Source: http://www.leg.state.vt.us/docs/2006/calendar/SC050510.htm
Timestamp: 2018-02-25 03:16:40
Document Index: 190610440

Matched Legal Cases: ['§ 5930', '§ 5930', '§ 5930', '§ 5930', '§ 5404', '§ 5930', '§ 5404', '§ 1314', '§ 291', '§ 291', '§ 5830', '§ 293', '§ 293', '§ 5830', '§ 5830', '§ 5830', '§ 293', '§ 5930', '§ 5404', '§ 312', '§ 312', '§ 312', '§ 312', '§ 312', '§ 4605', '§ 3172', '§ 5410', '§ 6061', '§ 2804', '§ 2804', '§ 5401', '§ 5401', '§ 2804', '§ 5402', '§ 6066', '§ 9456', '§ 1912', '§ 9410', '§ 4080', '§ 4080', '§ 4516', '§ 4588', '§ 1998', '§ 1998', '§ 2005', '§ 2003', '§ 2010', '§ 1396', '§ 1396', '§ 4801', '§ 4802', '§ 4803', '§ 4804', '§ 4805', '§ 4806', '§ 4807', '§ 9417', '§ 9437', '§ 9440', '§ 9413', '§ 9413', '§ 2023', '§ 2024', '§ 5848', '§ 5822', '§ 5822', '§ 1972', '§ 313', '§ 1998', '§ 2461', '§ 2461', '§ 2461', '§ 9420', '§ 4', '§ 4', '§ 4']

126 DAY OF BIENNIAL SESSION
UNFINISHED BUSINESS OF FRIDAY, MAY 6, 2005
S. 165 Economic advancement tax incentives & economic development........ 836 Finance Committee Report 836
Sen. Illuzzi Amendment............................................................ 844
S. 172 Municipal authority to charge fees for fire services............................. 844
H. 156 Conservation motor vehicle registration plates.................................... 844
H. 201 Relating to a vacancy on a school board............................................ 844
Education Committee Report................................................... 844
H. 299 Agency fee for teachers and administrators........................................ 845
Ec. Dev., Housing & General Affairs Committee Report........... 845
Education Committee Report................................................... 845
H. 507 Relating to the health of Vermont’s fish population............................. 845
Natural Resources and Energy Committee Report.................... 845
S. 28 Relating to survivors of emergency personnel..................................... 845
Joint Resolutions for Action
JRH 41 Mercury manometer removal and replacement program..................... 846
JRH 42 May 7-15 as 22nd annual celebration of National Tourism Week...... 846
H. 504 Appraisals and education finance....................................................... 846
Finance Committee Report...................................................... 846
H. 524 Universal access to health care in Vermont..............................................
S. 31 Predatory pricing.............................................................................. 849
S. 62 Banking, insurance, securities and health care administration............... 850
S. 113 Nonprofit hospitals to convert charitable assets.................................. 851
S. 81 School busses................................................................................... 851
S. 98 Voc. rehabilitation & payment under workers compensation.............. 852
S. 117 State recognition of the Abenaki people............................................ 852
S. 157 Relating to rulemaking for Vermont origin.......................................... 852
An act relating to economic advancement tax incentives and economic development.
By the Committee on Economic Development, Housing and General Affairs. (Sen. Miller for the Committee)
First: In Sec. 1, subdivision (3) by striking out the following: “Total reduction in Education Fund: 3.2 million” and inserting in lieu thereof the following: Total reduction in Education Fund: 2.7 million
Second: By striking out Sec. 3 in its entirety and inserting in lieu thereof a new Sec. 3 to read as follows:
Sec. 3. RECAPTURE AND DISALLOWANCE OF PRIOR EATI AWARDS
(a) The Attorney General shall consult with the Department of Taxes and the Vermont Economic Progress Council on legal strategies for recapturing or disallowing awards authorized by the council both prior to and subsequent to July 1, 2000.
(b) If the Attorney General concludes that legal action to recapture or disallow any awards is warranted, the Attorney General shall pursue appropriate legal action for the purpose. The Attorney General may take legal actions in support of or independent of any administrative action taken by the Department of Taxes and the Vermont Economic Progress Council to recapture or disallow awards.
(c) On or before November 1, 2005, the Attorney General shall report to the Joint Fiscal Committee and the Economic Development Study Committee established by Sec. 9 of this act regarding any legal actions taken pursuant to subsection (b) of this section. This report shall include recommendations by the Attorney General for statutory changes for recapturing or disallowing awards.
(d) For the purposes of this section, and notwithstanding any other provision of law, the Attorney General shall have access to all records and documents pertaining to the EATI awards subject to this section in the possession of the Vermont Economic Progress Council and the Department of Taxes, and shall in turn be subject to the confidentiality requirements and applicable penalties for any breach of confidentiality.
Third: In Sec. 5, by striking out subsection (c) in its entirety and inserting in lieu thereof a new subsection (c) to read as follows:
(c) For the fiscal years beginning July 1, 2005 but before July 1, 2007, the Vermont Economic Progress Council is authorized to grant the awards pursuant to the single, payroll-based incentive program established by Sec. 7 of this act. Unless extended by act of the General Assembly, Sec. 7 of this act is repealed effective July 1, 2007, and any unused authorizations granted before July 1, 2007 shall remain in effect.
Fourth: In Sec. 7, 32 V.S.A. § 5930b(g), by striking out the following:
“Credits taken minus [qualifying capital investments made ÷ minimum qualifying capital investment] × total award”
Credits taken minus [(qualifying capital investments made ÷ minimum qualifying capital investment) × total award ]
Fifth: In Sec. 7, 32 V.S.A. § 5930b, by striking out subsection (h) in its entirety and inserting in lieu thereof a new subsection (h) to read as follows:
(h) Notwithstanding subsection (e) of this section, the council may authorize credits in excess of the incentive ratio multiplied by the net fiscal benefit or credits resulting in a net fiscal cost. In either case, credits under this section shall not exceed an annual authorization established by law.
Sixth: In Sec. 7, 32 V.S.A.§ 5930b(j), in the second sentence, following the word “contain” by inserting the following: information received from written reports in accordance with subsection 5930a(n) of this title,
Seventh: By striking out Sec. 8 in its entirety and inserting in lieu thereof a new Sec. 8 to read as follows:
Sec. 8. FISCAL YEAR 2006 CAPS
(a) Net and excess fiscal cost annual authorization. In fiscal year 2006, the annual authorization for credits in excess of the incentive ratio multiplied by the net fiscal benefits or credits resulting in a new fiscal cost, which the council may approve under 32 V.S.A. § 5930b(h), and property tax allocations and tax increment financing districts under 32 V.S.A. § 5404a(e) and (f), shall not exceed $1,000,000.00 from the general fund and education fund combined. Incentives approved within this annual authorization amount for the total net and excess fiscal cost shall be granted solely for awards to businesses located in a labor market area of this state in which the rate of unemployment is greater than the average for the state or in which the average annual wage is below the average annual wage for the state. For the purposes of this section, a “labor market area” shall be determined by the department of employment and training.
(b) Total credit and benefit annual authorization. In fiscal year 2006, the total amount of payroll-based job credits the Vermont Economic Progress council is authorized to approve under 32 V.S.A. § 5930b and property tax allocations and tax increment financing districts under 32 V.S.A. § 5404a(e) and (f) shall not exceed $17,500,000.00 from the general fund and education fund combined. This maximum annual amount may be exceeded by the Vermont Economic Progress Council upon application to and approval of the Emergency Board.
Eighth: By inserting a new section to be numbered Sec. 7a to read as follows:
Sec. 7a. 21 V.S.A. § 1314(e)(1) is amended to read:
(e)(1) Subject to such restrictions as the board may by regulation prescribe, information from unemployment insurance records may be made available to any public officer or public agency of this or any other state or the federal government dealing with the administration of relief, public assistance, unemployment compensation, a system of public employment offices, wages and hours of employment, or a public works program for purposes appropriate to the necessary operation of those offices or agencies. The commissioner may also make information available to colleges, universities and public agencies of the state, for use in connection with research projects of a public service nature, and to the Vermont economic progress council with regard to the administration of subchapter 11E of chapter 151 of Title 32; but no person associated with those institutions or agencies may disclose that information in any manner which would reveal the identity of any individual or employing unit from or concerning whom the information was obtained by the commissioner.
Ninth: In Sec. 9, subsection (d), in subdivisions (1) and (2), by striking out the word “oversee” each time it appears and inserting in lieu thereof the word review and in subdivision (2), by striking the year “2006” and inserting in lieu thereof the year 2007
Tenth: By striking out Sec. 10 (film industry credits) in its entirety and inserting in lieu thereof three new sections to be numbered Secs. 10, 10a, and 10b to read as follows:
Sec. 10. 10 V.S.A. § 291 is amended to read:
§ 291. VERMONT SEED CAPITAL FUND; AUTHORIZATION; LIMITATIONS
(B) If organized as a partnership, have and maintain a board of three advisors appointed by the governor with the advice and consent of the senate Vermont economic development authority. The board of advisors shall represent solely the public economic interest of the state with respect to the management of the fund and shall have no civil liability for the financial performance of the fund. The board of advisors shall be advised of investments made by the fund and shall have access to all information held by the fund with respect to investments made by the fund.
(5) No person shall be allocated more than 10 percent of the available tax credits. For the purposes of determining allocation, the attribution rules of Section 318 of the Internal Revenue Code in effect as of the effective date of this chapter shall apply.
(6) The first $2 million of initial capitalization of the Vermont seed capital fund raised from Vermont taxpayers by the termination date as set by the fund, which termination date shall be on or before January 1, 2014, shall be eligible for partial tax credits as specified in 32 V.S.A. § 5830b.
Sec. 10a. 10 V.S.A. § 293 is amended to read:
§ 293. CAPITALIZATION
The fund may solicit and receive subscriptions, provided that if total subscriptions for amounts exceeding $2 the fund exceed $5 million by the termination date as set by the fund, the tax credit amount available to taxpayers under 32 V.S.A. § 5830b shall be reduced pro rata among subscribers subscribing for more than $2 million in the event the issue is oversubscribed by the termination date as set by the fund subscriber taxpayers so that the total cost of the tax credits shall be $1 million. The minimum capitalization shall be $1 million.
Sec. 10b. 32 V.S.A. § 5830b is amended to read:
§ 5830b. TAX CREDITS; VERMONT SEED CAPITAL FUND
(a) The initial capitalization of the Vermont seed capital fund, comprising a maximum $2 $5 million raised from Vermont taxpayers on or before January 1, 2007 2014, shall entitle those taxpayers to a credit against the tax imposed by sections 5822, 5832, 5836, or 8551 of this title. The credit may be claimed for the taxable year in which a contribution is made and each of the four succeeding the next taxable years year. The amount of the credit for each year shall be the lesser of ten percent of the taxpayer's contribution or 50 20 percent of the taxpayer's tax liability for that taxable year prior to the allowance of this credit; provided, however, that in no event shall the aggregate credit allowable under this section for all taxable years exceed 50 20 percent of the taxpayer's contribution to the initial $2 $5 million capitalization of the Vermont seed capital fund. The credit shall be nontransferable except as provided in subsection (b) of this section. The amount of the credit available under this section will be reduced proportionally by the provisions of 10 V.S.A. § 293 if fund subscriptions exceed $5 million.
(b) If the taxpayer disposes of an interest in the Vermont seed capital fund within four two years after the date on which the taxpayer acquired that interest, any unused credit attributable to the disposed-of interest is disallowed. This disallowance does not apply in the event of an involuntary transfer of the interest, including a transfer at death to any heir, devisee, legatee, or trustee, or in the event of a transfer without consideration to or in trust for the benefit of the taxpayer or one or more persons related to the taxpayer as spouse, descendant, parent, grandparent, or child.
Eleventh: By striking out Secs. 12 and 13 (Wood products credits) in their entirety.
Twelfth: In Sec. 14, 32 V.S.A. § 5930a(a), in the seventh sentence, by striking out the word “may” each time it appears and inserting in lieu thereof the word shall and in the eighth sentence, after the words “general assembly” by inserting the following: shall serve two-year terms and and in the eleventh sentence; by inserting after the following: “section 1010 of this” the word title and by striking out the words “any members appointed by the general assembly who are members of the legislature” and inserting in lieu thereof the words legislative members
Thirteenth: By striking out Sec. 17 (Brownfields) in its entirety.
Fourteenth: In Sec. 18, 32 V.S.A. § 5404a, by striking out subsections (e) and (f) in their entirety and inserting in lieu thereof new subsections (e) and (f) to read as follows:
(e) A municipality may apply to the Vermont economic progress council for an allocation of the education grand list value for up to ten years, of a portion of the increase in the value and liability assessed under section 5402 of this title on new economic development that is subsequently real property improvements approved by the Vermont economic progress council pursuant to this section and section 5930a of this title. The council shall not approve an allocation unless it determines that the project is consistent overall with the “but for” test, the guidelines, and other criteria set forth in subsection 5930b(c), (d), and (e) of this title. Allocation to a municipality pursuant to this subsection shall be in addition to any other payments to the municipality under chapter 133 of Title 16. If allocated, the allocated portion of the education fund liability shall be used by the municipality to support economic development through the purchase or financing of for infrastructure, including, but not limited to wastewater treatment, water supply, transportation, and utility connections, that supports the real property improvements.
(f) Municipalities which have existing tax increment financing districts under subchapter 5 of chapter 53 of Title 24 shall have the authority to expand those districts and to collect all state and local property taxes on properties within the tax increment financing district and apply those revenues to repayment of debt issued to finance improvements within the tax increment financing district to the extent approved for this purpose by the Vermont economic progress council upon application by the district under procedures for approval of tax stabilization agreements under this section, and that any such action shall be included in the annual authorization limits provided in section 5930a(d)(1) of this title set forth in subsection 5930b of this title. Approval shall be given only if the council determines that the new real property improvements would not have occurred but for the proposed application of the new tax revenues or would have occurred in a significantly different or significantly less desirable manner. The council shall also evaluate the overall consistency of the project with the criteria set forth in subsections 5930b(c), (d), and (e) of this title.
Fifteenth: By adding two new sections to be numbered Secs.18a and 18b to read as follows:
Sec. 18a. 32 V.S.A. § 312 is added to read:
§ 312. TAX EXPENDITURE LEGISLATION AND REPORTS
(b) Tax expenditure legislation. In any legislation which proposes to enact a tax expenditure for a state-level tax, the general assembly shall include a statement of the following:
(2) A description of and the estimated number of taxpayers who will directly benefit from the expenditure.
(3) The estimated annual cost of the tax expenditure.
(c) Tax expenditure reports. Annually, as part of the budget process, beginning January 15, 2009, the department of taxes shall file with the house committees on ways and means and appropriations and the senate committees on finance and appropriations a report on tax expenditures that are reported on filed personal and corporate income, sales and use, and meals and rooms tax returns, and education property tax grand lists. The report shall also include, for each tax expenditure, the following information:
(3) The purpose of the expenditure as described in the enacting legislation and the most recent measure of whether the purpose is being achieved.
Sec. 18b. TRANSITION REPORTS
(a) The department of taxes shall file with the House Committees on Ways and Means and Appropriations, and to the Senate Committees on Finance and Appropriations reports on the following:
(1) By January 15, 2006, tax expenditures reported under the personal and corporate income tax with the information required by32 V.S.A. § 312(c) for the most recent fiscal year available.
(2) By January 15, 2007, tax expenditures reported under the personal and corporate income tax and the sales and use tax, with the information required by 32 V.S.A. § 312(c) for the most recent fiscal year available.
(3) By January 15, 2008, tax expenditures under the personal and corporate income tax, sales and use tax and meals and rooms tax, and education property tax, with the information required by 32 V.S.A. § 312 (c) for the most recent fiscal year available.
(b) The department of taxes shall advise the Joint Fiscal Committee at its September meeting in 2005, 2006, and 2007, on the status of the department’s research in preparation for the report due the following January under subsection (a) of this section.
Sixteenth: By striking out Sec. 19 in its entirety and inserting in lieu thereof a new Sec. 19 to read as follows:
This act shall take effect from passage, except that:
(1) Secs. 5 and 6, providing for termination of the EATI program, shall take effect for taxable years beginning on and after July 1, 2005.
(2) Secs. 7 and 8, providing for the creation of the payroll-based tax credit program, shall take effect July 1, 2005, and Sec. 7 shall terminate July 1, 2007 unless extended by the General Assembly.
(3) Sec. 10, relating to repeal of the financial services development tax credit, shall take effect July 1, 2005.
(4) Secs. 11, 12, and 13, relating to VEPC board membership, public information, and reporting, shall take effect July 1, 2005.
AMENDMENT TO S. 165 TO BE OFFERED BY SENATOR ILLUZZI, ON BEHALF OF THE COMMITTEE ON ECONOMIC DEVELOPMENT, HOUSING AND GENERAL AFFAIRS
Senator Illuzzi, on behalf of the Committee on Economic Development, Housing and General Affairs, moves to amend the bill in Sec. 4 by striking out subdivision (4) in its entirety and inserting in lieu thereof the following:
(4) the minimum level of restoration of employment necessary within the recapture period shall be seventy-five percent of the highest annual average number of full-time employees of the applicant during any year in a period of six years after the initial authorization of an incentive by the council.
An act relating to municipal authority to charge fees for fire services.
An act relating to conservation motor vehicle registration plates.
An act relating to a vacancy on a school board.
Reported favorably by Senator Starr for the Committee on Education.
(For House amendments, see House Journal for April 29, page 871; April 3, page 908).
H. 299
An act relating to an agency fee for teachers and administrators.
Reported favorably by Senator MacDonald for the Committee on Economic Development, Housing and General Affairs.
Reported favorably by Senator Collins for the Committee on Education.
(For House amendments, see House Journal for April 19, 2005, page 700)
H. 507
An act relating to the health of Vermont’s fish population.
The Committee recommends that the Senate propose to the House to amend the bill in Sec. 2, 10 V.S.A. § 4605 subsection (a) as follows:
(a) A person shall not introduce or attempt to introduce pickerel or great northern pike into any waters, or any fish, except trout or salmon, into public any waters frequented by trout or salmon.
An act relating to survivors of emergency personnel.
In Sec. 1, 20 V.S.A. § 3172(a), line 14, after the words “emergency personnel”, by adding the following: , employed by the state of Vermont, a county or municipality of the state, or a nonprofit entity which provides services in the state,
J.R.H. 41
Joint resolution relating to federal funding and state administration of a mercury manometer removal and replacement program
(For text of Resolution, see Senate Journal for May 6, 2005, page 570)
Joint resolution designating May 7-15 as the 22nd annual celebration of National Tourism Week.
(For text of Resolution, see Senate Journal for May 6, 2005, page 571)
H. 504
An act relating to appraisals and education finance.
Reported favorably with recommendation of proposal of amendment by Senator MacDonald for the Committee on Finance.
First: In Sec. 6, in 32 V.S.A. § 5410(i), by inserting at the end of the subsection a new sentence to read as follows: Any change in property classification under this subsection shall not be entered on the grand list.
Second: In Sec. 7, in 32 V.S.A. § 6061(13), after the words “and declared”, by inserting the words before July 15
Third: By adding two new sections to be numbered Secs. 24 and 25 to read:
Sec. 24. 24 V.S.A. § 2804 is amended to read:
§ 2804. RESERVE FUNDS; USE
(a) At an annual or special meeting duly warned, a municipality may establish a reserve fund to be under the control and direction of the legislative branch of the municipality. The reserve fund shall be kept in a separate account and invested as are other public funds and may be expended for such purposes for which established, or when authorized by a majority of the voters present and voting at an annual or special meeting duly warned, for other purposes.
(b) If a reserve fund is established under subsection (a) of this section to pay a school district’s future school capital construction costs approved under chapter 123 of Title 16, any funds raised by the district as part of its education spending to pay for those future costs shall be considered “approved school capital construction spending” in calculating excess spending under 32 V.S.A. § 5401(12). Districts shall submit to the Department of Education annually a report of deposits into and expenditures from a school capital construction reserve fund. If the Department of Education determines that any amount in the reserve fund has not been used for approved school capital construction within five years after deposit into the fund, then 150% of that amount shall be added to the district’s education spending in the then-current year for purposes of calculating the excess spending penalty. The definitions in Chapter 133 of Title 16 shall apply to this subsection.
Sec. 25. 32 V.S.A. § 5401(12) is amended to read:
(A) the per-equalized pupil amount of
(ii) the portion of education spending which is approved school capital construction spending or deposited into a reserve fund under 24 V.S.A. § 2804 to pay future approved school capital construction costs;
Fourth: By adding three new sections to be numbered Secs. 26, 27 and 28 to read:
32 V.S.A. § 5402b(b) (annual adjustment of the applicable percentage base for homestead property tax adjustments) is repealed for claims related to 2006 property taxes and after.
Sec. 27. 32 V.S.A. § 6066(a)(1)(A), (B) and (D) are amended to read:
(II) the statewide education tax rate as adjusted under subdivision 5402(a)(2) of this title, multiplied by the equalized value of the housesite in the taxable year in excess of $160,000.00 $200,000.00.
Sec. 28. EFFECTIVE DATES
Sec. 26 (repeal of applicable percentage adjustment) and Sec. 27 (household income threshold and housesite maximum) shall apply to claims filed for 2006 property taxes and after.
Fifth: In Sec. 8, by striking out “$8.80” and “$8.50” and inserting in lieu thereof “$8.50” and “$8.20”, respectively.
Sixth: By striking out Sec. 13 in its entirety and inserting a new Sec. 13 to read:
Sec. 13. HOUSE COMMITTEE ON WAYS AND MEANS STUDY OF INCOME-BASED EDUCATION TAX SYSTEM
(a) The House Committee on Ways and Means shall study income-based education property tax for Vermonters. The committee shall analyze the current prebate and rebate system, including the renter rebate program, by which most Vermonters pay education property tax based on income, and propose a more understandable and efficient income-based system, taking into account taxpayer confidentiality. In analyzing and designing its proposals, the committee shall consider:
(4) concerns with the amount of benefit available in the circumstance of a taxpayer with very high property tax and very low income, and methods to assure that a taxpayer in such circumstance does not receive an inappropriate benefit (as defined by the Committee) without creating a hardship for those in true need; ways to limit manipulation of “household income” eligibility, including income averaging; and balancing of the needs of individual taxpayers against the cost to other taxpayers.
(b) The committee shall meet no more than six times and hold at least one public hearing. It shall provide a copy of its findings and recommendations, and any legislation it may propose, by January 15, 2006, to the Senate Committee on Finance.
(For House amendments, see House Journal for April 14, 2005, page 667; April 15, 2005, page 679.)
An act relating to universal access to health care in Vermont.
Reported favorably with recommendation of proposal of amendment by Senator Leddy for the Committee on Health and Welfare.
(1) In 2006, it is projected that Vermont will spend $3.8 billion on health care. That amount has doubled since 1998. If the trend continues, health care spending will double again in eight years. In other words, for every year Vermont fails to address the health care crisis, health care costs will rise by at least another $350 million.
(2) Over 60,000 Vermonters have no health insurance. The costs of health services provided to individuals who are unable to pay are shifted to others. Of the $2.1 billion charged by hospitals in 2005, $88 million was not collected as follows: $37 million in charity care and $51 million in bad debt.
(3) There are two fundamental inequities in the insurance-based financing system: (A) premiums are not based on ability to pay, and (B) deductibles and coinsurance place a financial burden on those with serious illness. In addition, health care financing is complex and fragmented, placing administrative burdens on health care professionals, in particular.
(4) Improvements in health care quality will result in improved health and reduced costs. The existing payment system, because it is based on the amount of care provided, does not tie reimbursement to improved health.
(5) The Vermont health care system is fragmented and disorganized, leading in some instances to excessive care or inadequate care and creating barriers to coordination and accountability among health care professionals, payers, and patients.
(1) By 2009, all Vermonters shall have access to affordable, continuous, quality health care that is financed in a fair and equitable manner. To achieve this ultimate goal, it is imperative that health care costs are brought under control.
(2) Cost containment measures shall include global budgeting of hospitals, tort reform, increased consumer access to health care price and quality information, promotion of self-care and healthy lifestyles, enhanced prescription drug initiatives, funding of the chronic care initiative, investments in health information technology, alignment of health care professional reimbursement with best practices and outcomes rather than utilization, and development of a long-term strategy for integrating the health care delivery system as well as a strategy for integrating health care policy, planning, and regulation within government.
(3) In addition, as an intermediate step toward reaching the goal of universal access to affordable health care, the state shall offer a benefit of primary and preventive health services to all uninsured Vermonters.
(4) Subsequent steps shall include expanded benefits to expanded populations. Expansions shall occur only upon a showing that they will further specified benchmarks. The benchmarks shall measure the appropriateness and feasibility of a proposed expansion based on its ability to promote the following: cost savings, increased access, improved quality and delivery, administrative simplification, fair and equitable financing, financial sustainability, and continuity of coverage.
Sec. 4. 18 V.S.A. § 9456 is amended to read:
(d) For hospital fiscal year 2006 and thereafter, the hospital budget shall serve as a spending cap within which hospital costs are controlled, resources directed, and quality and access assured. The hospital budget shall limit the total annual growth of hospital costs to the Consumer Price Index plus the rate of growth of the gross state product. The commissioner shall ensure that any certificate of need requests under subchapter 5 of chapter 221 of this title are consistent with the hospital budgets.
(f)(g) The commissioner may, upon application, adjust a budget established under this section upon a showing of need based upon exceptional or unforeseen circumstances in accordance with the criteria and processes established under section 9405 of this title. The department may adopt rules for the development of a voluntary three-year hospital budget process to facilitate long-term planning and to moderate variation in utilization. The rules shall include a process for annual budget adjustment within the three-year period.
Sec. 5. 12 V.S.A. § 1912 is added to read:
(a) An expression of regret or apology, or an explanation of how a medical error occurred, made by or on behalf of a health care provider, including one that is made in writing, orally, or by conduct, does not constitute a legal admission of liability for any purpose and shall be inadmissible in any civil or administrative proceeding against the health care provider, including any arbitration or mediation proceeding.
(b) In any civil or administrative proceeding against a health care provider, including any arbitration or mediation proceeding, the health care provider, or any other person who makes an expression of regret, apology, or explanation on behalf of the health care provider, including one that is made in writing, orally, or by conduct, may not be examined by deposition or otherwise with respect to the expression of regret, apology, or explanation.
(c) As used in this section, “health care provider” shall have the meaning defined in subdivision 1910(e)(1)(A) of this title.
Sec. 6. MEDICAL MALPRACTICE CAPTIVE INSURER REQUEST FOR PROPOSALS
The commissioner of banking, insurance, securities, and health care administration shall prepare and publish a request for proposals to prepare a plan for establishing either a captive insurer, a cell captive, or a risk retention group based in Vermont to provide Vermont health professionals with medical malpractice insurance at the lowest possible cost. The plan shall include recommendations for state participation in order to reduce the cost of the initial capitalization and facilitate the creation of the insurer. The plan shall be submitted to the general assembly and the House committees on health care and commerce and the Senate committees on health and welfare and finance on or before January 15, 2006.
Sec. 7. 18 V.S.A. § 9410(a) and (c) are amended to read:
Sec. 8. 8 V.S.A. § 4080a(h) is amended to read:
(i) limit any discount, rebate, or waiver of cost sharing to not more than 15 percent of the cost of employee-only coverage;
Sec. 9. 8 V.S.A. § 4080b(h) is amended to read:
Sec. 10. 8 V.S.A. § 4516 is amended to read:
Sec. 11. 8 V.S.A. § 4588 is amended to read:
Sec. 12. 33 V.S.A. § 1998(a) is amended to read:
§ 1998. PHARMACY BEST PRACTICES AND COST CONTROL PROGRAM ESTABLISHED
(3) Any strategy designed to negotiate with pharmaceutical manufacturers on behalf of state employees and retirees, individuals under the supervision of the department of corrections, the division of mental health, or the department for children and families, individuals receiving coverage for prescription drugs through Medicaid, the Vermont Health Access Program (VHAP), Dr. Dynasaur, VHAP Pharmacy, VScript, VScript-Expanded, Healthy Vermonters, Healthy Vermonters Plus, and workers’ compensation on behalf of the applicable state agency, and any other insurer or employer who elects to participate, to lower the cost of prescription drugs for program participants, including a supplemental rebate program;.
Sec. 13. 18 V.S.A. chapter 221, subchapter 9 is added to read:
(6) Disclose to the health plan all financial terms and arrangements for remuneration of any kind that apply between the pharmacy benefit manager and any prescription drug manufacturer, including formulary management and drug-switch programs, educational support, claims processing, pharmacy network fees charged from retail pharmacies and data sales fees, and any other information required to be disclosed under section 9420 of this title. A pharmacy benefit manager providing information under this subsection may designate that material as confidential. Information designated as confidential by a pharmacy benefit manager and provided to a health plan under this subsection may not be disclosed by the health plan to any person without the consent of the pharmacy benefit manager, except that disclosure may be made in a court filing under the consumer fraud provisions of chapter 63 of Title 9 or when authorized by that chapter or ordered by a court for good cause shown.
In addition to any other remedy provided by law, a health plan aggrieved by a violation of this subchapter may file an action in superior court for injunctive relief and an award of compensatory and punitive damages. The superior court may award to the health plan which prevails in an action under this section reasonable costs and attorney’s fees.
Sec. 14. APPLICATION
Sec. 13 of this act applies to contracts executed or renewed on or after September 1, 2005. For purposes of this section, a contract executed pursuant to a memorandum of agreement executed prior to September 1, 2005 is deemed to have been executed prior to September 1, 2005 even if the contract was executed after that date.
Sec. 15. 33 V.S.A. § 2005(a)(4) is amended and (d) is added to read:
Sec. 16. 33 V.S.A. § 2003 is amended to read:
Sec. 17. 33 V.S.A. § 2010 is added to read:
(1) the average wholesale price;
(2) the wholesale acquisition cost;
(3) the average manufacturer price as defined in 42 U.S.C. § 1396r-8(k); and
(4) the best price as defined in 42 U.S.C. § 1396r‑8(c)(1)(C).
(b) The calculation of average wholesale price and wholesale acquisition cost must be the net of all volume discounts, prompt payment discounts, charge-backs, short-dated product discounts, cash discounts, free goods, rebates, and all other price concessions or incentives provided to a purchaser that result in a reduction in the ultimate cost to the purchaser.
(c) When reporting the average wholesale price, wholesale acquisition cost, average manufacturer price and best price, a manufacturer of prescription drugs dispensed in this state shall include also a detailed description of the methods by which the prices were calculated.
(d) When a manufacturer of prescription drugs dispensed in this state reports the average wholesale price, wholesale acquisition cost, average manufacturer price, or best price, the president or chief executive officer of the manufacturer shall certify to the agency, on a form provided by the director of the office of Vermont health access, that the reported prices are accurate.
(e) Except as provided in this subsection, all information provided to the director by a manufacturer of prescription drugs under this section is confidential and may not be disclosed by any person or by the office to any person without the consent of the manufacturer. Disclosure may be made by the office to an entity providing services to the office under this section. Disclosure may be ordered by a court for good cause shown or made in a court filing under seal unless or until otherwise ordered by a court. Nothing in this subsection limits the attorney general’s use of civil investigative demand authority under the Vermont Unfair Trade Practices Act to investigate violations of this section.
* * * Electronic Monitoring of Prescriptions * * *
Sec. 18. 33 V.S.A. chapter 48 is added to read:
CHAPTER 48. ELECTRONIC MONITORING OF PRESCRIPTIONS
§ 4801. ELECTRONIC DATABASE FOR PRESCRIPTIONS
(a) Contingent upon the receipt of funding, the Vermont department of health may establish an electronic system for monitoring Schedules II, III, and IV controlled substances that are dispensed within the state of Vermont by a practitioner or pharmacist or dispensed to an address within the state by a pharmacy licensed by the Vermont board of pharmacy.
(c) Every dispenser within the state of Vermont or who is licensed by the Vermont board of pharmacy shall report to the Vermont department of health the data required by this section in a timely manner as prescribed by the department of health, except that reporting shall not be required for:
(2) a drug dispensed by a practitioner at a facility licensed by the Vermont department of health, provided that the quantity dispensed is limited to an amount adequate to treat the patient for a maximum of 48 hours.
(d) Data for each controlled substance that is dispensed shall include, but not be limited to, the following:
(e) The data shall be provided in the electronic format specified by the department of health unless a waiver has been granted by the department to an individual dispenser.
(f)(1) The data collected pursuant to this chapter shall be confidential and not subject to public records law except as provided in this section. The department of health shall maintain procedures to ensure that the privacy and confidentiality of patients and patient information collected, recorded, transmitted, and maintained is not disclosed to persons except as provided in this section.
(2) The department of health shall be authorized to provide data to only the following persons:
(D) Personnel or contractors, as necessary for establishing and maintaining the program's electronic system.
(3) A person who receives data or any report of the system from the department of health shall not provide it to any other person or entity except by order of a court of competent jurisdiction.
(4) The department shall purge all information that is more than six years old.
(g) The failure by a dispenser to transmit data to the department of health as required by subsections (c), (d), or (e) of this section shall be subject to discipline by the board of pharmacy or by the applicable professional licensing entity.
(h) Knowing disclosure of transmitted data to a person not authorized by subsection (f) of this section or by other state law, or obtaining information under this section not relating to a bona fide specific investigation, shall be punishable by imprisonment for not more than one year or a fine of not more than $1,000.00, or both.
§ 4802. DEFINITIONS
As used in this chapter, the following definitions shall have the following meanings:
(1) “Patient identifier” means a patient’s:
(B) Address, including zip code;
(D) Social Security number or an alternative identification number established pursuant to section 4806 of this title.
(2) “Pharmacy Universal Claim Form” means a form that:
(A) Is in the format of the “Pharmacy Universal Claim Form” incorporated by reference in section 4807 of this title; and
(B) Contains the information specified by section 4801 of this title.
(3) “Report” means a compilation of data concerning a patient, a dispenser, a practitioner, or a controlled substance.
§ 4803. DATA REPORTING
(a) A dispenser shall report all controlled substances dispensed after September 1, 2005.
(b) A dispenser of a Schedule II, III, or IV controlled substance shall transmit or provide the following data to the department of health or the department of health’s agent:
(1) The patient identifier;
(2) The national drug code of the drug dispensed;
(3) The metric quantity of the drug dispensed;
(4) The date of dispensing;
(5) The estimated days’ supply dispensed;
(6) The Drug Enforcement Administration registration number of the prescriber;
(7) The serial number assigned by the dispenser; and
(8) The Drug Enforcement Administration registration number of the dispenser.
(c)(1) The data shall be transmitted within 16 days of the date of dispensing unless the department of health grants an extension.
(2) An extension may be granted if a dispenser suffers a mechanical or electronic failure or cannot meet the deadline established by subdivision (1) of this subsection for other reasons beyond his or her control. A dispenser shall apply, in writing, for an extension. An application for an extension shall state the reason why an extension is required and the period of time for which the extension is required.
(3) An extension shall be granted to all dispensers if the department of health or its agent is unable to receive electronic reports.
(d) Except as provided in subsection (g) of this section, the data shall be transmitted by:
(1) An electronic device compatible with the receiving device of the department of health or its agent;
(2) A double-sided, high-density micro floppy disk; or
(3) A one-half inch nine-track 1600 or 6250 BPI magnetic tape.
(e) The data shall be transmitted in the format established by the “ASAP Telecommunications Format for Controlled Substances.”
(f) The department of health shall provide a toll-free telephone number for transmitting electronic reports by modem.
(g)(1) A dispenser who does not have an automated recordkeeping system capable of producing an electronic report in the format established by “ASAP Telecommunications Format for Controlled Substances” may request a waiver from electronic reporting. The request shall be made in writing to the department of health.
(2) A dispenser shall be granted a waiver if he or she agrees in writing to report the data by submitting a completed “Pharmacy Universal Claim Form.”
§ 4804. COMPLIANCE
(a) A dispenser shall be deemed to be the person who is registered with the U.S. Drug Enforcement Administration.
(b) A dispenser may presume that the patient identification information provided by the patient or the patient’s agent is correct.
§ 4805. REQUEST FOR REPORT
(a) A written request shall be filed with the department of health prior to the release of a report.
(b) A request for a report shall be made on a request form, except for a subpoena issued by a grand jury.
§ 4806. ALTERNATIVE PATIENT IDENTIFICATION NUMBER
(a) If a patient does not have a Social Security number or refuses to provide a Social Security number, the patient’s driver’s license number shall be used.
(b) If a patient does not have a Social Security number or a driver’s license number, the patient shall use a number designated by the Vermont department of health.
§ 4807. RULEMAKING
The department may adopt rules as necessary for the implementation of this chapter.
* * * Chronic Care Initiative * * *
Sec. 19. BLUEPRINT FOR HEALTH; APPROPRIATION
There is appropriated from the health access trust fund $3,000,000.00 to the office of Vermont health access to fund the goals of the Vermont Blueprint for Health: The Chronic Care Initiative. The goals of the initiative are to: (1) implement a statewide system of care that enables Vermonters with, and at risk for, chronic disease to lead healthier lives; (2) develop a system of care that is financially sustainable; and (3) forge a public-private partnership to develop and sustain the new system of care. On or before January 1, 2006, and annually thereafter, the director of the office of Vermont health access, in consultation with the commissioner of health, shall file a report with the general assembly detailing progress made in reaching these three goals.
Sec. 20. 18 V.S.A. § 9417 is added to read:
(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, including computerized physician order entry technology, electronic common claims technology, and smart card technology;
(4) make 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.
(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 deliberations and decisions are fair and equitable.
(d) The following persons shall be invited to participate in VITL as nonvoting members:
(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;
(3) the commissioner or his or her designee.
(3) determining whether and how best to expand the pilot program on a statewide basis;
(4) implementing strategies for future developments in health care technology, policy, management, governance, and finance; and
(5) ensuring patient data confidentiality at all times.
(g) On or before January 1, 2007, VITL shall submit to the commissioner, the commissioner of information and innovation, the director of the office of Vermont health access, and the general assembly a 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. The plan shall include also recommendations for self‑sustainable funding for the ongoing development, maintenance, and replacement of the health information technology system. Upon approval by the commissioner, 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 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.
(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, 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.
Sec. 21. 18 V.S.A. § 9437(4) and (5) are amended and (6) is added to read:
(6) if the application is for the purchase or lease of new health care information technology, it conforms with the health information technology plan established under section 9417 of this title, upon approval of the plan by the commissioner.
Sec. 22. 18 V.S.A. § 9440b is added to read:
Notwithstanding the procedures in section 9440 of this title, upon approval by the commissioner of the health information technology plan developed under section 9417 of this title, the commissioner shall establish by rule standards and expedited procedures for reviewing applications for the purchase or lease of health care information technology that otherwise would be subject to review under this subchapter. Such applications may not be granted or approved unless they are consistent with the health information technology plan and the health resource allocation plan. The commissioner’s rules may include a provision requiring that applications be reviewed by the health information advisory group authorized under subsection 9417(c) of this title. The advisory group shall make written findings and a recommendation to the commissioner in favor of or against each application.
Sec. 23. 18 V.S.A. § 9413 is added to read:
§ 9413. VERMONT HEALTH CARE PURCHASING POOL
(a) The secretary of administration shall establish a Vermont health care purchasing pool for the purpose of coordinating and enhancing the purchasing power of health care benefit plans of the groups identified in subsection (b) of this section. It is not the intent of the general assembly to exacerbate cost shifting or adverse selection in the Vermont health care system through the creation of the health care purchasing pool. In offering and administering the purchasing pool, the secretary shall not discriminate against individuals or groups based on age, gender, geographic area, industry, or medical history. The secretary shall not administer the purchasing pool under this subsection in a manner that pools the risks of participants. The provisions of this section shall not affect the rights of any party to a collective bargaining agreement and shall not require that participating health insurance plans have a common benefit plan.
(b)(1) The secretary may include in the purchasing pool all employees, retirees, and dependents covered by the group health insurance plans of the following entities:
(A) the state of Vermont;
(B) the University of Vermont;
(C) Vermont State Colleges;
(D) any municipality, including any school district, that chooses to participate in the pool; and
(E) such portions of the Medicaid caseload, Green Mountain Health, or any other public health care program as the secretary deems proper, in consultation with the director of the office of Vermont health access. Access to medical care or benefit levels for Medicaid recipients shall not diminish as a result of participation or nonparticipation in the pool.
(2) On and after October 1, 2006, the secretary may make the purchasing pool available to any employer group, association, or trust that chooses to participate in the pool on behalf of the employees or members of the group, association, or trust.
(c) In administering the purchasing pool, the secretary may:
(1) Contract on behalf of participants in the pool with health care providers, health care facilities, and health insurers for the delivery of health care services, including agreements securing discounts for regular bulk payments to providers, and agreements establishing uniform provider reimbursement;
(3) Create a health care cost and utilization database for participants in the pool, and evaluate potential cost savings; and
(d) On or before December 15 of each year, the secretary shall report to the general assembly on the operation of the purchasing pool, including the number and types of groups and group members participating in the pool, the costs of administering the pool, and the savings attributable to participating groups from the operation of the pool.
(e) On or before January 15, 2006, the secretary shall report to the general assembly with his or her recommendations concerning the feasibility and merits of authorizing the secretary to act as an insurer in pooling risk and providing benefits, including a common benefits plan, to participants of the purchasing pool.
Sec. 24. 33 V.S.A. chapter 19, subchapter 6 is added to read:
In order to ensure all Vermont residents have access to key health services and all contribute to the financial sustainability of Vermont’s health care system, Green Mountain Health is established to provide uninsured Vermont residents a defined benefit package of primary and preventive care. Expansions to the program shall be consistent with recommendations approved by the general assembly under Sec. 32 of this act.
(a) The office of Vermont health access shall define benefits to be provided uninsured Vermont residents under Green Mountain Health, beginning July 1, 2006. The benefits shall be submitted to the general assembly for approval January 1, 2006.
(b) The office shall ensure the benefits provide a choice of services and of health care professionals, contain costs over time, and improve the quality of care and health outcomes.
(c) The benefits shall consist of at least the same primary and preventive care health services covered under the Vermont health access plan. In developing the benefits, the office shall:
§ 2023. BUDGET FOR BENEFITS
(b) In developing the proposed budget, the office shall consider the payment methods under section 2024 of this title, the negotiated payment amounts under section 2025 of this title, cost sharing developed under section 2027 of this title, and the cost containment targets under subsection (c) of this section.
(c) To further the legislative goals of this subchapter, the office shall develop and issue a cost containment target for each health care sector. The cost containment target shall be considered when negotiating payment amounts under section 2025 of this title.
§ 2024. PAYMENT METHODS
(a) By February 1, 2006, the office of Vermont health access shall determine by rule pursuant to chapter 25 of Title 3 the type of payment method to be used for the health services covered under Green Mountain Health. The payment methods shall be in alignment with the goals of this subchapter and shall encourage cost‑containment, provision of high quality, evidence-based health services in an integrated setting, patient self‑management, and healthy lifestyles. In developing the payment methods, the department shall consult with health care professionals prior to filing the draft rules for comment.
(3) fixed annual payments to health care facilities; and
(c) The office shall modify the payment methods by rule as it deems appropriate.
(a) The intent of this section is to ensure reasonable payments to health care professionals and to eliminate the shift of costs between the payers of health services.
(b) The office shall negotiate with health care professionals and groups of health care professionals to establish a payment amount for the health services provided by Green Mountain Health. The amount shall be sufficient to provide reasonable access to health services, provide sufficient payment to health care professionals, and encourage the financial stability of health care professionals. In determining the payment amount, the department shall consider:
(c) The office may negotiate a contract including payment methods and amounts with any out-of-state health care professional or hospital that regularly treats a sufficient volume of Vermont residents to provide health services under Green Mountain Health.
(d) The office or plan administrator shall make available the necessary information, forms, and billing procedures to health care professionals to ensure payment for health services covered under Green Mountain Health. The office or plan administrator may use a single, uniform, simplified form to determine eligibility for Medicaid, any Medicaid waiver program, any state‑funded pharmacy program, and Green Mountain Health to ensure that any individual eligible for these programs has the opportunity to enroll. The office shall provide coverage for health services up to three months prior to the date of application for Medicaid, any Medicaid waiver program, or the state pharmacy programs.
Sec. 25. 32 V.S.A. chapter 151, subchapter 4A is added to read:
Subchapter 4A. Universal Hospital Access for
Green Mountain Health Infrastructure Premium
§ 5848. GREEN MOUNTAIN HEALTH EMPLOYER INFRASTRUCTURE PREMIUM
(a) An employer health insurance impact premium is imposed upon every person who is required under subchapter 4 of this chapter to withhold income taxes from payments of income with respect to services. The premium shall be imposed at the rate of:
(1) 3.0 percent of the wages as defined for Vermont Medicare part A taxable earnings paid to each resident employee in the reporting period, reduced by:
(2) qualified health insurance premiums and costs of qualified self-insurance paid for those employees in the reporting period, but not reduced below $0.00.
(b) The premium under subsection (a) shall not be imposed upon the wages of any employee who is covered by health insurance through another employee of the employer during the reporting period.
(c) The premium under this section shall be paid in the same manner as income withholding under subchapter 4 of this chapter and shall be subject to administrative and enforcement provisions of this chapter. Revenues from this premium shall be deposited into the Vermont health access trust fund established under section 1972 of Title 33 for the purpose of financing health care coverage under Green Mountain Health, as provided under subchapter 6 of chapter 19 of Title 33.
(d) “Qualified health insurance” and “qualified self-insurance” in this section mean coverage offered by the employer to any employee who works on a basis of at least 17.5 hours per week in the reporting period.
Sec. 26. 32 V.S.A. § 5822a is added to read:
§ 5822a. GREEN MOUNTAIN HEALTH INDIVIDUAL IMPACT PREMIUM
(a) An individual health insurance impact premium is imposed upon every resident who is subject to income tax under section 5822 of this title. The premium shall be in the amount of 3.0 percent of the taxpayer’s wage income plus the taxpayer’s self-employment income, both as defined for Vermont Medicare part A taxable earnings. The premium shall be withheld from the individual’s wages in the same manner as income tax under chapter 151 of this title, and paid from self-employment income in the same manner as quarterly income tax payments under chapter 151 of this title; and shall be subject to administrative and enforcement provisions of that chapter. Revenues from this premium shall be deposited into the Vermont health access trust fund established under section 1972 of Title 33 for the purpose of financing health care coverage under Green Mountain Health, as provided under subchapter 6 of chapter 19 of Title 33.
(b) An individual shall be exempt from the health insurance impact premium for any calendar quarter following a quarter in which the individual submits proof, as required by the commissioner of banking, insurance, securities, and health care administration, of health insurance coverage for the individual and his or her spouse and dependents.
(c) In this section, “health insurance coverage” means coverage for primary care, preventive care, immunizations and prenatal care.
Sec. 27. IMPLEMENTATION AND EFFECTIVE DATE
(b) The health care premiums imposed by Secs. 23 and 24 of this act shall take effect for taxable years beginning on or after January 1, 2007.
Sec. 28. 33 V.S.A. § 1972(b) is amended to read:
(1) revenue from the cigarette and tobacco products tax established in chapter 205 of Title 32;
(2) revenue from health care provider assessments collected and deposited into the health care trust fund pursuant to subchapter 2 of chapter 19 of this title;
(3) transfers from the tobacco litigation settlement fund established in section 435a of Title 32, authorized by the general assembly;
(4) transfers from the general fund, authorized by the general assembly; and
(5) revenue raised under sections 5822a and 5848 of Title 32; and
(6) the proceeds from grants, donations, contributions, and taxes and any other sources of revenue as may be provided by statute or by rule.
Sec. 29. 1 V.S.A. § 313(a) is amended to read:
Sec. 30. 33 V.S.A. § 1998(f)(2) is amended to read:
Sec. 31. ECONOMIC, FINANCING, AND ADMINISTRATIVE STUDIES
(a) In order to assess more fully the benefits and costs and to prepare and plan for the implementation of full and universal access to health care in Vermont, the general assembly, in consultation with the department of banking, insurance, securities, and health care administration, directs that the following studies be undertaken during the interim of the 2005 legislative session.
(1) Economic impact study. The joint fiscal committee shall direct its staff or contract for a consultant to undertake a study of the economic impact of full implementation of Green Mountain Health to provide universal access to health care in Vermont. The study shall examine the impact on business and the labor force, the future growth of the economy and the economic competitiveness of Vermont, and the effects on residents and population groups and on current and potential insurers and providers of health care.
(2) Financing options. The joint fiscal committee shall direct its staff or contract for a consultant to undertake a study of the financing options and implications for financing expansions to Green Mountain Health. The study shall include examination of all financing options and their implications including the income tax, a payroll tax, premiums or cost-sharing measures, consumption taxes, specific more limited taxes to support parts of the health care system’s financial needs, and other revenue sources including insurance risk pools and insurance assistance and incentives. In addition, it shall address issues involved with federal law and taxation, including ERISA and other areas of preemption and shall analyze methods for recapturing insurance premiums as a result of any reductions in uncompensated care, such as the Dirigo model enacted in the state of Maine.
(3) Governance and administrative study. The secretary of administration, in consultation with the office of Vermont health access, the department of banking, insurance, securities, and health care administration, and the agency of human services, shall examine and develop a plan for reorganizing their respective offices and functions consistent with the purposes of this act, including recommendations relating to personnel, operations, and budgetary requirements. The recommendations shall consider the most appropriate and efficient approach to integrating health care policy, planning, delivery, regulation, and defining clear lines of accountability within the health care system. The study shall include also an examination of means to coordinate or integrate Green Mountain Health with the current workers’ compensation system.
(b) Reports, including findings and recommendations, from each study required by this section shall be submitted to the General Assembly no later than January 15, 2006.
* * * Schedule for Attainment of Health Care Goals * * *
Sec. 32. SCHEDULE FOR ATTAINMENT OF HEALTH CARE GOALS
(a) During the interim of the 2005 legislative session and of subsequent sessions, the joint fiscal committee, in consultation with the health access oversight committee, the senate committee on health and welfare, and the house committee on health care shall oversee and monitor Green Mountain Health and any expansions to that program. In addition, the committee shall receive input and make recommendations to the general assembly regarding long-term development of policies and programs designed to insure that, by 2009, all Vermonters have access to affordable, continuous, quality health care that is financed in a fair and equitable manner.
(b) On July 1, 2006, Green Mountain Health shall offer a package of primary and preventive care to all uninsured Vermont residents.
(c) On July 1, 2007, provided the joint fiscal committee confirms that benchmarks consistent with this section have been met, the following programs shall be implemented:
(1) Green Mountain Health shall be expanded to include hospital coverage; and
(2) Under a premium-based model, all Vermonters shall have the option of participating in Green Mountain Health. The joint fiscal committee shall recommend whether such coverage shall include:
(A) the full Green Mountain Health plan, including primary and preventive care and hospital coverage;
(B) only hospital coverage; or
(C) specified primary or preventive health services.
(d) On July 1, 2009, provided the joint fiscal committee confirms that benchmarks consistent with this section are met, all Vermonters shall have a minimum common benefit level, including hospital coverage, and shall be able to choose between Green Mountain Health and any commercial plan offering a common benefit level.
(e) In addition, the joint fiscal committee shall consider the following:
(1) offering publicly financed stop-loss insurance to all health plans doing business in Vermont;
(2) designing organizational structures that integrate the delivery of care at both the regional and state level;
(3) incorporating within a public health care program the health benefits covered under workers’ compensation policies; and
(4) implementing tort reform consistent with the findings and recommendations of the medical malpractice study authorized under Sec. 292 of No. 122 of the Acts of the 2003 Adj. Sess. (2004).
(f) Recommendations by the joint fiscal committee shall be based on data received or proposals made by the office of Vermont health access and the department of banking, insurance, securities, and health care administration as well as on any other relevant public input received by the committee.
(g) The office of Vermont health access and the department of banking, insurance, securities, and health care administration shall report to the joint fiscal committee at such times and with such information as the committee determines is necessary to fulfill its legislative oversight responsibilities.
(h) All recommendations by the joint fiscal committee to the general assembly shall be assessed in terms of benchmarks that measure cost savings; increased access; improvements in quality and delivery; administrative simplification; fairness and equity in financing; continuity of coverage; and financial sustainability.
(i) Specific benchmarks that measure the viability of maintaining or developing health care programs or policies may include:
(1) changes in health care sector growth rate as measured against the projected growth rate;
(2) changes in aggregate health care spending as measured against projected spending;
(3) insurance rates as compared to trend filings;
(4) Medicaid spending;
(5) availability of funds;
(6) survey data such as quality reports and the rate of uninsured; and
(7) a hospital rate of growth that is not greater than the Consumer Price Index plus the rate of growth of the gross state product.
(j) With respect to each of its proposals, the joint fiscal committee shall determine whether access to health care and cost containment are best achieved through public plans, private plans, or a combination thereof.
(k) Any data or reports requested by the joint fiscal committee not available until the legislative session shall be submitted to the president of the senate, the speaker of the house, the senate committees on finance and on health and welfare, and the house committees on health care and on human services.
* * * Appropriation * * *
Sec. 33. APPROPRIATION
There is appropriated in fiscal year 2005:
(1) the amount of $125,000.00 from the general fund to the general assembly for the studies authorized by Sec. 31 of this act;
(2) the amount of $1,000,000.00 from the general fund to the department of banking, insurance, securities, and health care administration as follows: $250,000.00 plus an additional appropriation of $750,000.00 in dollar-for-dollar matching funds to leverage resources necessary to fund the pilot program authorized under Sec. 20, subsection 9417(e) of Title 18; and
(3) the amount of $3,000,000.00 from the general fund to the office of Vermont health access to fund the Vermont Blueprint for Health: The Chronic Care Initiative under Sec. 19 of this act.
(Committee vote: 5-1-0)
(For House amendments, see House Journal for April 20, 2005, page 704.)
An act relating to predatory pricing.
First: In Sec. 1, 9 V.S.A. § 2461c(a), in the second sentence, by striking out "or deceptive practice" and inserting in lieu thereof "method of competition"
Second: In Sec. 1, in 9 V.S.A. § 2461c(b), by striking out "in the Sherman Act and the Robinson Patman Price Discrimination Act" and inserting in lieu thereof "in federal anti-trust law"
Third: In Sec. 1, 9 V.S.A. § 2461c(c), by striking out " interpreting the Sherman Act and the Robinson Patman Price Discrimination Act" and inserting in lieu thereof "construing federal anti-trust law"
The House proposes to the Senate to amend the bill by adding two new sections to read as follows:
For the purpose of preventing federal preemption of state law with respect to Medicare supplemental insurance policies, the department of banking, insurance, securities, and health care administration may adopt amendments to its administrative rule (Regulation H-2001-02; Medicare Supplement Insurance Minimum Standards Regulations) on or before September 1, 2005 by emergency rule, provided the department is actively engaged in the process of proposing to amend such rule pursuant to the non-emergency rule-making process.
An act authorizing nonprofit hospitals to convert charitable assets.
First: In Sec. 1, 18 V.S.A. § 9420(j), by striking “subsection (h)” where it appears in the first sentence and inserting in lieu thereof “subsection (i)” and in (l), by striking “subdivision (h)(2)” where it appears in the first sentence and inserting in lieu thereof “subdivision (i)(2)”
Second: In Sec. 1, by striking subdivision 9420(h)(3) of Title 18 and inserting in lieu thereof the following:
An act relating to school buses.
S. 81. An act relating to school buses.
Respectfully report that they have met and considered the same and recommend that the Senate concur with the House proposal of amendment and that the bill be further amended as follows:
First: In Sec. 1, 23 V.S.A. § 4(34)(A)(v), in the first complete sentence, by striking out after the words “feet in length” the words “which carries” and inserting in lieu thereof the following: “with a manufacturer’s rated seating capacity of”
Second: In Sec. 1, 23 V.S.A. § 4(34)(A)(vi), in the first complete sentence, by striking out the words “motor coach” and inserting in lieu thereof “multifunction school activity bus”
Third: In Sec. 1, 23 V.S.A. § 4(34)(C), by striking out the word “less” and inserting in lieu thereof the word “fewer”
(For text of committee reports, see Senate Calendar for May 4, 2005, page 763)
(For text of committee reports, see Senate Calendar for April 15, 2005, page 518)