of immigration consequences of pleading guilty to a criminal offense.



§ 6565. PLEAS

* * *

(c)(1) Prior to accepting a plea of guilty or a plea of nolo contendere from a defendant in a criminal proceeding pursuant to Rule 11 of the Vermont Rules of Criminal Procedure, the court shall address the defendant personally in open court, informing the defendant and determining that the defendant understands that, if he or she is not a citizen of the United States, admitting to facts sufficient to warrant a finding of guilt or pleading guilty or nolo contendere to a crime may have the consequences of deportation or denial of United States citizenship.

(2) If the court fails to advise the defendant in accordance with this subsection, and he or she later at any time shows that the plea and conviction may have or has had a negative consequence regarding his or her immigration status, the court, upon the defendant’s motion, shall vacate the judgment and permit the defendant to withdraw the plea or admission and enter a plea of not guilty.

(d) Each state’s attorney shall submit an annual report to the office of the executive director of the state’s attorneys, in such form as he the executive director may require, providing information as to the use of plea agreements.

Sec. 2. Vermont Rules of Criminal Procedure Rule 11(c) is amended to read:

(c) Advice to Defendant. The court shall not accept a plea of guilty or nolo contendere without first, by addressing the defendant personally in open court, informing him the defendant determining that he the defendant understands the following:

* * *

(5) if there is a plea agreement and the court has not accepted it pursuant to subdivision (e)(3) of this rule, that the court is not limited, within the maximum permissible penalty, in the sentence it may impose; and

(6) if the court intends to question the defendant under oath, on the record, and in the presence of counsel about the offense to which he has pleaded, that his answers may later be used against him in a prosecution for perjury or false statement; and

(7) if he or she is not a citizen of the United States, admitting to facts sufficient to warrant a finding of guilt or pleading guilty or nolo contendere to a crime may have the consequences of deportation or denial of United States citizenship.


This act shall take effect September 1, 2006 and shall apply to pleas of guilty, pleas of nolo contendere, and admissions to sufficient facts which occur on or after the effective date of this act.


S. 310

An act relating to common sense initiatives in health care.


* * * WELLNESS INITIATIVES * * *

* * * Healthy Lifestyle Insurance Discount * * *

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

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

(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 commissioner shall, by rule, adopt standards and a process for permitting registered small group 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 (20%), and provided further that the commissioner’s rules may not permit any medical underwriting and screening.

(B) The commissioner’s regulations shall permit a carrier, including a hospital or medical service corporation and a health maintenance organization, to establish rewards, premium discounts, 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 and the director of the office of Vermont health access in the development of health promotion and disease prevention regulations. Such regulations shall:

(i) limit any reward, discount, rebate, or waiver or modification of cost-sharing amounts to not more than a total of 15 percent of the cost of the premium for the applicable coverage tier , provided that the sum of any rate deviations under subdivision (2)(A) of section 4080a of this title does not exceed 30% ;

(ii) be designed to promote good health or prevent disease for individuals in the program and not be used as a subterfuge for imposing higher costs on an individual based on a health factor;

(iii) provide that the reward under the program is available to all similarly situated individuals; and

(iv) provide a reasonable alternative standard to obtain the reward to any individual for whom it is unreasonably difficult due to a medical condition or other reasonable mitigating circumstance to satisfy the otherwise applicable standard for the discount and disclose in all plan materials that describe the discount program the availability of a reasonable alternative standard.

(C) The commissioner’s regulations shall include:

(i) standards and procedures for health promotion and disease prevention programs based on the best scientific, evidence-based medical practices as recommended by the commissioner of health;

(ii) standards and procedures for evaluating an individual’s adherence to programs of health promotion and disease prevention; and

(iii) any other standards and procedures necessary or desirable to carry out the purposes of this subdivision (2).

(3) The commissioner may exempt from the requirements of this section an association as defined in section subdivision 4079(2) of this title which:

(A) offers a small group plan to a member small employer which is community rated in accordance with the provisions of subdivisions (1) and (2) of this subsection. The plan may include risk classifications in accordance with subdivision (2) of this subsection;

(B) offers a small group plan that guarantees acceptance of all persons within the association and their dependents; and

(C) offers one or more of the common health care plans approved by the commissioner under subsection (e) of this section.

(4) The commissioner may revoke or deny the exemption set forth in subdivision (3) of this subsection if the commissioner determines that:

(A) because of the nature, size, or other characteristics of the association and its members, the employees, or members are in need of the protections provided by this section; or

(B) the association exemption has or would have a substantial adverse effect on the small group market.

Sec. 2. 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 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. After July 1, 1993, provided that the premium charged shall not deviate above or below the community rate filed by the carrier by more than 40 percent (40%) for two years, and thereafter 20 percent (20%). Such rules may not permit, and provided further that the commissioner’s regulations may not permit any medical underwriting and screening and shall give due consideration to the need for affordability and accessibility of health insurance.

(B) The commissioner’s regulations shall permit a carrier, including a hospital or medical service corporation and a health maintenance organization, to establish rewards, premium discounts, 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 and the director of the office of Vermont health access in the development of health promotion and disease prevention regulations. Such regulations shall:

(i) limit any reward, discount, rebate, or waiver or modification of cost-sharing amounts to not more than a total of 15 percent of the cost of the premium for the applicable coverage tier , provided that the sum of any rate deviations under subdivision (2)(A) of section 4080a of this title does not exceed 30% ;

(ii) be designed to promote good health or prevent disease for individuals in the program and not be used as a subterfuge for imposing higher costs on an individual based on a health factor;

(iii) provide that the reward under the program is available to all similarly situated individuals; and

(iv) provide a reasonable alternative standard to obtain the reward to any individual for whom it is unreasonably difficult due to a medical condition or other reasonable mitigating circumstance to satisfy the otherwise applicable standard for the discount and disclose in all plan materials that describe the discount program the availability of a reasonable alternative standard.

(C) The commissioner’s regulations shall include:

(i) standards and procedures for health promotion and disease prevention programs based on the best scientific, evidence-based medical practices as recommended by the commissioner of health;

(ii) standards and procedures for evaluating an individual’s adherence to programs of health promotion and disease prevention; and

(iii) any other standards and procedures necessary or desirable to carry out the purposes of this subdivision (2).


§ 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) of this title.


§ 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) of this title.


§ 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) of this title.

* * * Community Grants * * *

Sec. 6. COORDINATED HEALTHY ACTIVITY, MOTIVATION, AND PREVENTION PROGRAMS

(a) The department of health initiative known as “champps,” coalition for healthy activity, motivation, and prevention programs, shall serve as the foundation for the community wellness initiatives within the department.

(b) The secretary of human services shall compile an inventory of existing state programs or initiatives, including those administered by other agencies, that fund or promote health, recreation, wellness, or like efforts, along with the amount of funds allotted to the program or initiative, the source of the funds, and the period for which the funds will be available. The secretary shall file the inventory with the senate committee on health and welfare and the house committees on human services and on health care no later than December 15, 2006.

(c) It is the intent of the legislature that the base funding for the department of health programs on healthy aging and fit and healthy kids, the base funding for community grants as part of the blueprint for health program, $500,000.00 of the grant funds received by the department of health from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration and potentially other programs as identified from the inventory to be prepared pursuant to subsection (b) above, be

incorporated into the community health and wellness grant fund program in fiscal year 2008, through the budget process.

Sec. 7. 18 V.S.A. § 104b is added 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:

(1) use comprehensive approaches designed to promote healthy behavior and disease prevention across the community and across the lifespan of individual Vermonters and address issues which may include promoting nutrition and exercise for children, community recreation programs, elderly wellness, lead poisoning abatement, obesity prevention, maternal and child health and immunization, mental health and substance abuse, and tobacco prevention and cessation.

(2) be consistent with the blueprint for health and other state health initiatives as well as the overall goals of the applicant community;

(3) be goal and outcome driven;

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

(5) provide data for evaluating and monitoring progress.

(b) The commissioner shall assist community projects by:

(1) providing technical assistance;

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

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

(4) providing other assistance as appropriate.

(c)(1) No later than September 1, 2006, the commissioner shall establish a grant committee, which the commissioner or deputy commissioner shall chair, that shall consist of:

(A) the commissioner of education or designee; the commissioner for children and families or designee; the secretary of agriculture, food and markets or designee; the commissioner of disabilities, aging, and independent living or designee; and the director of health access or designee;

(B) a representative from the Vermont school boards association;

(C) a representative from the Vermont league of cities and towns;

(D) the administrator of the Vermont tobacco evaluation and review board or designee; and

(E) a member of the governor’s commission on healthy aging; and

(F) six individuals appointed by the governor representing local communities, collaboratives, or coalitions.

(2) For attendance at meetings which are held when the general assembly is not in session, the legislative members of the committee shall be entitled to the same per diem compensation and reimbursement for necessary expenses as those provided to members of standing committees under 2 V.S.A. § 406.

(d) The grant committee shall, consistent with this section:

(1) design comprehensive project parameters, including criteria for evaluating the success of community projects;

(2) create an integrated funding framework;

(3) determine grant application criteria and procedures that are community-friendly, including use of a single, simple grant application and simple reporting requirements;

(4) develop criteria for preparation grants designed to enable a community to obtain initial funds for the purpose of preparing the community for application for a full grant;

(5) encourage and facilitate private participation in community projects; and

(6) write requests for proposals to request grant applications;

(7) review and score grant applications and recommend to the commissioner which grants to fund and in what amount for grant funding to begin July 1, 2007.

(e) By January 15 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.

(f) The commissioner may adopt regulations pursuant to chapter 25 of Title 3, the administrative procedure act, necessary for the implementation of this program.

(g) The commissioner is authorized to accept donations or contributions from private sources for community wellness grants.

* * * Medical Event Reporting * * *

Sec. 8. 18 V.S.A. § 1905(19) is added to read:

(19) All hospitals shall comply with the regulations adopted by the commissioner pursuant to section 1912 of this title. License applications shall certify compliance with the regulations.

Sec. 9. 18 V.S.A. § 1912 is added to read:

§ 1912. PATIENT SAFETY SURVEILLANCE AND IMPROVEMENT SYSTEM


(1) “Adverse event” is any untoward incident, therapeutic misadventure, iatrogenic injury, or other undesirable occurrence directly associated with care or services provided by a health care provider or health care facility.

(2) “Causal analysis” means a formal root cause analysis, similar analytic methodologies or any similarly effective but simplified processes that use a systematic approach to identify the basic or causal factors that underlie the occurrence or possible occurrence of a reportable adverse event, adverse event, or near miss.

(3) “Commissioner” means the commissioner of health.

(4) “Corrective action plan” means a plan to implement strategies intended to eliminate or significantly reduce the risk of a recurrence of an adverse event and to measure the effectiveness of such strategies.

(5) “Department” means the department of health.

(6) “Hospital” shall have the same meaning as in subdivision 1902(1) of this title.

(7) “Health care provider” shall have the same meaning as in subdivision 9402(8) of this title.

(8) "Intentional unsafe act" shall mean an adverse event or near miss that results from:

(A) a criminal act;

(B) a purposefully unsafe act;

(C) alcohol or substance abuse; or

(D) patient abuse.

(9)“Near miss” means any process variation that did not affect the outcome, but for which a recurrence carries a significant chance of a serious adverse outcome.

(10) “Reportable adverse event” means those adverse events a hospital is required to report to the department pursuant to regulations adopted under subsection (c) of this section.

(11) “Safety system” means the comprehensive patient safety surveillance and improvement system established pursuant to this section and the regulations adopted hereunder.

(12) “Serious bodily injury” means bodily injury that creates a substantial risk of death or that causes substantial loss or impairment of the function of any bodily member or organ or substantial impairment of health or substantial disfigurement.

(b) The commissioner shall establish a comprehensive patient safety surveillance and improvement system for the purpose of improving patient safety, eliminating adverse events in Vermont hospitals, and supporting and facilitating quality improvement efforts by hospitals. The department may contract with a qualified organization having expertise in patient safety to develop and implement all or part of the safety system.

(c) The commissioner shall promulgate regulations pursuant to chapter 25 of Title 3 necessary for the implementation of this program. The regulations shall list reportable adverse events, which shall include the “serious reportable events” published by the National Quality Forum. The commissioner shall consult with experts and hospitals when making changes to the list of reportable adverse events and shall consider the implications of reporting requirements that may be established as a result of the federal Patient Safety and Quality Improvement Act of 2005. The department shall consult with other regulatory agencies and departments and, to the extent possible, avoid imposing duplicative reporting requirements.

(d) The department shall:

(1) collect data concerning the occurrence of reportable adverse events;

(2) aggregate and analyze data for the purpose of developing and implementing strategies to target and eliminate specific adverse events;

(3) verify that hospitals are in compliance with all the requirements of this section and regulations adopted hereunder;

(4) for reportable adverse events, verify that hospitals are conducting causal analyses and developing corrective action plans consistent with standards set by the department, current patient safety science, and relevant

clinical standards;

(5) provide technical assistance or assist hospitals in locating technical assistance resources for analyzing adverse events and near misses and developing and implementing corrective action plans; and

(6) encourage hospitals to utilize anonymous in-hospital reporting when possible.

(e) The regulations adopted hereunder shall require hospitals to:

(1) develop, maintain, and implement internal policies and procedures that meet the standards of the department to:

(A) identify, track, and analyze reportable adverse events, adverse events, and near misses;

(B) determine what type of causal analysis, if any, is appropriate;

(C) conduct causal analyses and develop corrective action plans; and

(D) disclose to patients, or, in the case of a patient death, an adult member of the immediate family, at a minimum, adverse events that cause death or serious bodily injury.

(2) report reportable adverse events to the department.

(3) provide the department with copies of its causal analysis and corrective action plan in connection with each reportable adverse event.

(4) for reportable adverse events that must also by law be reported to other departments or agencies, notify the department of health or provide a copy of any written report and provide any causal analysis information required by the department. Such reports shall not constitute a waiver of peer review or any other privilege.

(5) for the purpose of evaluating a hospital’s compliance with the provisions of this section, provide the commissioner and designees reasonable access to:

(A) information protected by the provisions of the patient’s privilege under subsection 1612(a) of Title 12 or otherwise required by law to be held confidential; and

(B) the minutes and records of a peer review committee and any other information subject to peer review protection under section 1443 of Title 26. Hospitals may replace health care provider identifying information with a surrogate identifier that allows for tracking of adverse events involving the same provider without disclosing the provider’s identity.

(f)(1) A hospital shall notify the department, within the time frames established by regulation, if the information available supports a reasonable, good faith belief that an intentional unsafe act as it pertains to patients has occurred.

(2) For intentional unsafe acts reportable to other departments or agencies, notify the department of health or provide a copy of any written report. Such reports shall not constitute a waiver of peer review or any other privilege.

(3) If the department confirms or independently concludes, based on a reasonable, good faith belief, that an intentional unsafe act occurred, it shall notify relevant state and federal licensing and other regulatory entities and, in the case of possible criminal activity, relevant state and federal law enforcement authorities.

(4) There shall be no liability on the part of and no cause of action for damages shall arise against any individual or hospital for any act or proceeding related to activities undertaken or performed within the scope of the obligations imposed by this subsection, provided that the individual or hospital acts without malice and with the reasonable belief that the action is warranted by the facts known after making reasonable efforts to obtain all the facts.

(5) Nothing in this subsection shall prevent a hospital from conducting its own investigation or peer review.

(g)(1) All information made available to the department and its designees under this section shall be confidential and privileged, exempt from the public access to records law, and in any civil or administrative action against a provider of professional health services arising out of the matters which are subject to evaluation and review by the department, immune from subpoena or other disclosure and not subject to discovery or introduction into evidence. No person with access to information made available to the commissioner or his or her designees under this section shall be permitted or required to testify as to any findings, recommendations, evaluations, opinions, or other actions of the department in any civil or administrative action against a provider of professional health services arising out of the matters which are subject to evaluation and review by the department. Within the department, access to peer review protected information shall be limited to individuals responsible for verifying compliance with the safety system and for providing necessary consultation and supervision to that program.

(2) Notwithstanding subdivision (1) of this subsection:

(A) hospitals and the department staff responsible for verifying compliance with the safety system are authorized to disclose information

necessary to comply with their reporting obligations in subsection (f) of this section;

(B) the department staff responsible for verifying compliance with the patient safety surveillance and improvement system may disclose information to others in the department, and the department may disclose information to the board of health and others responsible for carrying out the department’s enforcement responsibilities with respect to this section if the department reasonably believes that a hospital deliberately or repeatedly has not complied with the requirements of this section and any regulations adopted hereunder. The commissioner, the board of health, and others responsible for carrying out the department’s enforcement responsibilities with respect to this section are authorized to disclose such information during the course of any legal or regulatory action taken against a hospital for deliberate or repeated noncompliance with the requirements of this section and any regulations adopted hereunder. Information disclosed under this subdivision shall otherwise maintain all applicable protections under subdivision (1) of this subsection and otherwise provided by law.

(3) Nothing in this section shall prohibit a hospital from making a good faith report to regulatory or law enforcement authorities based on information, documents, or records known or available to it from original sources. Information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any other action merely because they were made available to the department’s patient safety surveillance and improvement system.

(h) The commissioner shall consult with the commissioner of banking, insurance, securities, and health care administration, and with patient safety experts, hospitals, health care professionals, and members of the public and shall make recommendations to the commissioner of banking, insurance, securities, and health care administration concerning which patient safety data should be included in the hospital community reports required by section 9405b of this title. The commissioner shall make such recommendations no more than 18 months after data collection is initiated.

(i) If the commissioner determines that a hospital has failed to comply with any of the provisions of this section, the commissioner may sanction the hospital as provided in this title. In evaluating compliance, the commissioner shall place primary emphasis on assuring good faith compliance and effective corrective action by the facility, reserving punitive enforcement or disciplinary action for those cases in which the facility has displayed recklessness, gross negligence, or willful misconduct or in which there is evidence, based on other similar cases known to the department, the agency of human services, or the

office of the attorney general, of a pattern of significant substandard performance that has the potential for or has actually resulted in harm to patients.

(j) After notice and an opportunity for hearing, the commissioner may impose on a hospital who knowingly violates a provision of this subchapter or a rule or order adopted pursuant to this subchapter a civil administrative penalty of no more than $10,000.00 or, in the case of a continuing violation, a civil administrative penalty of no more than $100,000.00 or one-tenth of one percent of the gross annual revenues of the health care facility, whichever is greater. A hospital aggrieved by a decision of the commissioner under this subdivision may appeal the commissioner’s decision pursuant to section 128 of this title.

(k) The authority granted to the commissioner under this section is in addition to any other authority granted to the commissioner under law.

(1) The commissioner may retain or contract with such additional professional or other staff as needed to carry out responsibilities under this section.

(m) No later than January 15, 2008, the commissioner of health shall provide an interim report to the senate committee on health and welfare and the house committees on human services and on health care on the status of the safety system, its effectiveness in improving patient safety and health care quality in the state, and cost savings. No later than January 15, 2009, the commissioner shall make a final report to those committees on those subjects and shall make recommendations regarding expansion of the system to include health care facilities other than hospitals.

(n) Beginning July 1, 2007, e xpenses incurred for development and implementation of the safety system shall be borne as follows: 50 percent from general fund monies and 50 percent by the hospitals.

Sec. 10. 26 V.S.A. § 1443(b) and (c) are amended to read:

(b) Notwithstanding the provisions of subsection (a) of this section, a peer review committee shall provide a board with all supporting information and evidence pertaining to information required to be reported under section 1317 of this title and shall provide access to such information and evidence to the department of health as provided in and for the purpose of determining a hospital’s compliance with section 1912 of Title 18.

(c) Notwithstanding the provisions of section 1318 of this title, relating to accessibility and confidentiality of disciplinary matters, the proceedings, reports, records, reporting information, and evidence of a peer review

committee provided by the committee to a board in accordance with the provisions of section 1317 of this title or to the department of health in accordance with section 1912 of Title 18 and subsection (b) of this section, may be used by the board or by the commissioner of health or board of health for disciplinary and enforcement purposes but shall not be subject to public disclosure.

Sec. 11. 1 V.S.A. § 317(c) is amended to read:

(c) The following public records are exempt from public inspection and copying:

* * *

(34) affidavits of income and assets as provided in section 662 of Title 15 and Rule 4 of the Vermont Rules for Family Proceedings;

* * *(36) records provided to the department of health pursuant to the patient

safety surveillance and improvement system established by section 1912 of Title 18.

* * * Hospital Infection Rate Reporting * * *

Sec. 12. 18 V.S.A. § 9405b(a) is amended to read:

§ 9405b. HOSPITAL COMMUNITY REPORTS

(a) The commissioner, in consultation with representatives from the public oversight commission, hospitals, and other groups of health care professionals, and members of the public representing patient interests, shall adopt rules establishing a standard format for community reports, as well as the contents, which shall include:

(1) measures of quality, including process and outcome measures, that are valid, reliable, and useful, including comparisons to appropriate national benchmarks for high quality and successful outcomes;

(2) measures of patient safety that are valid, reliable, and useful, including comparisons to appropriate industry benchmarks for safety;

(3) measures of hospital-acquired infections that are valid, reliable, and useful, including comparisons to appropriate industry benchmarks;

(3)(4) measures of the hospital’s financial health, including comparisons to appropriate national benchmarks for efficient operation and fiscal health;

(4)(5) a summary of the hospital’s budget, including revenue by source and quantification of cost shifting to private payers;

(5)(6) measures that provide valid, reliable, useful, and efficient information for payers and the public for the comparison of charges for higher volume health care services;

(6)(7) the hospital’s process for achieving openness, inclusiveness, and meaningful public participation in its strategic planning and decision-making;

(7)(8) the hospital’s consumer complaint resolution process, including identification of the hospital officer or employee responsible for its implementation;

(8)(9) information concerning recently completed or ongoing quality improvement and patient safety projects;

(9)(10) a summary of the community needs assessment, including a description of strategic initiatives discussed with or derived from the assessment; the one-year and four-year capital expenditure plans; and the depreciation schedule for existing facilities; and

(10)(11) information on membership and governing body qualifications, a listing of the current governing body members, and means of obtaining a schedule of meetings of the hospital’s governing body, including times scheduled for public participation.

* * * Administrative Simplification * * *

Sec. 13. COMMON CLAIMS AND PROCEDURES

(a) No later than July 1, 2008, the commissioner shall amend the rules adopted pursuant to section 9408 of Title 18 as may be necessary to implement the recommendations of the final report described in subsection (g) of this section, as the commissioner deems appropriate in his or her discretion. Nothing in this section shall be construed to alter the commissioner’s authority under Title 8 or chapter 221 of Title 18.

(b) No later than July 1, 2006, a common claims and procedures work group shall form, composed of:

(1) two representatives selected by the Vermont association of hospitals and health systems;

(2) two representatives selected by the Vermont medical society;

(3) one representative of each of the three largest health care insurers;

(4) the director of the office of health access or designee;

(5) two representatives from business groups appointed by the governor;

(6) the health care ombudsman or designee;

(7) one representative of consumers appointed by the governor; and

(8) the commissioner of the department of banking, insurance, securities and health care administration or designee.

(c) The group shall design, recommend, and implement steps to achieve the following goals:

(1) Simplifying the claims administration process for consumers, health care providers, and others so that the process is more understandable and less time-consuming.

(2) Lowering administrative costs in the health care financing system.

(d) The group shall elect a chair at its first meeting. The chair, or the chair's designee, shall be responsible for scheduling meetings and ensuring the completion of the reports called for in subsection (g) of this section. Each organization represented on the work group shall be asked to contribute funds for the group's administrative costs.

(e) On or before September 1, 2006, the work group shall present a two - year work plan and budget to the house committee on health care and the senate committee on health and welfare.

(f) This work plan may include the elements of the claims administration process, including claims forms, patient invoices, and explanation of benefits forms, payment codes, claims submission and processing procedures, including electronic claims processing, issues relating to the prior authorization process and reimbursement for services provided prior to being credentialed.

(g) The work group shall make an interim report to the governor and the general assembly on or before January 15, 2007 describing the progress of the group and any interim steps taken to achieve the goals of the work plan. The work group shall make a final report to the governor and the general assembly on or before January 15, 2008 with the findings that illustrate the outcomes of implementations derived from the work group actions along with a list of future actions and goals, which shall specify cost savings achieved and expected future savings.


§ 9408a. UNIFORM PROVIDER CREDENTIALING

(a) Definitions. As used in this section:

(1) “Credentialing” means a process through which an insurer or hospital makes a determination, based on criteria established by the insurer or hospital, concerning whether a provider is eligible to:

(A) provide health care services to an insured or hospital patients; and

(B) receive reimbursement for the health care services.

(2) “Health care services” means health - care - related services or products rendered or sold by a provider within the scope of the provider’s license or legal authorization, including hospital, medical, surgical, dental, vision, and pharmaceutical services or products.

(3) “Insured” means an individual entitled to reimbursement for

expenses of health care services under a policy issued or administered

by an insurer.

(4) “Insurer” has the same meaning as in subdivision 9402(9) of this title.

(5) “Provider” has the same meaning as in subdivision 9402(8) of this title.

(b) The department shall prescribe the credentialing application form used by the Council for Affordable Quality Healthcare (CAQH), or a similar, nationally recognized form prescribed by the commissioner, in electronic or paper format, which must be used beginning January 1, 2007 by an insurer or a hospital that performs credentialing.

(c) An insurer or a hospital shall notify a provider concerning a deficiency on a completed credentialing application form submitted by the provider not later than 30 business days after the insurer or hospital receives the completed credentialing application form.

(d) An insurer or 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 insurer or hospital makes a final credentialing determination concerning the provider.

(e) The commissioner may enforce compliance with the provisions of this section as to insurers and as to hospitals as if the hospital were an insurer under section 3661 of Title 8.

* * * INFORMATION TECHNOLOGY * * *

* * * Coordination of IT Efforts * * *


§ 2222a. HEALTH CARE SYSTEM REFORM; IMPROVING QUALITY AND AFFORDABILITY

(a) The secretary of administration shall be responsible for the coordination of health care system reform initiatives among executive branch agencies, departments, and offices.

(b) The secretary shall ensure that those executive branch agencies, departments, and offices responsible for the development, improvement, and implementation of Vermont’s health care system reform do so in a manner that is timely, patient-centered, and seeks to improve the quality and affordability of patient care.

(c) Vermont’s health care system reform initiatives include:

(1) the state’s chronic care infrastructure, disease prevention, and management program contained in the blueprint for health, the goal of which is to achieve a unified, comprehensive, statewide system of care that improves the lives of Vermonters with or at risk for chronic disease.

(2) the Vermont health information technology project pursuant to section 9417 of Title 18.

(3) the multi-payer data collection project pursuant to section 9410 of Title 18.

(4) the common claims administration project pursuant to section 9408 of Title 18.

(5) the consumer price and quality information system pursuant to section 9410 of Title 18.

(6) any information technology work done by the quality assurance system pursuant to section 9416 of Title 18.

(7) the public health promotion programs of the department of health and the department of disabilities, aging, and independent living.

(8) Medicaid, the Vermont health access plan, Dr. Dynasaur, VPharm, and Vermont Rx, which are established in chapter 19 of Title 33 and provide health care coverage to elderly, disabled, and low to middle income Vermonters.

(d) The secretary shall report to the commission on health care reform, the health access oversight committee, the house committee on health care, the senate committee on health and welfare, and the governor on or before December 1, 2006 with a five-year strategic plan for implementing Vermont’s health care system reform initiatives, together with any recommendations for administration or legislation. Annually, beginning January 15, 2007, the secretary shall report to the general assembly on the progress of the reform initiatives.

(e) The secretary of administration or designee shall provide information and testimony on the activities included in this section to the health access oversight committee, the commission on health care reform, and to any legislative committee upon request.

Sec. 16. AGENCY OF HUMAN SERVICES INFORMATION TECHNOLOGY

The secretary of the agency of human services shall ensure that the blueprint for health project in the department of health, the global clinical record being developed by the office of Vermont health access, and any other health care - related information technology initiatives are incorporated into and comply with the statewide health information technology plan developed under 18 V.S.A. § 9417 and any other information technology initiatives coordinated by the secretary of administration pursuant to section 2222a of Title 3.

Sec. 17. 18 V.S.A. § 9416(a) is amended to read:

§ 9416. VERMONT PROGRAM FOR QUALITY IN HEALTH CARE

(a) The commissioner shall contract with the Vermont Program for Quality in Health Care, Inc. to implement and maintain a statewide quality assurance system to evaluate and improve the quality of health care services rendered by health care providers of health care facilities, including managed care organizations, to determine that health care services rendered were professionally indicated or were performed in compliance with the applicable standard of care, and that the cost of health care rendered was considered reasonable by the providers of professional health services in that area. The commissioner shall ensure that the information technology components of the quality assurance system are incorporated into and comply with the statewide health information technology plan developed under section 9417 of this title and any other information technology initiatives coordinated by the secretary of administration pursuant to section 2222a of Title 3.


§ 9417. HEALTH INFORMATION TECHNOLOGY

(a) The commissioner shall facilitate the development of a statewide health information technology plan that includes the implementation of an integrated electronic health information infrastructure for the sharing of electronic health information among health care facilities, health care professionals, public and private payers, and patients. The plan shall include standards and protocols designed to promote patient education, patient privacy, physician best practices, electronic connectivity to health care data, and, overall, a more efficient and less costly means of delivering quality health care in Vermont.

(b) The health information technology plan shall:

(1) support the effective, efficient, statewide use of electronic health information in patient care, health care policymaking, clinical research, health care financing, and continuous quality improvements;

(2) educate the general public and health care professionals about the value of an electronic health infrastructure for improving patient care;

(3) promote the use of national standards for the development of an interoperable system, which shall include provisions relating to security, privacy, data content, structures and format, vocabulary, and transmission protocols;

(4) propose strategic investments in equipment and other infrastructure elements that will facilitate the ongoing development of a statewide infrastructure; and

(5) recommend funding mechanisms for the ongoing development and maintenance costs of a statewide health information system;

(6) incorporate the existing health care information technology initiatives in order to avoid incompatible systems and duplicative efforts;

(7) integrate the information technology components of the blueprint for health project in the department of health, the global clinical record and all other Medicaid management information systems being developed by the office of Vermont health access, information technology components of the quality assurance system, the program to capitalize electronic medical record systems in primary care practices with loans and grants, and any other information technology initiatives coordinated by the secretary of administration pursuant to section 2222a of Title 3; and

(8) address issues related to data ownership, governance, and confidentiality and security of patient information.

(c) The commissioner shall contract 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 in the certificate of need regulations to ensure that deliberations and decisions are fair and equitable.

(d) The following persons shall be members of VITL:

(1) the commissioner of information and innovation, who shall advise the group on technology best practices and the state’s information technology policies and procedures, including the need for a functionality assessment and feasibility study related to establishing an electronic health information infrastructure under this section;

(2) the director of the office of Vermont health access or his or her designee; and

(3) the commissioner of health or his or her designee; and

(3)(4) the commissioner or his or her designee.

(e) On or before July 1, 2006, VITL shall initiate a pilot program involving at least two hospitals using existing sources of electronic health information to establish electronic data sharing for clinical decision support, pursuant to priorities and criteria established in conjunction with the health information technology advisory group. Objectives of the pilot program may include:

(1) Objectives of the pilot program shall include:

(A) supporting patient care and improving quality of care;

(2)(B) enhancing productivity of health care professionals and reducing administrative costs of health care delivery and financing;

(2) Objectives of the pilot program may include:

(3)(A) determining whether and how best to expand the pilot program on a statewide basis;

(4)(B) implementing strategies for future developments in health care technology, policy, management, governance, and finance; and

(5)(C) ensuring patient data confidentiality at all times.

(f) The standards and protocols developed by VITL shall be no less stringent than the “Standards for Privacy of Individually Identifiable Health

Information” established under the Health Insurance Portability and Accountability Act of 1996 and contained in 45 C.F.R., Parts 160 and 164, and any subsequent amendments. In addition, the standards and protocols shall ensure that there are clear prohibitions against the out-of-state release of individually identifiable health information for purposes unrelated to treatment, payment, and health care operations, and that such information shall under no circumstances be used for marketing purposes. The standards and protocols shall require that access to individually identifiable health information is secure and traceable by an electronic audit trail.

(g) On or before January 1, 2007, VITL shall submit to the secretary of administration, the commissioner, the commissioner of information and innovation, the director of the office of Vermont health access, and the general assembly 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 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 this title by the commissioner.

(h) Beginning January 1, 2006, and annually thereafter, VITL shall file a report with the secretary of administration, the commissioner, the commissioner of information and innovation, the director of the office of Vermont health access, and the general assembly. 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. In addition, VITL shall file quarterly progress reports with the secretary of administration, the health access oversight committee and shall publish minutes of VITL meetings and any other relevant information on a public website.

(i) VITL is authorized to seek matching funds to assist with carrying out the purposes of this section. In addition, it may accept any and all donations, gifts, gifts, and grants of money, equipment, supplies, materials, and services from the federal or any local government, or any agency thereof, and from any person, firm, or corporation for any of its purposes and functions under this

section and may receive and use the same subject to the terms, conditions, and regulations governing such donations, gifts, and grants.

(j) The commissioner, in consultation with VITL, may seek any waivers of federal law, rule, or regulation that might assist with implementation of this section.

(k) The commissioner, in collaboration with VITL and other departments and agencies of state government, shall establish a loan and grant program to provide for the capitalization of electronic medical records systems at primary care practices. Health information technology acquired under a grant or loan authorized by this section shall comply with data standards for interoperability adopted by VITL and the state health information technology plan. An implementation plan for this loan and grant program shall be incorporated into the state health information technology plan.

* * * Multi-Payer Database and

Consumer Price and Quality Information * * *


§ 9410. HEALTH CARE DATA BASE DATABASE

(a)(1) The commissioner shall establish and maintain a unified health care data base to enable the commissioner to carry out the duties under this chapter and Title 8, including:

(1)(A) Determining the capacity and distribution of existing resources.

(2)(B) Identifying health care needs and informing health care policy.

(3)(C) Evaluating the effectiveness of intervention programs on improving patient outcomes.

(4)(D) Comparing costs between various treatment settings and approaches.

(5)(E) Providing information to consumers and purchasers of health care.

(F) Improving the quality and affordability of patient health care and health care coverage.

(2)(A) The program authorized by this section shall include a consumer health care price and quality information system designed to make available to consumers transparent health care price information, quality information, and such other information as the commissioner determines is necessary to empower individuals, including uninsured individuals, to make economically sound and medically appropriate decisions.

(B) The commissioner shall convene a working group composed of the commissioner of health, the director of the office of Vermont health access, health care consumers, the office of the health care ombudsman, employers and other payers, health care providers and facilities, the Vermont program for quality in health care, health insurers, and any other individual or group appointed by the commissioner to advise the commissioner on the development and implementation of the consumer health care price and quality information system.

(C) The commissioner may require a health insurer covering at least five percent of the lives covered in the insured market in this state to file with the commissioner a consumer health care price and quality information plan in accordance with regulations adopted by the commissioner.

(D) The commissioner shall adopt such regulations as are necessary to carry out the purposes of this subdivision. The commissioner’s regulations may permit the gradual implementation of the consumer health care price and quality information system over time, beginning with health care price and quality information that the commissioner determines is most needed by consumers or that can be most practically provided to the consumer in an understandable manner. The regulations shall permit health insurers to use security measures designed to allow subscribers access to price and other information without disclosing trade secrets to individuals and entities who are not subscribers. The regulations shall avoid unnecessary duplication of efforts relating to price and quality reporting by health insurers, health care providers, health care facilities, and others, including activities undertaken by hospitals pursuant to their community report obligations under section 9405b of this title.

* * *

(c) Health insurers, health care providers, health care facilities and governmental agencies shall file reports, data, schedules, statistics, or other information determined by the commissioner to be necessary to carry out the purposes of this section. Such information may include:

(1) health insurance claims and enrollment information used by health insurers;

(2) information relating to hospitals filed under subchapter 7 of this chapter (hospital budget reviews); and

(3) any other information relating to health care costs, prices, quality, utilization, or resources required to be filed by the commissioner.

* * *

(h)(1) Data Collection and Information Sharing. All health insurers shall electronically provide to the commissioner in accordance with standards and procedures adopted by the commissioner by rule:

(A) their encrypted health insurance claims data;

(B) cross-matched claims data on requested members, subscribers, or policyholders; and

(C) member, subscriber, or policyholder information necessary to determine third party liability for benefits provided.

(2) The collection, storage, and release of health care data and statistical information that is subject to the federal requirements of the Health Insurance Portability and Accountability Act (“HIPAA”) shall be governed exclusively by the rules adopted thereunder in 45 CFR Parts 160 and 164.

(A) All health insurers that collect the Health Employer Data and Information Set (HEDIS) shall annually submit the HEDIS information to the commissioner in a form and in a manner prescribed by the commissioner.

(B) All health insurers shall accept electronic claims submitted in Centers for Medicare and Medicaid Services format for UB-92 or HCFA-1500 records, or as amended by the Centers for Medicare and Medicaid Services.

(3)(A) The commissioner shall collaborate with the agency of human services and participants in agency of human services initiatives in the development of a comprehensive health care information system. The collaboration is intended to address the formulation of a description of the data sets that will be included in the comprehensive health care information system, the criteria and procedures for the development of limited use data sets, the criteria and procedures to ensure that HIPAA compliant limited use data sets are accessible, and a proposed time frame for the creation of a comprehensive health care information system.

(B) To the extent allowed by HIPAA, the data shall be available as a resource for insurers, employers, providers, purchasers of health care, and state agencies to continuously review health care utilization, expenditures, and performance in Vermont and to enhance the ability of Vermont consumers and employers to make informed and cost-effective health care choices. In presenting data for public access, comparative considerations shall be made regarding geography, demographics, general economic factors, and institutional size.

(C) Consistent with the dictates of HIPAA, and subject to such terms and conditions as the commissioner may prescribe by regulation, the Vermont information technology leaders (VITL) shall have access to the database for

use in the development of a statewide health information technology plan pursuant to section 9417 of this title, and the Vermont program for quality in health care shall have access to the database for use in improving the quality of health care services in Vermont.

(C)(D) Notwithstanding HIPAA or any other provision of law, the comprehensive health care information system shall not include or publicly disclose any data that contains direct personal identifiers. For the purposes of this section, “direct personal identifiers” include information relating to an individual that contains primary or obvious identifiers, such as the individual’s name, street address, e-mail address, telephone number, and Social Security number.

(i)(1) As used in this section, and without limiting the meaning of subdivision 9402(9) of this title, the term “health insurer” includes:

(A) any entity defined in subdivision 9402(9) of this title;

(B) any third party administrator, any pharmacy benefit manager, any entity conducting administrative services for business, and any other similar entity with claims data, eligibility data, provider files, and other information relating to health care provided to Vermont resident, and health care provided by Vermont health care providers and facilities required to be filed by a health insurer under this section;

(C) any health benefit plan offered or administered by or on behalf of the state of Vermont or an agency or instrumentality of the state; and

(D) any health benefit plan offered or administered by or on behalf of the federal government with the agreement of the federal government.

(2) The commissioner may adopt rules to carry out the provisions of this subsection, including standards and procedures requiring the registration of persons or entities not otherwise licensed or registered by the commissioner and criteria for the required filing of such claims data, eligibility data, provider files, and other information as the commissioner determines to be necessary to carry out the purposes of this section and this chapter.

* * * Master Provider Index * * *

Sec. 19a. MASTER PROVIDER INDEX

(a) No later than September 1, 2006, a work group shall be convened by the area health education centers (AHEC) program for the purpose of making recommendations for the creation of a master provider index designed to assure uniform and consistent identification and cross - reference of all Vermont health care professionals in the development and implementation of health care technology in Vermont. The work group shall:

(1) be composed of interested parties, including representatives of health care provider associations and societies, public and private insurers, the Vermont program for quality health care (VPQHC), appropriate departments of state government, including the commissioner of the department of banking, insurance, securities, and health care administration or designee, the area health education centers (AHEC) program, and Vermont information technology leaders (VITL), for the purpose of creating a set of common data fields for a master provider index of all health care providers, as defined in subdivision 9402(8) of Title 18;

(2) compile recommendations from those parties regarding data fields that are necessary to be included in a database that allows for comprehensive cross - referencing of the multiple “unique identification codes” applied to health care providers through licensure, credentialing, and billing and claims processing mechanisms for the purpose of supporting the implementation of health information exchange and public health and policy research, analysis and planning;

(3) provide cost and time estimates for development and implementation of such an index; and

(4) develop recommendations for the governance of the index and its relationship to other state health information data systems, technologies, and records.

(b) No later than January 15, 2007, the work group shall report to the general assembly on the information obtained and shall make recommendations regarding the advisability of creating and sustaining a master provider index.

* * * PROVIDER INITIATIVE * * *

* * * Loan Repayment for Health Care Providersin Underserved Areas and Health Educators * * *


§ 10a. LOAN REPAYMENT FOR HEALTH CARE PROVIDERS AND HEALTH CARE EDUCATOR FUND

(a) There is hereby established a special fund to be known as the Vermont educational loan repayment fund which shall be used for the purpose of ensuring a stable and adequate supply of health care providers and health care educators to meet the health care needs of Vermonters, with a focus on recruiting and retaining providers and health care educators in underserved geographic and specialty areas.

(b) The fund shall be established and held separate and apart from any other funds or moneys of the state and shall be used and administered exclusively for the purpose of this section. The money in the fund shall be invested in the same manner as permitted for investment of funds belonging to the state or held in the treasury. The fund shall consist of the following:

(1) Such sums as may be appropriated or transferred thereto from time to time by the general assembly, the state emergency board, or the joint fiscal committee during such times as the general assembly is not in session.

(2) Interest earned from the investment of fund balances.

(3) Any other money from any other source accepted for the benefit of the fund.

(c) The fund shall be administered by the department of health, which shall make funds available to the University of Vermont college of Medicine area health education centers (AHEC) program for loan repayment awards. The commissioner may require certification of compliance with this section prior to the making of an award.

(d) AHEC shall administer awards in such a way as to comply with the requirements of Section 108(f) of the Internal Revenue Code.

(e) AHEC shall make loan repayment awards in exchange for service commitment by health care providers and health care educators and shall define the service obligation in a contract with the health care provider or health care educator. Payment awards shall be made directly to the educational loan creditor of the health care provider or health care educator.

(f) Loan repayment awards shall only be available for a health care provider or health care educator who :

(1) is a Vermont resident;

(2) serves Vermont;

(3) accepts patients with coverage under Medicaid, Medicare, or other state-funded health care benefit programs, if applicable; and

(4) has outstanding educational debt acquired in the pursuit of an undergraduate or graduate degree from an accredited college or university that exceeds the amount of the loan repayment award.

(g) Additional eligibility and selection criteria will be developed annually by the commissioner in consultation with AHEC and may include local goals for improved service, community needs, or other awarding parameters.

(h) The commissioner may adopt regulations in order to implement the program established in this section.

(i) As used in this section:

(1) “Health care educator” shall mean an individual employed by or contracted by an accredited postsecondary institution in Vermont to teach in a health care profession educational program.

(2) “Health care provider” shall mean an individual licensed, certified, or authorized by law to provide professional health care service in this state to an individual during that individual’s medical or dental care, treatment, or confinement.

* * * Advance Directives * * *

Sec. 21. 18 V.S.A. § 9701 is amended as follows:

§ 9701. DEFINITIONS

As used in this chapter:

* * *

(3) “Anatomical gift” shall have the same meaning as provided in subdivision 5238(1) of this title.

(3)(4) “Capacity” means an individual’s ability to make and communicate a decision regarding the issue that needs to be decided.

(A) An individual shall be deemed to have capacity to appoint an agent if the individual has a basic understanding of what it means to have another individual make health care decisions for oneself and of who would be an appropriate individual to make those decisions, and can identify whom the individual wants to make health care decisions for the individual.

(B) An individual shall be deemed to have capacity to make a health care decision if the individual has a basic understanding of the diagnosed condition and the benefits, risks, and alternatives to the proposed health care.

(4)(5) “Clinician” means a medical doctor licensed to practice under chapter 23 of Title 26, an osteopathic physician licensed pursuant to subdivision 1750(9) of Title 26, an advance practice registered nurse licensed pursuant to subdivision 1572(4) of Title 26, and a physician’s assistant certified pursuant to section 1733 of Title 26 acting within the scope of the license under which the clinician is practicing.

(5)(6) “Commissioner” means the commissioner of the department of health.

(6)(7) “Do-not-resuscitate order” or “DNR order” means a written order of the principal’s clinician directing health care providers not to attempt resuscitation.

(7)(8) “DNR identification” means a document, bracelet, other jewelry, wallet card, or other means of identifying the principal as an individual who has a DNR order.

(8)(9) “Emergency medical personnel” shall have the same meaning as provided in section 2651 of Title 24.

(9)(10) “Guardian” means a person appointed by the probate court who has the authority to make medical decisions pursuant to subdivision 3069(b)(5) of Title 14.

(10)(11) “Health care” means any treatment, service, or procedure to maintain, diagnose, or treat an individual’s physical or mental condition, including services provided pursuant to a clinician’s order, and services to assist in activities of daily living provided by a health care provider or in a health care facility or residential care facility.

(11)(12) “Health care decision” means consent, refusal to consent, or withdrawal of consent to any health care.

(12)(13) “Health care facility” shall have the same meaning as provided in subdivision 9432(7) of this title.

(13)(14) “Health care provider” shall have the same meaning as provided in subdivision 9432(8) of this title and shall include emergency medical personnel.

(14)(15) “HIPAA” means the Health Insurance Portability and Accountability Act of 1996, codified at 42 U.S.C. § 1320d and 45 C.F.R.

§§ 160-164.

(15)(16) “Informed consent” means the consent given voluntarily by an individual with capacity after being fully informed of the nature, benefits, risks, and consequences of the proposed health care, alternative health care, and no health care.

(16)(17) “Interested individual” means:

(A) the principal’s spouse, adult child, parent, adult sibling, adult grandchild, reciprocal beneficiary, or clergy person; or

(B) any adult who has exhibited special care and concern for the principal and who is personally familiar with the principal’s values.

(17)(18) “Life sustaining treatment” means any medical intervention, including nutrition and hydration administered by medical means and antibiotics, which is intended to extend life and without which the principal is likely to die.

(18)(19) “Nutrition and hydration administered by medical means” means the provision of food and water by means other than the natural ingestion of food or fluids by eating or drinking. Natural ingestion includes spoon feeding or similar means of assistance.

(19)(20) “Ombudsman” means an individual appointed as a long-term care ombudsman under the program contracted through the department of aging and independent living pursuant to the Older Americans Act of 1965, as amended.

(20)(21) “Patient’s clinician” means the clinician who currently has responsibility for providing health care to the patient.

(21)(22) “Principal” means an adult who has executed an advance directive.

(22)(23) “Principal’s clinician” means a clinician who currently has responsibility for providing health care to the principal.

(23)(24) “Probate court designee” means a responsible, knowledgeable individual independent of a health care facility designated by the probate court in the district where the principal resides or the county where the facility is located.

(25) “Procurement organization” shall have the same meaning as in subdivision 5238(10) of this title.

(24)(26) “Reasonably available” means able to be contacted with a level of diligence appropriate to the seriousness and urgency of a principal’s health care needs, and willing and able to act in a timely manner considering the urgency of the principal’s health care needs.

(25)(27) “Registry” means a secure, web-based database created by the commissioner to which individuals may submit an advance directive or information regarding the location of an advance directive that is accessible to principals and agents and, as needed, to individuals appointed to arrange for the disposition of remains, organ procurement organizations, tissue and eye banks, health care providers, health care facilities, residential care facilities, funeral directors, crematory operators, cemetery officials, probate court officials, and the employees thereof.

(26)(28) “Residential care facility” means a residential care home or an assisted living residence as those terms are defined in section 7102 of Title 33.

(27)(29) “Resuscitate” or “resuscitation” includes chest compressions and mask ventilation; intubation and ventilation; defibrillation or cardioversion; and emergency cardiac medications provided according to the guidelines of the American Heart Association’s Cardiac Life Support program.

(28)(30) “Suspend” means to terminate the applicability of all or part of an advance directive for a specific period of time or while a specific condition exists.


§ 9702. ADVANCE DIRECTIVE

(a) An adult may do any or all of the following in an advance directive:

* * *

(10) identify those interested individuals, or entities, whether or not otherwise qualified to bring an action under section 9718 of this title, who shall or shall not have authority to bring an action under that section;

* * *

(13) identify a preferred primary care clinician and affirm that the clinician has been notified;

* * *

(c) The principal’s health care provider may not be the principal’s agent. Unless related to the principal by blood, marriage, civil union, or adoption, an agent may not be an owner, operator, employee, agent, or contractor of a residential care facility, a health care facility, or a correctional facility in which the principal resides at the time of execution of an advance directive.

(d) Unless related to the principal by blood, marriage, civil union, or adoption, an individual may not exercise the authority pursuant to an advance directive for disposition of remains, anatomical gifts, or funeral goods and services while serving the interests of the principal in one of the following capacities:

(1) a funeral director or employee of the funeral director;

(2) a crematory operator or employee of the crematory operator; or

(3) a cemetery official or employee of the cemetery; or

(4) an employee or representative of a procurement organization.


§ 9704. AMENDMENT, SUSPENSION, AND REVOCATION

* * *

(b)(1) Except as provided in subdivision (2)(3) of this subsection, a principal with or without capacity may suspend or revoke all or part of an advance directive, including the designation of an agent:

(A) by signing a statement suspending or revoking the designation of an agent all or part of an advance directive;

(B) by personally informing the principal's clinician, who shall make a written record of the suspension or revocation in the principal's medical record; or

(C) by burning, tearing, or obliterating the advance directive, either by the principal personally or by another person at the principal’s express direction and in the presence of the principal; or

(D) For any provision other than the designation of an agent, orally, in writing, or by any other act evidencing a specific intent to suspend or revoke.

(2) Except as provided in subdivision (3) of this subsection, a principal with or without capacity may suspend or revoke any provision other than the designation of an agent, orally, in writing, or by any other act evidencing a specific intent to suspend or revoke.

(2)(3) A provision in an advance directive executed pursuant to subsection 9707(h) of this title may be suspended or revoked only if the principal has capacity.

(3)(4) To the extent possible, the principal shall communicate any suspension or revocation to the agent or other interested individual.

(c)(1) A clinician, health care provider, health care facility, or residential care facility who becomes aware of an amendment, suspension, or revocation while treating an incapacitated principal shall make reasonable efforts to:

* * *

(C) flag the amendment, suspension, or revocation in the principal's medical record on the front of the medical folder or on the front of any advance directive filed in the medical record; and

(D) notify the principal, agent, and guardian of the amendment, suspension, or revocation; and

(E) inform the registry of the amendment, suspension, or revocation.

* * *

(3) A health care provider, health care facility, or residential care facility not currently providing health or residential care to a principal who becomes aware of an amendment, suspension, or revocation shall ensure that the amendment, suspension, or revocation is recorded and flagged in the principal’s medical record and is submitted to the registry.

* * *


§ 9712. OBLIGATIONS OF FUNERAL DIRECTORS, CREMATORY OPERATORS, CEMETERY OFFICIALS, PROCUREMENT ORGANIZATIONS, AND INDIVIDUALS APPOINTED TO ARRANGE FOR THE DISPOSITION OF THE PRINCIPAL’S REMAINS

* * *

(c) Any procurement organization having knowledge of a principal’s advance directive shall follow the advance directive and any instructions of the individual appointed in the advance directive to arrange for the recovery of the principal’s anatomical gifts unless the procurement organization determines such gifts are unsuitable for the purposes for which they are made or if recovery of such gifts would cause the procurement organization to violate standards of professional conduct or any applicable regulation or law.

(c)(d) Every funeral director, crematory operator, and cemetery official, and procurement organization shall develop systems:

(1) to ensure that a principal’s advance directive is promptly available when services are to be provided, including that the existence of an advance directive is prominently noted on any file jacket or folder, and that a note is entered into any electronic database of the director, operator, or official, or organization;

(2) within 120 days of the commissioner’s announcing the availability of the registry, to ensure that the director, operator, official, or organization checks the registry at the time services are to be provided to determine whether the decedent has an advance directive.

(d)(e) In the event the principal’s instructions in an advance directive regarding disposition of remains or for funeral goods and services are in apparent conflict with a contract entered into by the principal for the disposition of remains, funeral goods, or services, the most recent document created by the principal shall be followed to the extent of the conflict. Nothing in this subsection shall be construed as limiting any other available remedies.


§ 9713. IMMUNITY

* * *

(b)(1) No health care provider, health care facility, residential care facility, funeral director, crematory operator, cemetery official, or any other person acting for or under such person's control shall, if the provider, or facility, director, operator, or official has complied with the provisions of this chapter, be subjected subject to civil or criminal liability for:

(A) providing or withholding health care or services in good faith pursuant to the provisions of an advance directive, a DNR identification of the principal, the consent of a principal with capacity or of the principal’s agent or guardian, or a decision or objection of a principal; or

(B) relying in good faith on a suspended or revoked advance directive.

(2) No funeral director, crematory operator, cemetery official, or procurement organization, or any other person acting for or under such person's control, shall, if the director, operator, official, or organization has complied with the provisions of this chapter, be subject to civil or criminal liability for providing or withholding its services in good faith pursuant to the provisions of an advance directive, whether or not the advance directive has been suspended or revoked.

(2)(3) Nothing in this subsection shall be construed to establish immunity for the failure to follow standards of professional conduct and to exercise due care in the provision of services.

* * *

Sec. 26. 18 V.S.A. § 9714(b) is amended to read:

(b) A health care provider, health care facility, residential care facility, funeral home director, crematory operator, or cemetery official, probate court official, or procurement organization, or an employee of any of them, who accesses the registry without authority or when authority has been denied specifically by the principal, agent, or guardian is subject to review and disciplinary action by the appropriate licensing, accreditation, or approving entity.


(a) A petition may be filed in probate court under this section by:

(1) a, principal, guardian, agent, ombudsman, or interested individual other than one identified in an advance directive, pursuant to subdivision 9702(a)(10) of this title, as not authorized to bring an action under this section;

(2) a social worker or health care provider employed by or directly associated with the health care provider, health care facility, or residential care facility providing care to the principal;

(3) the defender general if the principal is in the custody of the department of corrections; or

(4) a representative of the state-designated protection and advocacy system if the principal is in the custody of the department of health; or

(5) an individual or entity identified in an advance directive, pursuant to subdivision 9702(a)(10) of this section, as authorized to bring an action under this section.


§ 9719. OBLIGATIONS OF STATE AGENCIES

(a) Within 180 days of the effective date of this chapter No later than July 1, 2006 , and from time to time thereafter, the commissioner, in consultation with all appropriate agencies and organizations, shall adopt rules pursuant to chapter 25 of Title 3 to effectuate the intent of this chapter. The rules shall cover at least one optional form of an advance directive with an accompanying form providing an explanation of choices and responsibilities, the form and content of clinician orders for life sustaining treatment, the use of experimental treatments, a model DNR order which meets the requirements of subsection 9708(a) of this title, DNR identification, revocation of a DNR identification, and consistent statewide emergency medical standards for DNR orders and advance directives for patients and principals in all settings. The commissioner shall also provide, but without the obligation to adopt a rule, optional forms for advance directives for individuals with disabilities, limited English proficiency, and cognitive translation needs.

(b)(1) Within 180 days of the effective date of this chapter Within one year of the effective date of this chapter, the commissioner shall develop and maintain a registry to which a principal may submit his or her advance directive, including a terminal care document and a durable power of attorney. The rules shall describe when health care providers, health care facilities, and residential care facilities may access an advance directive in the registry. In no event shall the information in the registry be accessed or used for any purpose unrelated to decision-making for health care or disposition of remains, except that the information may be used for statistical or analytical purposes as long as the individual’s identifying information remains confidential.

(2)(A) Within 180 days one year of the effective date of this chapter, the commissioner shall adopt rules pursuant to chapter 25 of Title 3 on the process

for securely submitting, revoking, amending, replacing, and accessing the information contained in the registry. The rules shall provide for incorporation into the registry of notifications of amendment, suspension, or revocation under subsection 9704(c) of this title and revocations of appointment under subsection 9704(d) of this title.

(B) The commissioner shall provide to any individual who submits an advance directive to the registry a sticker that can be placed on a driver’s license or identification card indicating that the holder has an advance directive in the registry.

(c)(1) Within 180 days one year of the effective date of this chapter, the commissioner shall provide on the department’s public website information on advance directives and the registry to appropriate state offices. The commissioner shall also include information on advance directives, and on the registry and the optional forms of an advance directive.

(2) Within 180 days one year of the effective date of this chapter, the commissioner of motor vehicles shall provide motor vehicle licenses and identity cards, as soon as existing licenses or cards have been depleted, which allow the license holder or card holder to indicate that he or she has an advance directive and whether it is in the registry.


(a) Any member of the following classes of individuals, in the order of priority listed, may make an anatomical gift of all or a part of the decedent’s body for an authorized purpose, unless the decedent has made an unrevoked refusal to make that anatomical gift:

(1) An individual appointed by the decedent, pursuant to an advance directive under chapter 231 of this title, to make an anatomical gift.

(1)(2) The spouse of the decedent.

(2)(3) The reciprocal beneficiary of the decedent.

(3)(4) An adult son or daughter of the decedent.

(4)(5) Either parent of the decedent.

(5)(6) An adult brother or sister of the decedent.

(6)(7) A grandparent of the decedent.

(7)(8) An individual possessing a durable power of attorney agent named in an advance directive.

(8)(9) A guardian of the person of the decedent at the time of death.

(9)(10) Any other individual authorized or under obligation to dispose of the body.

* * * Improving Access to Care * * *

Sec. 29a. FQHC LOOK-ALIKES AND UNCOMPENSATED CARE POOL

(a) Funds appropriated to the department of health in Section 263(e)(4) and Section 255(a)(7)(C) related to Section 277(f) of Act 71 of 2005 for state fiscal year 2006 may be carried forward by the department for the purposes described in Section 277(f) of Act 71 of 2005 to state fiscal year 2007. Of those appropriated funds, a total of $150,000 shall be provided as a direct grant to new federally qualified health center look-alike entities approved during state FY06 and shall be split evenly between qualifying organizations on a non-competitive basis.

(b) Funds appropriated in Section 30 of this act to the department of health shall be expended for the purpose of providing to federally qualified health center (FQHC) look-alikes uncompensated care pool funds for an income - sensitized sliding scale fee schedule for patients of these organizations. In distributing the grants, the department shall consider ensuring the geographic distribution of health centers around the state as well as criteria under federal law. Initial priority shall be given to health centers in Lamoille, Washington, Windsor/Windham, and Addison counties, and other counties that demonstrate readiness to achieve look-alike status. The goal shall be to ensure there are FQHC look-alikes in each county in Vermont.

(c) If funds appropriated for this Section exceed $200,000, additional uncompensated care pool funds shall be made available to primary care practices meeting conditions for serving a disproportionate share of the uninsured and Medicaid populations comparable to the federal expectations for federally qualified health centers and look-alikes, including:

(1) Seeing all patients regardless of ability to pay, on a sliding scale fee schedule;

(2) Remaining open to new and existing patients enrolled in the Medicaid and Medicare programs;

(3) Maintaining no less than a combined 25 percent Medicaid and uninsured patient payer mix; and

(4) Participating in the blueprint for health program as it expands across the state.

(5) Existing federally qualified health center Section 330 grantees shall also be eligible to participate in this uncompensated care pool.

(6) Funding from the pool shall not be permitted to supplant existing state, federal or private grants or funding for pre-existing “charity care” and patient assistance programs.

(d) Uncompensated care pool funds under this section shall be distributed to participating providers under criteria and methodology developed by the department of health office of rural health and primary care and bi-state primary care association, with input from the Vermont medical society and Vermont chapter of the American academy of family practice physicians.

(e) If deemed appropriate, funds appropriated for this section may be disbursed by the Vermont community foundation or other suitable charitable organization.

Sec. 29b. MEDICAID OUTREACH

Bi-State Primary Care Association, in consultation with the medical care advisory committee, established in section 1901c of Title 33, will research efforts in Vermont and in other states that have succeeded in enrolling individuals eligible for Medicaid and Medicaid waiver programs. The association will report its findings and recommendations to the house committee on health care, the senate committee on health and welfare, the health access oversight committee and the agency of human services no later than November 15, 2006.

* * * Appropriations * * *

Sec. 30. APPROPRIATIONS AND FUNDING

(a) In fiscal year 2007, the amount of $700,000.00 of the funds appropriated under Sec. 87 of H. 881 (Fiscal Year 2007 General Appropriations Act) is allocated to the department of banking, insurance, securities, and health care administration for the pilot program authorized under 18 V.S.A. § 9417(e) and to contract for the development of the health information technology plan and other duties required by 18 V.S.A. § 9417.

(b) For fiscal year 2007, the sums of $84,000.00 from the general fund and $76,000.00 from the Global Commitment fund are appropriated to the department of health for development and implementation of the patient safety surveillance and improvement system established pursuant to 18 V.S.A.

§ 1912. In addition, the department of health, with assistance from the department of banking, insurance, securities, and health care administration, shall collect and utilize for such purposes the sum of $40,000.00 to be contributed from hospitals licensed in Vermont. In fiscal year 2007, there is appropriated $31,300.00 of general funds and $44,700.00 federal funds to the

agency of human services for the Global Commitment for Health Demonstration Waiver.

(c) In fiscal year 2007, the amount of $400,000.00 of the funds appropriated under Sec. 87 of H. 881 (Fiscal Year 2007 General Appropriations Act) is allocated to the department of banking, insurance, securities, and health care administration for further development of the multi-payer database established by 18 V.S.A. § 9410(h), and the consumer price and quality information system.

(d) The sum of $340,000.00 is appropriated from the Global Commitment fund to the department of health in fiscal year 2007. These funds combined with $540,000.00 which shall be allocated from funds appropriated in Sec. 119 of H.881, providing a total of $880,000.00, shall be deposited in the Vermont educational loan repayment fund established under Sec. 20 of this act and used for the purposes of loan repayment for health care providers and health care educators. There is appropriated $340,000.00 from the general fund to the agency of human services for the Global Commitment for Health Demonstration Waiver.

(e) The amount of $80,000.00 of funds appropriated in Sec. 119 of H.881 (Fiscal Year 2007 General Appropriations Act) is allocated for the Vermont student assistance corporation for loan forgiveness programs for health care providers through the dental hygienist incentive loan program and the nursing incentive loan program.

(f) The sum of $50,000.00 of funds appropriated in Sec. 118 of H.881 (Fiscal Year 2007 General Appropriations Act) is allocated to the commissioner of health for the advance directive registry established by

18 V.S.A. § 9719.

(g) For fiscal year 2007, the sum of $200,000.00 is appropriated from the general fund to the department of health for federally qualified health center (FQHC) look-alike uncompensated care pool funds, as described in Sec. 29a of this act.

(h) For fiscal year 2007, the sum of $40,000.00 from the Global Commitment fund is appropriated to the office of Vermont health access to be expended upon approval of the health access oversight committee for Medicaid outreach, consistent with the report specified in Sec. 29b of this act. There is appropriated $16,470.00 general funds and $23,530.00 federal funds to the agency of human services for the Global Commitment for Health Demonstration Waiver.

* * * Technical Provision * * *

Sec. 31. TECHNICAL PROVISION

Except for subdivision 2222a(c)(1) of Title 3, the provisions in Sec. 15 of this Act shall supersede any conflicting provisions in Sec. 3 of H.861 (An Act Relating to Health Care Affordability for Vermonters) if enacted. Subdivision (c)(1) of section 2222a of Title 3, if enacted in H.861, shall supercede subdivision (c)(1) of section 2222a of Title 3 in this act. Any additional provisions contained in Sec. 3 of H.861 that are not contained in Sec. 15 of this Act shall not be superseded. Any technical revisions necessary to ensure accuracy or conformity between the sections, such as the numbering of subdivisions, may be made the office of legislative council.

Sec. 32. Sec. 87 of H.881 of the 2005 adjourned session is amended to read:

Sec. 87. Banking, insurance, securities, and health care administration - health care administration

Personal services 4,641,080 4,541,080

Operating expenses 379,818 379,818

Total 5,020,898 4,920,898

Source of funds

General fund 790,000 711,000

Special funds 2,423,717 2,423,717

Global Commitment fund 1,737,181 1,716,181

Interdepartmental transfer 70,000 70,000

Total 5,020,898 4,920,898

* * *

Sec. 33. Sec. 101 of H.881 of the 2005 adjourned session is amended to read:

Sec. 101. Secretary’s office - Global Commitment

Grants 788,357,850 788,336,850

Source of funds

General fund 116,951,586 116,942,938

Special funds 13,011,162 13,011,162

Tobacco fund 19,299,711 19,299,711

Global Commitment fund 0 0

State health care resources fund 151,803,088 151,803,088

Federal funds 485,013,100 485,000,748

Interdepartmental transfer 2,279,203 2,279,203

Total 788,357,850 788,336,850

* * *

Sec. 34. Subdivision (a)(1) of Sec. 271 of H.881 of the 2005 adjourned session is amended to read:

(a) In FY 2006, the following amounts are appropriated or transferred from the general fund:

(1) $1,325,800 $1,013,357 in general funds and $1,454,200 $1,079,289 in Global Commitment funds to the department of health - administration for implementation of “The Vermont Blueprint for Health Chronic Care Initiative,” and $1,124,200 $859,266 in general funds to the agency of human services for Global Commitment.

NOTICE CALENDAR


H. 150

An act relating to insurance fraud.

Reported favorably with recommendation of proposal of amendment by Senator Illuzzi for the Committee on Judiciary.


Sec. 1. 13 V.S.A. § 2031 is added to read:

§ 2031. INSURANCE FRAUD

(a) Definitions. As used in this section:

(1) “Conceal” means to take affirmative action intended to prevent others from discovering information. Mere failure to disclose information does not constitute concealment.

(2) “Insurance policy” has the same meaning as in 8 V.S.A. § 4722(3).

(3) “Insurer” has the same meaning as in 8 V.S.A. § 4901(2).

(4) “Person” means a natural person, company, corporation, unincorporated association, partnership, professional corporation, agency of government, or any other entity.

(b) Fraudulent insurance act. No person shall, with intent to defraud:

(1) present or cause to be presented a claim for payment or benefit pursuant to any insurance policy that contains false representations as to any material fact or which conceals a material fact;

(2) present or cause to be presented any information which contains false representations as to any material fact or which conceals a material fact concerning the solicitation for sale of any insurance policy or purported insurance policy, an application for certificate of authority, or the financial condition of any insurer.

(c) Penalties. A person who violates subsection (b) of this section shall:

(1) if the benefit wrongfully obtained or the loss suffered by any person as a result of the violation has a value of less than $750.00, be imprisoned for not more than six months or fined not more than $5,000.00, or both; or

(2) if the benefit wrongfully obtained or the loss suffered by any person as a result of the violation has a value of more than $750.00, be imprisoned for not more than five years or fined not more than $10,000.00, or both; or

(3) for a second or subsequent offense, regardless of the value of the benefit wrongfully obtained, be imprisoned not more than five years or fined not more than $20,000.00, or both.

(d) This section shall not be construed to limit or restrict prosecution under any other applicable law.

(e) This section shall not apply to worker’s compensation fraud. Cases involving worker’s compensation fraud shall be prosecuted under section 2024 of this title.

(f) The public policy of this state is that the standards of this section shall not apply or be introduced into evidence in any civil or administrative proceeding, whether to argue public policy, materiality, or for any other purpose.


CHAPTER 130. INSURANCE FRAUD

§ 4750. INSURER ANTI-FRAUD PLANS

(a) Every insurer with direct written premiums shall prepare, implement, and maintain an insurance anti-fraud plan. Each insurer’s anti-fraud plan shall outline specific procedures, appropriate to the type of insurance the insurer writes in this state, to:

(1) Prevent, detect, and investigate all forms of insurance fraud, including fraud involving the insurer’s employees or agents; fraud resulting from misrepresentations in the application, renewal, or rating of insurance policies; claims fraud; and security of the insurer’s data processing systems.

(2) Educate appropriate employees on fraud detection and the insurer’s anti-fraud plan.

(3) Provide for the hiring of or contracting for fraud investigators.

(4) Report insurance fraud to appropriate law enforcement and regulatory authorities in the investigation and prosecution of insurance fraud.

(5) Where appropriate, pursue restitution for financial loss caused by insurance fraud.

(6) Ensure that applicable state and federal privacy laws are complied with and that the confidential personal and financial information of consumers and insureds is protected.

(7) Comply with such other procedures as the commissioner may require by rule.

(b) The commissioner may require an insurer to file annually its anti-fraud plan with the department and an annual summary of the insurer’s anti-fraud activities and results.

(c) This section confers no private rights of action. This section does not affect private rights of action conferred under other laws or court decisions.

(d) Enforcement. Notwithstanding any other provision of this title, the following are the exclusive monetary penalties for violation of this section. Insurers that fail to prepare, implement, maintain, or submit to the department of banking, insurance, securities, and health care administration an insurance anti-fraud plan are subject to a penalty of $500.00 per day, not to exceed $10,000.00.

Sec. 3. 1 V.S.A. § 317(c)(36) is added to read:

(36) anti-fraud plans and summaries submitted by insurers to the department of banking, insurance, securities, and health care administration for the purposes of complying with 8 V.S.A. § 4750.


This act shall take effect July 1, 2006, except for Sec. 2, which shall take effect January 1, 2007.



H. 253

An act relating to establishing energy efficiency standards for certain appliances.

Reported favorably with recommendation of proposal of amendment by Senator Ayer for the Committee on Natural Resources and Energy.



CHAPTER 74. ENERGY EFFICIENCY STANDARDS

FOR APPLIANCES AND EQUIPMENT

§ 2791. GENERAL PURPOSE

This chapter establishes minimum efficiency standards for certain products sold or installed in the state.

§ 2792. FINDINGS

The general assembly finds that:

(1) Efficiency standards for certain products sold or installed in the state assure consumers and businesses that those products meet minimum efficiency performance levels, thus saving money on utility bills.

(2) These efficiency standards save energy and thus reduce pollution and other environmental impacts associated with the production, distribution, and use of electricity, natural gas, and oil.

(3) These efficiency standards can make electricity systems more reliable by reducing the strain on the electricity grid during peak demand periods. Furthermore, improved energy efficiency can reduce or delay the need for new power plants, power transmission lines, and power distribution system upgrades.

(4) Energy efficiency standards contribute to the economy of this state by helping to balance better energy supply and demand, thus reducing pressure for higher natural gas and electricity prices. By saving consumers and businesses money on energy bills, efficiency standards help the state and local economy since energy bill savings can be spent on local goods and services.


As used in this chapter:

(1) “Ballast” means a device used with an electric discharge lamp to obtain necessary circuit conditions (voltage, current, and waveform) for starting and operating the lamp.

(2) “Commissioner” means the commissioner of the department of public service.

(3) “Compensation” means money or any other valuable thing, regardless of form, received or to be received by a person for services rendered.

(4) “Electricity ratio (ER)” is the ratio of furnace electricity use to total furnace energy use. ER = (3.412*EAE)/(1000*EF + 3.412 EAE) where EAE (average annual auxiliary electrical consumption) and EF(average annual fuel energy consumption) are defined in 10 C.F.R. Part 430, Subpart B, Appendix N.

(5) “High-intensity discharge lamp” means a lamp in which light is produced by the passage of an electric current through a vapor or gas and in which the light-producing arc is stabilized by bulb wall temperature, and the arc tube has a bulb wall loading in excess of three watts per square centimeter.

(6) “Medium voltage dry-type distribution transformer” means a transformer that:

(A) has an input voltage of more than 600 volts but less than or equal to 34,500 volts;

(B) is air-cooled;

(C) does not use oil as a coolant; and

(D) is rated for operation at a frequency of 60 Hertz.

(7) “Metal halide lamp” means a high intensity discharge lamp in which the major portion of the light is produced by radiation of metal halides and their products of dissociation, possibly in combination with metallic vapors.

(8) “Metal halide lamp fixture” means a light fixture designed to be operated with a metal halide lamp and a ballast for a metal halide lamp.

(9) “Probe-start metal halide ballast” means a ballast used to operate metal halide lamps which does not contain an ignitor and which instead starts lamps by using a third starting electrode probe in the arc tube.

(10) “Residential boiler” means a self-contained appliance that is primarily designed for space heating by means of steam or hot water and that uses only

single-phase electric current in conjunction with natural gas, propane, or home heating oil, and which has a heat input rate of less than 300,000 Btus per hour .

(11) “Residential furnace” means a self-contained space heater designed to supply heated air through ducts of more than 10 inches in length and which utilizes only single-phase electric current or single-phase electric current or DC current in conjunction with natural gas, propane, or home heating oil, and which:

(A) is designed to be the principal heating source for the living space of one or more residences;

(B) is not contained within the same cabinet with a central air conditioner whose rated cooling capacity is above 65,000 Btus per hour; and

(C) has a heat input rate of less than 225,000 Btus per hour.

(12) “Single-voltage external AC to DC power supply” means a device that:

(A) is designed to convert line voltage AC input into lower voltage DC output;

(B) is able to convert to only one DC output voltage at a time;

(C) is sold with, or intended to be used with, a separate end-use product that constitutes the primary power load;

(D) is contained within a separate physical enclosure from the end - use product;

(E) is connected to the end-use product via a removable or hard - wired male or female electrical connection, cable, cord, or other wiring;

(F) does not have batteries or battery packs, including those that are removable, that physically attach directly to the power supply unit;

(G) does not have a battery chemistry or type selector switch and indicator light; or does not have a battery chemistry or type selector switch and a state of charge meter; and

(H) has a nameplate output power less than or equal to 250 watts.

(13) “State - regulated incandescent reflector lamp” means a lamp that is not colored or designed for rough or vibration service applications, that has an inner reflective coating on the outer bulb to direct the light, an E26 medium screw base, and a rated voltage or voltage range that lies at least partially within 115 and 130 volts, and that falls into either of the following categories:

(A) a blown PAR (BPAR), bulged reflector (BR), or elliptical reflector (ER) bulb shape, with a diameter which equals or exceeds 2.25 inches; or

(B) a reflector (R), parabolic aluminized reflector (PAR), or similar bulb shape with a diameter of 2.25 to 2.75 inches.

(14)(A) “Transformer” means a device that consists of two or more coils of insulated wire and that is designed to transfer alternating current by electromagnetic induction from one coil to another, in order to change the original voltage or current value.

(B) The term “transformer” does not include:

(i) devices with multiple voltage taps, with the highest voltage tap equaling at least 20 percent more than the lowest voltage tap; or

(ii) devices, such as those commonly known as drive transformers, rectifier transformers, auto transformers, uninterruptible power system transformers, impedance transformers, regulating transformers, sealed and nonventilating transformers, machine tool transformers, welding transformers, grounding transformers, or testing transformers, that are designed to be used in a special purpose application and are unlikely to be used in general purpose applications.

§ 2794. SCOPE

(a) The provisions of this chapter apply to the following types of new products sold, offered for sale, or installed in the state:

(1) Medium voltage dry-type distribution transformers.

(2) Metal halide lamp fixtures.

(3) Residential furnaces and residential boilers.

(4) Single-voltage external AC to DC power supplies.

(5) State - regulated incandescent reflector lamps.

(6) Any other product that may be designated by the commissioner in accordance with section 2797 of this title.

(b) The provisions of this chapter do not apply to:

(1) New products manufactured in the state and sold outside the state and the equipment used in manufacturing those products.

(2) New products manufactured outside the state and sold at wholesale inside the state for final retail sale and installation outside the state.

(3) Products installed in mobile manufactured homes at the time of construction.

(4) Products designed expressly for installation and use in recreational vehicles.

§ 2795. EFFICIENCY STANDARDS

Not later than June 1, 2007, the commissioner shall adopt rules in accordance with the provisions of 3 V.S.A. chapter 25 establishing minimum efficiency standards for the types of new products set forth in section 2794 of this title. The rules shall provide for the following minimum efficiency standards:

(1) Medium voltage dry-type distribution transformers shall meet minimum efficiency levels three-tenths of a percentage point higher than the Class 1 efficiency levels for medium voltage distribution transformers specified in Table 4-2 of the “Guide for Determining Energy Efficiency for Distribution Transformers” published by the National Electrical Manufacturers Association (NEMA Standard TP-1-2002).

(2) Metal halide lamp fixtures designed to be operated with lamps rated greater than or equal to 150 watts but less than or equal to 500 watts shall not contain a probe-start metal halide ballast.

(3)(A) Residential furnaces and residential boilers shall meet or exceed the following Annual Fuel Utilization Efficiency (AFUE) and electricity ratio values:

Product Type Minimum AFUE

Maximum electricityratio

Natural gas- and propane-fired furnaces 90% 2.0%

Oil-fired furnaces> 94,000

Btus/hour in capacity83% 2.0%

Oil-fired furnaces<94,000

Btus/hour in capacity83% 2.3%

Natural gas-, oil-, and propane- fired hot water residential boilers

84% Not applicable

Natural gas-, oil-, and propane-fired steam residential boilers

82% Not applicable

(B) AFUE shall be measured in accordance with the federal test method for measuring the energy consumption of furnaces and boilers contained in Appendix N to subpart B of part 430, Title 10, Code of Federal Regulations.

(C) The commissioner may adopt rules to exempt compliance with these residential furnace or residential boiler AFUE standards at any building, site, or location where complying with these standards would be in conflict with any local zoning ordinance, building or plumbing code, or other rule regarding installation and venting of residential boilers or residential furnaces.

(4)(A) Single-voltage external AC to DC power supplies shall meet the energy efficiency requirements of the following table:

Nameplate output power Minimum efficiency in Active Mode

0 to < 1 watt 0.49* Nameplate Output

> 1 watt and < 49 watts 0.09*Ln(Nameplate Output power) + 0.49

> 49 watts 0.84

Maximum Energy Consumption in No-Load Mode

0 to < 10 watts 0.5 watts

> 10 watts and < 250 watts 0.75 watts

* Where Ln (Nameplate Output) = Natural logarithm of the nameplate output expressed in watts.

(B) This standard applies to single voltage AC to DC power supplies that are sold individually and to those that are sold as a component of or in conjunction with another product. Single voltage AD to DC power supplies that are made available by a product manufacturer as accessories, service parts, or spare parts for its products manufactured prior to January 1, 2008 shall be exempt from the requirements of this standard.

(C) For purposes of this subdivision (4), the efficiency of

single-voltage external AC to DC power supplies shall be measured in accordance with the test methodology specified by the U.S. Environmental

Protection Agency’s Energy Star Program, “Test Method for Calculating the Energy Efficiency of Single-Voltage External AC-DC and AC-AC Power Supplies (August 11, 2004).”

(5)(A) State-regulated incandescent reflector lamps shall meet the minimum average lamp efficacy requirements for federally regulated incandescent reflector lamps contained in 42 U.S.C. § 6295(i)(1)(A).

(B) The following types of incandescent reflector lamps are exempt from these requirements:

(i) lamps rated at 50 watts or less of the following types: BR30, ER30, BR40, and ER40;

(ii) lamps rated at 65 watts of the following types: BR30, BR40, and ER40; and

(iii) R20 lamps of 45 watts or less.

§ 2796. IMPLEMENTATION

(a) No new medium voltage dry-type distribution transformer, state - regulated incandescent reflector lamp, or single-voltage external AC to DC power supply manufactured on or after January 1, 2008 may be sold or offered for sale in the state unless the efficiency of the new product meets or exceeds the efficiency standards set forth in the rules adopted pursuant to section 2795 of this title.

(b) On or after January 1, 2009, no new metal halide lamp fixture may be sold or offered for sale in the state unless the efficiency of the new product meets or exceeds the efficiency standards set forth in the rules adopted pursuant to section 2795 of this title.

(c) No later than six months after the date of enactment of this chapter, the commissioner, in consultation with the attorney general, shall determine if implementation of state standards for residential furnaces and residential boilers requires a waiver from federal preemption. If the commissioner determines that a waiver from federal preemption is not needed, those state standards shall go into effect on June 1, 2008, or if this determination is made after June 1, 2007, those standards shall go into effect one year after the date of this determination. If the commissioner determines that a waiver from federal preemption is required, the commissioner shall apply for that waiver within one year of that determination and upon approval of that waiver application, the applicable standards shall go into effect at the earliest date permitted by federal law.

(d) One year after the date upon which the sale or offering for sale of certain products becomes subject to the requirements of subsection (a) or (b) of

this section, no new products may be installed for compensation in the state unless the efficiency of a new product meets or exceeds the efficiency standards set forth in the rules adopted pursuant to section 2795 of this title.

(e) Owners and operators of commercial and industrial facilities shall be allowed to utilize appliances and equipment that do not meet the requirements of section 2795 of this title for the repair or replacement of existing equipment, provided that the equipment being repaired or replaced was acquired before the implementation date determined according to the provisions of this section. At the discretion of the owners and operators, these appliances and equipment may be used at any time before or after the effective date of those requirements.

(f) The standard for single-voltage external power supplies shall not go into effect until the commissioner determines that the California energy commission has adopted and put into effect a standard for single-voltage external power supplies. Vermont’s standard shall mirror the revised standard adopted in California.

§ 2797. REVISED STANDARDS

The commissioner may adopt rules, in accordance with the provisions of 3 V.S.A. chapter 25, to revise efficiency standards for the products listed in section 2794 of this title, in order to make the standards conform to standards in effect in other states, where to do so is in the interests of the electrical energy consumers of the state. In considering increased standards, the commissioner shall set efficiency standards upon a determination that increased efficiency standards would serve to promote energy conservation in the state and would be cost - effective for consumers who purchase and use those products. No increased efficiency standards shall become effective within one year following the adoption of any amended rules establishing those increased efficiency standards. The commissioner may apply for a waiver of federal preemption in accordance with federal procedures (42 U.S.C.§ 6297(d)) for state efficiency standards for any product regulated by the federal government.

§ 2798. TESTING, CERTIFICATION, LABELING, AND ENFORCEMENT

(a) The commissioner shall adopt test protocols for determining the energy efficiency of the new products covered by section 2794 of this title if those protocols are not provided for in section 2795 of this title or in the residential building energy standards adopted under 21 V.S.A. § 266. The commissioner shall require U.S. Department of Energy - approved test methods, or in the absence of those test methods, other appropriate nationally recognized test methods. The manufacturers of these products shall cause samples of their

products to be tested in accordance with the test protocols adopted pursuant to this chapter or those specified in the residential building energy standards. The commissioner may adopt updated test methods when new versions of test protocols become available.

(b) Manufacturers of new products covered by section 2794 of this title, except for single voltage external AC to DC power supplies, shall certify to the commissioner that these products are in compliance with the provisions of this chapter. These certifications shall be based on test results. The commissioner shall adopt rules governing the certification of those products and shall coordinate with the certification programs of other states with similar standards.

(c) Manufacturers of new products covered by section 2794 of this title shall identify each product offered for sale or installation in the state as being in compliance with the provisions of this chapter by means of a mark, label, or tag on the product and packaging at the time of sale or installation. The commissioner shall adopt rules governing the identification of these products and packaging, which shall be coordinated to the greatest practical extent with the labeling programs of other states and federal agencies with equivalent efficiency standards. The commissioner shall allow the use of existing marks, labels, or tags which connote compliance with the efficiency requirements of this chapter.

(d) The commissioner may test products covered by section 2794 of this title. If any product so tested is found not to be in compliance with the minimum efficiency standards established under section 2795 of this title, the commissioner shall:

(1) Charge the manufacturer of that product for the cost of product purchase and testing.

(2) Make available to the public information on products found not to be in compliance with the standards.

(e) With prior notice and at reasonable and convenient hours, the commissioner may cause periodic inspections to be made of distributors or retailers of new products covered by section 2794 of this title in order to determine compliance with the provisions of this chapter.

(f) The commissioner is granted the authority to adopt further rules as necessary to ensure the proper implementation of the provisions of this chapter.

(g) Any manufacturer, or distributor, or any person who installs a product covered by this chapter for compensation, who violates any provision of this

chapter shall be subject to a civil penalty of not more than $250.00. Each violation shall constitute a separate offense, and each day that such violation continues shall constitute a separate offense. Penalties assessed under this subsection are in addition to costs assessed under subsection (d) of this section.

Sec 2. 4 V.S.A. § 437 is amended to read:

§ 437. CIVIL JURISDICTION OF DISTRICT COURT

The district court shall have jurisdiction of the following actions:

(1) Appeals of final decisions of the judicial bureau.

* * *

(12) Proceedings to enforce 9 V.S.A. chapter 74 relating to energy efficiency standards for appliances and equipment.



H. 294

An act relating to groundwater management.

Reported favorably with recommendation of proposal of amendment by Senator Snelling for the Committee on Natural Resources and Energy.


Sec. 1. 10 V.S.A. chapter 48, subchapter 5 is added to read:

Subchapter 5. Interim Groundwater Withdrawal Permit

§ 1415. INTERIM GROUNDWATER WITHDRAWAL PERMIT


(1) “Groundwater” means water below the land surface.

(2) "Person" means any individual, partnership, company, corporation, cooperative, association, unincorporated association, joint venture, trust, the state of Vermont or any department, agency, subdivision, or municipality, the United States government or any department, agency, or subdivision, or any other legal or commercial entity.

(3) “Withdraw” means the removal of groundwater by any method or instrument.

(b) No person shall withdraw more than 50,000 gallons of groundwater a day from a well drilled after July 1, 2006, for commercial or industrial purposes without first receiving from the secretary of natural resources an interim groundwater withdrawal permit under this section. Prior to issuance of a permit under this section:

(1) The secretary shall determine that such withdrawal meets the applicable requirements of section 1675 of this title and any applicable rules adopted thereunder or the requirements adopted pursuant to subsection (e) of this section; and

(2) the applicant shall submit to the Vermont state geologist and the department of environmental conservation a geologic cross section and groundwater contour map of an area, the size of which shall be in conformance with appendix A, part 3, subsection 3.3.5.2 of the Vermont water supply rule, surrounding the proposed source of the groundwater withdrawal.

(c) Groundwater withdrawal by a public water system, as that term is defined in section 1671 of this title, or for use for fire safety, agriculture, agricultural or dairy processing, dewatering operations during building construction, geothermal energy production, or public sanitation shall be exempt from the requirements of this section.

(d) A permit issued under this section shall be valid for the period of time specified in the permit but not more than five years.

(e) The secretary of natural resources may adopt rules to implement the provisions of this section and to establish criteria for the issuance of a permit under section 1675 of this title for commercial or industrial groundwater withdrawals from a well drilled after July 1, 2006.

Sec. 2. 10 V.S.A. § 1675(g) is added to read:

(g)(1) Effective July 1, 2006, a public water system applying for a permit under this section for the bottling of more than 50,000 gallons of drinking water a day from a single source for public distribution and sale shall, in addition to complying with the requirements of this chapter and any rules adopted thereunder, submit to the Vermont state geologist and the department of environmental conservation a geologic cross section and groundwater contour map of an area, the size of which shall be in conformance with appendix A, part 3, subsection 3.3.5.2 of the Vermont water supply rule, surrounding the proposed source.

(2) The requirements of subdivision (1) of this subsection shall apply to a public water system permitted under this section when the system proposes to expand the bottling of drinking water from a single source such that the total

gallons of water bottled from the single source would exceed 50,000 gallons a day.

Sec. 3. STUDY OF GROUNDWATER REGULATION AND FUNDING

(a) A committee is established to examine potential regulatory programs to protect the groundwater resources of the state. The committee shall issue a preliminary report of its findings to the house committee on fish, wildlife and water resources, the senate committee on natural resources and energy, and the house and senate committees on agriculture by January 15, 2007 . The committee shall issue a final report of its findings to the house committee on fish, wildlife and water resources, the senate committee on natural resources and energy, and the house and senate committees on agriculture by January 15, 2008. The final report shall include:

(1) A recommendation from the committee as to whether the groundwater resources of the state of Vermont should be declared a public trust resource.

(2) An analysis of the regulatory implications of declaring the groundwater of the state to be a public trust resource if the committee so recommends under subdivision (1) of this subsection.

(3) A proposed schedule for the groundwater mapping of the state by the agency of natural resources.

(4) A proposed appropriation to the agency of natural resources for the groundwater mapping of the state, including any proposed new or existing revenue sources that may be used by the agency to aid in funding the groundwater mapping.

(5) Proposed legislation for the regulation of groundwater withdrawal in the state, addressing:

(A) The type of groundwater withdrawals subject to regulation;

(B) A threshold amount or amounts of groundwater withdrawal subject to regulation;

(C) Groundwater users exempt from regulation;

(D) The regulation of interbasin groundwater transfers;

(E) The fee to be charged for regulated groundwater withdrawal;

(F) Monitoring, reporting, or recordkeeping requirements for regulated groundwater withdrawal; and

(G) Any other issues deemed relevant by the committee.

(b) The committee shall consist of the following members:

(1) the secretary of natural resources or his or her designee;

(2) the state geologist or his or her designee;

(3) the secretary of agriculture, food and markets or his or her designee;

(4) one member each from the house committees on agriculture and on fish, wildlife and water resources and the senate committees on agriculture and on natural resources and energy as appointed respectively by the speaker of the house and the committee on committees;

(5) a representative appointed by the governor from each of the following: the business community, municipalities, a local environmental organization, a regional or statewide environmental organization, and the general public;

(6) two representatives of the agricultural community appointed by the governor.

(c) The committee may elect a chair and a vice chair and may hold public hearings. Legislative council shall provide support for the committee.

(d) All members of the committee shall serve on the committee for the duration of the study unless circumstances dictate a permanent replacement. Vacancies shall be appointed in the same manner as original appointments.

Sec. 4. GROUNDWATER MAPPING

The agency of natural resources shall explore all available alternatives for the immediate initiation of groundwater mapping in the state, including working in cooperation with the U.S. Geologic Survey and obtaining the necessary funding from the U.S. Environmental Protection Agency. The agency shall report its findings to the house committee on fish, wildlife and water resources, the senate committee on natural resources and energy, and the house and senate committees on agriculture by January 15, 2007 .

Sec. 5. AGENCY OF NATURAL RESOURCES GROUNDWATER REPORT

On or before January 15, 2008, the agency of natural resources shall submit a report to the senate committee on natural resources and energy and the house committee on fish, wildlife and water resources regarding the status of the agency’s efforts to collect and analyze information regarding the groundwater resources of the state. The report shall include:

(1) An analysis by the agency of natural resources of whether the withdrawal of groundwater or bottling of drinking water in certain geographic

areas of the state has impacted the use or quality of groundwater or surface water for domestic drinking water or other purposes;

(2) A listing of any areas identified under subdivision (1) of this section, a summary of how the agency of natural resources responded to groundwater or surface water shortages in those areas, and agency recommendations on how to avoid similar impact areas in the future;

(3) A compilation of groundwater supply information included in the well completion or closure reports submitted to the agency of natural resources in the last 15 years by licensed well drillers;

(4) The amount of drinking water approved for bottling per day from each source in the state permitted under 10 V.S.A. § 1675 for use by a bottled water facility;

(5) Any groundwater mapping completed by the agency; and

(6) Any other information deemed relevant by the agency.

Sec. 6. 10 V.S.A. § 8003(a)(6) is amended to read:

(6) 10 V.S.A. chapter 48, relating to well drillers and groundwater withdrawal;

Sec. 7. SUNSET

10 V.S.A. chapter 48, subchapter 5 (interim groundwater withdrawal permit) is repealed July 1, 2011.



H. 602

An act relating to agricultural energy and fuel production.

Reported favorably with recommendation of proposal of amendment by Senator Kittell for the Committee on Agriculture.

The Committee recommends that the Senate propose to the House to amend the bill as follows:

First: In Sec. 1, 6 V.S.A. § 4710(g)(3)(C), by striking out the following: “is creating an enterprise that utilizes Vermont resources and provides” and inserting in lieu thereof the following is working in consultation with a Vermont farm, is creating an enterprise that utilizes Vermont resources, and provides

Second: In Sec. 2, by striking out the following “an internet website to serve as a basic reference guide” and inserting in lieu thereof the following an internet website comprised of internet links to reference materials

Third: By adding a new section, to be numbered Sec. 3 to read as follows:



As used in this chapter, except as otherwise specified, the following terms shall have the meanings stated below:

* * *(33) "Poultry" means any domesticated bird, whether live or dead.

(34) "Poultry product" means any poultry carcass or part of a carcass; or any product which is made wholly or in part from any poultry carcass or part of a carcass, including quail, pheasant, and partridge, excepting products which are otherwise exempted by the secretary from definition as a poultry product under conditions which he or she may prescribe to assure that the poultry ingredients in products are not adulterated, and that these products are not represented as poultry products.



H. 817

An act relating to stormwater management.

Reported favorably with recommendation of proposal of amendment by Senator Kittell for the Committee on Natural Resources and Energy.

The Committee recommends that the Senate propose to the House to amend the bill by as follows:

First: In Sec. 2, 10 V.S.A. § 1264(a)(18), by striking out the words “natural and” where they appear after the words “surface drains,” and before the words manmade wetlands

Second: By adding Secs. 5a and 5b to read as follows:

Sec. 5a. 10 V.S.A. § 1278 is added to read:

§ 1278. OPERATION, MANAGEMENT, AND EMERGENCY RESPONSE PLANS FOR POLLUTION ABATEMENT FACILITIES

(a) Findings. The general assembly finds that the state shall protect Vermont’s lakes, rivers, and streams from pollution by implementing programs to prevent sewage spills to Vermont waters and by requiring emergency planning to limit the damage from spills which do occur.

(b) Planning requirement. Effective July 1, 2007, the secretary of natural resources shall, upon renewal of a permit issued under section 1263 of this title, require a pollution abatement facility, as that term is defined in section 1571 of this title, to prepare and implement an operation, management, and emergency response plan for each permitted facility. An operation, management, and emergency response plan shall include the following:

(1) Identification of those elements of the facility, including collection systems that are determined to be prone to failure based on installation, age, design, or other relevant factors.

(2) Identification of those elements of the facility identified under subdivision (1) of this subsection which, if one or more failed, would result in a significant release of untreated or partially treated sewage to surface waters of the state.

(3) A requirement that the elements identified in subdivision (2) of this subsection shall be inspected in accordance with a schedule approved by the secretary of natural resources.

(4) An emergency contingency plan to reduce the volume of a detected spill and to mitigate the effect of such a spill on public health and the environment.

(c) The secretary of natural resources shall post publicly notice of an illegal discharge that may pose a threat to human health or the environment on its website within 24 hours of the agency’s receipt of notification of the discharge.

(d) Rulemaking. The secretary shall adopt rules implementing this section.

Sec. 5b. 10 V.S.A. § 1263(d) is amended to read:

(d) A discharge permit shall:

(1) specify the manner, nature, volume, and frequency of the discharge permitted and contain terms and conditions consistent with subsection (c) of this section;

(2) require proper operation and maintenance of any pollution abatement facility necessary in the treatment or processing of the waste by qualified personnel in accordance with standards established by the secretary. The secretary may require operators to be certified under a program established by

the secretary. The secretary may require a laboratory quality assurance sample program to insure qualifications of laboratory analysts;

(3) contain an operation, management, and emergency response plan when required under section 1278 of this title and additional conditions, requirements, and restrictions as the secretary deems necessary to preserve and protect the quality of the receiving waters, including but not limited to requirements concerning recording, reporting, monitoring, and inspection of the operation and maintenance of waste treatment facilities and waste collection systems; and

(4) be valid for the period of time specified therein, not to exceed five years.

Third: By striking out Sec. 10 in its entirety and inserting in lieu thereof the following:


(a) This section and Secs. 1 (findings), 2 (stormwater system definition), 3 (stormwater permitting compliance history), 4 (agricultural stormwater offset), 5 (orphan stormwater system pilot program), 6 (appropriations), 7 (agency of natural resources orphan stormwater system annual report), 8 (extension of local community implementation fund), and 9 (sunset of orphan stormwater system program) of this act shall take effect upon passage.

(b) Sec. 5a (operation, management, and emergency response plans for pollution abatement facilities) shall take effect July 1, 2006.

(c) Sec. 5b (wastewater discharge permits) shall take effect July 1, 2007.



H. 884

An act relating to the Vermont municipal employees’ retirement system.

Reported favorably with recommendation of proposal of amendment by Senator Kitchel for the Committee on Government Operations.

The Committee recommends that the Senate propose to the House to amend the bill by striking out Secs. 3 and 12 in their entirety


(No House amendments.)


S. 106

An act relating to increasing the beverage container handler’s fee and an ongoing evaluation of the bottle redemption system.


By striking Sec. 6 and inserting in lieu thereof the following:

Sec. 6. BOTTLE BILL STUDY AND REPORT

(a) The secretary of natural resources with the cooperation and assistance of interested parties, including representatives of distributors, retailers, stand alone redemption centers, beverage retailers with redemption centers, beverage manufacturers, environmental protection organizations, solid waste districts, the solid waste industry and the department of liquor control shall make recommendations to the senate committee on finance, the house committee on ways and means and the house and senate committees on natural resources and energy. The secretary shall propose specific recommendations to improve further the beverage container deposit-redemption system established by chapter 53 of Title 10. The evaluation and recommendations shall address at least the following issues:

(1) on or before January 15, 2007:(A) a review of the handling fee system and the associated costs and

revenues;(B) the feasibility of instituting a two-tiered fee based on co-mingling

agreements;(C) the costs and benefits of the deposit-redemption system;(D) the disposition of unredeemed deposits collected on beverage

containers;(2) and on or before January 15, 2008:

(A) the scope of beverage containers to be included under the bottle bill.

House Proposal of Amendment to Senate Proposal of Amendment

H. 538

An act relating to informing parents and students of their rights and responsibilities under state and federal law.

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

First: By striking out the proposed Sec. 1 and renumbering the remaining sections to be numerically correct

Second: In the newly numbered Sec. 1, 16 V.S.A. § 212 (14) at the end of the subdivision, by adding the following two sentences:

It is the intent of this subdivision that the commissioner of education shall make a good faith effort to compile a complete list of information to be made available to the electorate, community members, parents or guardians, and students. However, due to the difficult nature of compiling such a list, it is also the intent that failure to include relevant information on the list shall not constitute grounds for an action against the commissioner.

ORDERED TO LIE

S. 112

An act relating to the practice of optometry.

PENDING ACTION: Second reading of the bill.

S. 157

An act relating to rulemaking for Vermont origin.

PENDING ACTION: Second reading of the bill.

S. 315

An act relating to creation of the Vermont Land Bank program.

Pending Action: Second Reading of the bill.

S. 316

An act to accelerate access to broadband services throughout Vermont.


S. 319

An act relating to expanding the scope of the net metering program.


CONFIRMATIONS

The following appointments will be considered by the Senate, as a group, under suspension of the Rules, as moved by the President pro tempore, for confirmation together and without debate, by consent thereby given by the Senate. However, upon request of any senator, any appointment may be singled out and acted upon separately by the Senate, with consideration given to the report of the Committee to which the appointment was referred, and with full debate; and further, all appointments for the positions of Secretaries of Agencies, Commissioners of Departments, Judges, Magistrates, and members of the Public Service Board shall be fully and separately acted upon.

Robert Alberts of Bridport – Member of the Vermont Housing Finance Agency – By Sen. Ayer for the Committee on Finance. (2/10)

John Valente of Rutland – Member of the Vermont Municipal Bond Bank – By Sen. Maynard for the Committee on Finance. (2/24)

Paul Andrew of South Burlington – Member of the Vermont Municipal Bond Bank – By Sen. Ayer for the Committee on Finance. (3/15)

Thomas James of Essex Junction – Member of the State Board of Education – By Sen. Collins for the Committee on Education. (3/15)

Dagyne Canney of North Clarendon – Member of the Vermont Housing Finance Agency – By Sen. Maynard for the Committee on Finance. (3/27)

John Hall of St. Johnsbury – Commissioner of the Department of Housing and Community Affairs – By Sen. Gander for the Committee on Economic Development, Housing and General Affairs. (4/11)

Patricia McDonald of Berlin – Chair of the Vermont Employment Security Board (November 15, 2004-February 28, 2005)– By Sen. Miller for the Committee on Economic Development, Housing and General Affairs. (4/12)

Patricia McDonald of Berlin – Chair of the Vermont Employment Security Board (March 1, 2005-February 28, 2007) – By Sen. Miller for the Committee on Economic Development, Housing and General Affairs. (4/12)

Patricia McDonald of Berlin – Commissioner of the Department of Labor – By Sen. Miller for the Committee on Economic Development, Housing and General Affairs. (4/12)

Bruce Hyde of Granville – Commissioner of the Department of Tourism and Marketing – By Sen. Miller for the Committee on Economic Development, Housing and General Affairs. (4/12)

Michael A. Welch of St. Johnsbury – Member of the Valuation Appeals Board – By Sen. Ayer for the Committee on Finance. (4/13)

Sonia D. Alexander of Wilmington – Member of the Valuation Appeals Board – By Sen. Ayer for the Committee on Finance. (4/13)

Dawn Bugbee of St. Albans – Member of the Vermont Educational and Health Buildings Finance Agency Board – By Sen. Ayer for the Committee on Finance. (4/13)

Kevin Dorn of Essex Junction – Secretary of the Agency of Commerce and Community Development – By Sen. Illuzzi for the Committee on Economic Development, Housing and General Affairs. (4/13)

Michael W. Quinn of Essex Junction – Commissioner of the Department of Economic Development – By Sen. Miller for the Committee on Economic Development, Housing and General Affairs. (4/13)

Eryn Brownlee of Montpelier – Member of the Children and Family Council for Prevention Programs – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Lynn Marie Bundy of Montpelier – Member of the Children and Family Council for Prevention Programs – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Suzanne Masland of Thetford – Member of the Children and Family Council for Prevention Programs – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Robert Sheil of Montpelier – Member of the Children and Family Council for Prevention Programs – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

William B. LaWare of Williston – Member of the Children and Family Council for Prevention Programs – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Frank Mazur of South Burlington – Member of the Public Oversight Commission – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Gregory MacDonald of East Montpelier – Member of the Vermont Tobacco Evaluation and Review Board – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Coleen Krauss of Montpelier – Member of the Vermont Tobacco Evaluation and Review Board – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Gregory Peters of Shelburne – Member of the Public Oversight Commission – By Sen. Lyons for the Committee on Health and Welfare. (4/14)

Phyllis Soule of Fairfax – Member of the Human Services Board – By Sen. Kittell for the Committee on Health and Welfare. (4/14)

Mary Jane Wasik of Pittsford – Member of the Human Services Board – By Sen. Mullin for the Committee on Health and Welfare. (4/14)

Hillary Roper of Stowe – Member of the Public Oversight Commission – By Sen. Mullin for the Committee on Health and Welfare. (4/14)

David M. Anderson of Tunbridge – Member of the Public Oversight Commission – By Sen. Mullin for the Committee on Health and Welfare. (4/14)

John Lindley, III of Montpelier – Member of the Public Oversight Commission – By Sen. Mullin for the Committee on Health and Welfare. (4/14)

Kitty LaBarge of South Hero – Member of the Public Oversight Commission – By Sen. Mullin for the Committee on Health and Welfare. (4/14)

Ezekiel S. Cross of Shaftsbury – Member of the Board of Medical Practice – By Sen. Mullin for the Committee on Health and Welfare. (4/14)

Documents

AutoFill Template - Home | Vermont General Assembly ... · Web view(2)(A) Within 180 days one year of the effective date of this chapter, the commissioner shall adopt rules pursuant