Source: http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/journal/hj070321.htm
Timestamp: 2018-07-17 21:32:38
Document Index: 308257139

Matched Legal Cases: ['§ 5280', '§ 5281', '§ 5282', '§ 5283', '§ 5284', '§ 5285', '§ 5286', '§ 5287', '§ 5288', '§ 5289', '§ 5290', '§ 5290', '§ 5291', '§ 5292', '§ 5293', '§ 5294', '§ 5295', '§ 5296', '§ 2312', '§ 2312', '§ 2004', '§ 2004', '§ 5290', '§ 841', '§ 842', '§ 842', '§ 843', '§ 5295', '§ 5281', '§ 1251', '§ 1253', '§ 1264', '§ 1313', '§ 1313', '§ 613', '§ 1264', '§ 639', '§ 639', '§ 6236', '§ 6240', '§ 6240', '§ 1585']

At one o'clock in the afternoon minutes in the forenoon the Speaker called the House to order.
Devotional exercises were conducted by Rep. Carolyn Partridge of Windham.
Message from the Senate No. 35
S. 51. An act relating to prohibiting discrimination on the basis of gender identity.
In the passage of which the concurrence of the House is requested.
The Governor has informed the Senate that on the sixteenth day of March, 2007, he approved and signed a bill originating in the Senate of the following title:
S. 83. An act relating to delinquent tax penalties.
House bills of the following titles were severally introduced, read the first time and referred as follows:
H. 528
By Rep. Kitzmiller of Montpelier,
An act relating to approval of amendment to the charter of the city of Montpelier;
H. 529
By Reps. Hudson of Lyndon, Lawrence of Lyndon and Peaslee of Guildhall,
An act relating to establishing the town line between Burke and Kirby;
An act relating to prohibiting discrimination on the basis of gender identity;
Was taken up, read the first time and referred to the committee on Judiciary.
H. 523
An act relating to moving families out of poverty;
Appearing on the Calendar, carrying an appropriation, under rule 35a, was referred to the committee on Appropriations.
Bills Referred to Committee on Ways and Means
House bills of the following titles, appearing on the Calendar, affecting the revenue of the state, under the rule, were referred to the Committee on Ways and Means:
H. 524
An act relating to establishing a rebate for retail sales of biodiesel blends;
H. 526
An act relating to education quality and cost control.
House Resolution Placed on Calendar
Reps. Krawczyk of Bennington, Morrissey of Bennington, Botzow of Pownal, Browning of Arlington, Corcoran of Bennington, Komline of Dorset, Livingston of Manchester, Miller of Shaftsbury and Mook of Bennington offered a House resolution, entitled
House resolution requesting that Congress enact assured federal funding for veterans’ health care
Whereas, the U.S. Department of Veterans Affairs (VA) provides medical care for veterans, both men and women, who have risked their lives to protect the security of our nation, and
Whereas, Congress appropriates funding for VA health care each year as part of the discretionary federal budget, and
Whereas, each year’s federal budget for veterans’ health care has been very seriously underfunded, and
Whereas, this serious and now chronic shortfall affects the access to and the quality of medical care services that the VA provides for our veterans, and
Whereas, the priority of serving veterans must be absolute and irrevocable, and must serve as the foundation for the VA and of our nation’s public policy, now therefore be it
That this legislative body urgently requests that Congress enact assured funding for veterans’ health care, and be it further
Resolved: That Governor Douglas also request that Congress enact assured funding for veterans’ health care, and be it further
Resolved: That the clerk of the house be directed to send a copy of this resolution to the Governor, the President of the United States, the Vice President, Secretary of Veterans Affairs R. James Nicholson, Speaker of the House Nancy Pelosi, House Minority Leader John Boehner, Senate Majority Leader Harry Reid, Senate Minority Leader Trent Lott, the members of the Vermont Congressional Delegation, and Vermont veterans organizations.
Which was read and, in the Speaker’s discretion, placed on the Calendar for action tomorrow under Rule 52.
An act relating to employee free choice for bargaining representative;
Was taken up and pending the reading of the report of the committee on General, Housing and Military Affairs, on motion of Rep. Head of South Burlington, action on the bill was postponed until the next legislative day.
Bill Amended; Third Reading Not Ordered
H. 44
Rep. Frank of Underhill, for the committee on Human Services, to which had been referred House bill, entitled
An act relating to patient choice and control at end of life;
Reported in favor of its passage when amended by striking all after the enacting clause and inserting in lieu thereof the following:
(1) The state of Oregon has been implementing its Death with Dignity Act since 1998. According to the Eighth Annual Report on Oregon’s Death with Dignity Act, Oregon, in eight years, has seen a total of 390 terminal patients receive prescriptions to hasten death and, of those, 246 patients took the medication and died pursuant to the act. Oregon’s annual report on the act shows that in 2005, 64 prescriptions were written, and 38 patients died after ingesting the medication.
(2) Vermont has about one‑fifth the population of Oregon. In the 2000 census, Oregon had a population of 3,421,399 and Vermont a population of 608,827.
(3) In the past decade, Oregon has seen its hospice enrollment increase significantly. In 1993, only 20 percent of dying patients were enrolled in hospice. By 2005, enrollment increased to 54 percent. In 2005, 92 percent of the patients who used medication under the Death with Dignity Act were in hospice care.
(4) Oregon health care professionals report that ten terminal patients investigate their rights under the act for every patient who formally requests a prescription.
(5) Despite continuing improvements in techniques for palliative care, most medical experts agree that not all pain can be relieved. Some terminal diseases, such as bone cancer, inflict untreatable agony at the end of life. Many cancer patients report that they would have greater comfort and courage in facing their future if they were assured they could use a Death with Dignity law if their suffering became unbearable.
Sec. 2. 18 V.S.A. chapter 113 is added to read:
CHAPTER 113. RIGHTS OF QUALIFIED PATIENTS SUFFERING A TERMINAL CONDITION
§ 5280. DEFINITIONS
(1) “Attending physician” means the physician who has primary responsibility for the care of the patient and who is willing to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.
(2) “Capacity” shall have the same meaning as in subdivision 9701(4)(B) of this title.
(3) “Consulting physician” means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient’s illness and who is willing to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.
(4) “Counseling” means a consultation between a psychiatrist, psychologist, or clinical social worker licensed in Vermont and a patient for the purpose of confirming that the patient:
(A) has capacity; and
(B) is not suffering from a mental disorder or disease that causes the patient to have impaired judgment.
(5) “Health care provider” shall have the same meaning as in subdivision 9432(8) of this title.
(6) “Informed decision” means a decision by a patient to request and obtain a prescription to hasten his or her death based on the patient’s understanding and appreciation of the relevant facts and was made after the patient was fully informed by the attending physician of all the following:
(A) The patient’s medical diagnosis.
(B) The patient’s prognosis.
(C) The range of possible results, including potential risks associated with taking the medication to be prescribed.
(E) All feasible end-of-life services, including comfort care, hospice care, and pain control.
(7) “Patient” means a person who is 18 years of age or older, a resident of Vermont, and under the care of a physician.
(8) “Physician” means a physician licensed pursuant to chapters 23 and 33 of Title 26.
(9) “Qualified patient” means a patient with capacity who has satisfied the requirements of this chapter in order to obtain a prescription for medication to hasten his or her death. No individual shall qualify under the provisions of this chapter solely because of age or disability.
(10) “Terminal condition” means an incurable and irreversible disease which would, within reasonable medical judgment, result in death within six months.
§ 5281. REQUESTS FOR MEDICATION
(a) In order to qualify under this chapter:
(1) A patient with capacity who has been determined by the attending physician and consulting physician to be suffering from a terminal condition and who has voluntarily expressed a wish to hasten the dying process may request medication to be self-administered for the purpose of hastening his or her death in accordance with this chapter.
(2) A patient shall have made an oral request and a written request and shall have reaffirmed the oral request to his or her attending physician not less than 15 days after the initial oral request. At the time the patient makes the second oral request, the attending physician shall offer the patient an opportunity to rescind the request.
(b) Oral requests for medication under this chapter by the patient shall be made in the presence of the attending physician.
(c) A written request for medication shall be signed and dated by the patient and witnessed by at least two individuals who, in the presence of the patient, attest that, to the best of their knowledge and belief, the patient has capacity, is acting voluntarily, and is not being coerced to sign the request. Neither witness shall be any of the following persons:
(1) The patient’s attending physician.
(2) A relative of the patient by blood, marriage, civil union, or adoption.
(3) A person who at the time the request is signed would be entitled to any portion of the estate of the patient under any will or by operation of law.
(4) An owner, operator, or employee of a health care facility, nursing home, or residential care facility where the patient is receiving medical treatment or is a resident.
(d) A person who knowingly fails to comply with the requirements in subsection (d) of this section is subject to prosecution under section 2004 of Title 13.
(e) The written request shall be completed after the patient has been examined by a consulting physician as required by under section 5283 of this title.
§ 5282. ATTENDING PHYSICIAN; DUTIES
The attending physician shall perform all the following:
(1) Make the initial determination of whether a patient:
(A) is suffering a terminal condition;
(B) has capacity; and
(C) has made a voluntary request for medication to hasten his or her death.
(2) Request proof of Vermont residency, which may be shown by:
(A) a Vermont driver’s license or photo identification card;
(B) proof of Vermont voter’s registration;
(C) evidence of property ownership or a lease of residential premises in Vermont; or
(D) a Vermont personal income tax return for the most recent tax year.
(3) Inform the patient in person and in writing of all the following:
(4) Refer the patient to a consulting physician for medical confirmation of the diagnosis, prognosis, and a determination that the patient has capacity and is acting voluntarily.
(5) Refer the patient for counseling if appropriate under section 5284 of this chapter.
(6) Recommend that the patient notify the next of kin or someone with whom the patient has a significant relationship.
(7) Counsel the patient about the importance of having another individual present when the patient takes the medication pursuant to this chapter and the importance of not taking the medication in a public place.
(8) Inform the patient that the patient has an opportunity to rescind the request at any time and in any manner, and offer the patient an opportunity to rescind at the end of the 15-day waiting period.
(9) Verify, immediately prior to writing the prescription for medication under this chapter, that the patient is making an informed decision.
(10) Fulfill the medical record documentation requirements of section 5289 of this title.
(11) Ensure that all required steps are carried out in accordance with this chapter prior to writing a prescription for medication to hasten death.
(12)(A) Dispense medication directly, including ancillary medication intended to facilitate the desired effect to minimize the patient’s discomfort, provided the attending physician is licensed to dispense medication in Vermont, has a current Drug Enforcement Administration certificate, and complies with any applicable administrative rules; or
(B) With the patient’s written consent:
(i) contact a pharmacist and inform the pharmacist of the prescription; and
(ii) deliver the written prescription to the pharmacist, who will dispense the medication to the patient, the attending physician, or an expressly identified agent of the patient.
(13) Notwithstanding any other provision of law, the attending physician may sign the patient’s death certificate.
§ 5283. MEDICAL CONSULTATION REQUIRED
Before a patient is qualified in accordance with this chapter, a consulting physician shall physically examine the patient, review the patient’s relevant medical records, and confirm in writing the diagnosis of the attending physician that the patient is suffering from a terminal condition and verify that the patient has capacity, is acting voluntarily, and has made an informed decision.
§ 5284. COUNSELING REFERRAL
If a patient is not receiving hospice services at the time the written request for medication is made under this chapter, he or she shall undergo counseling under this section. If a patient is receiving hospice services at the time the written request for medication is made under this chapter and if, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a mental disorder or disease causing impaired judgment, either physician shall refer the patient for counseling. No medication to end the patient’s life shall be prescribed until the person performing the counseling determines that the patient is not suffering from a mental disorder or disease that causes the patient to have impaired judgment.
§ 5285. INFORMED DECISION
No person shall receive a prescription for medication to hasten his or her death unless the patient has made an informed decision. Immediately prior to writing a prescription for medication in accordance with this chapter, the attending physician shall verify that the patient is making an informed decision.
§ 5286. RECOMMENDED NOTIFICATION
The attending physician shall recommend that the patient notify the patient’s next of kin or someone with whom the patient has a significant relationship of the patient’s request for medication in accordance with this chapter. A patient who declines or is unable to notify the next of kin shall not be refused medication in accordance with this chapter.
§ 5287. RIGHT TO RESCIND
A patient may rescind the request at any time and in any manner regardless of the patient’s mental state. No prescription for medication under this chapter may be written without the attending physician offering the patient an opportunity to rescind the request.
§ 5288. WAITING PERIOD
The attending physician shall write a prescription no less than 48 hours after the last to occur of all of the following events:
(1) the patient’s written request for medication to hasten his or her death;
(2) the patient’s second oral request; and
(3) the attending physician’s offering the patient an opportunity to rescind the request.
§ 5289. MEDICAL RECORD DOCUMENTATION
The following shall be documented and filed in the patient’s medical record:
(1) The date and wording of all oral requests of the patient for medication to hasten his or her death.
(2) All written requests by a patient for medication to hasten his or her death.
(3) The attending physician’s diagnosis, prognosis, and basis for the determination that the patient has capacity, is acting voluntarily, and has made an informed decision.
(4) The consulting physician’s diagnosis, prognosis, and verification that the patient has capacity, is acting voluntarily, and has made an informed decision.
(5) A report of the outcome and determinations made during any counseling which the patient may have received.
(6) The date and wording of the attending physician’s offer to the patient to rescind the request for medication at the time of the patient’s second oral request.
(7) A note by the attending physician indicating that all requirements under this chapter have been satisfied and all the steps that have been taken to carry out the request, including a notation of the medication prescribed.
§ 5290. REPORTING REQUIREMENT
(a) The department of health shall require that any physician who writes a prescription pursuant to this chapter file a report with the department covering all the prerequisites for writing a prescription under this chapter. In addition, physicians shall report the number of written requests for medication that were received, regardless of whether or not a prescription was actually written in each instance.
(b) The department of health shall annually review the medical records of qualified patients who have hastened their deaths in accordance with this chapter.
(c) The department of health shall make rules to facilitate the collection of information regarding compliance with this chapter. The information collected shall not be public record and shall not be made available for inspection by the public.
(d) The department of health shall generate and make available to the public an annual statistical report of information collected under subsections (a) and (b) of this section. The report shall include the number of instances in which medication was taken by a qualified patient to hasten death but failed to have the intended effect.
§ 5290a. COLLECTION AND DISPOSAL OF UNUSED MEDICATIONS
The department of health shall develop a policy for ensuring that unused medications prescribed under this chapter are collected and disposed of appropriately.
§ 5291. PROHIBITIONS; CONTRACT CONSTRUCTION
(a) No provision in a contract, will, or other agreement, whether written or oral, shall be valid, to the extent the provision would affect whether a person may make or rescind a request for medication to hasten his or her death in accordance with this chapter.
(b) The sale, procurement, or issue of any life, health, or accident insurance or annuity policy or the rate charged for any policy shall not be conditioned upon or affected by the making or rescinding of a request by a person for medication to hasten his or her death in accordance with this chapter or the act by a qualified patient to hasten his or her death pursuant to this chapter. Neither shall a qualified patient’s act of ingesting medication to hasten his or her death have an effect on a life, health, or accident insurance or annuity policy.
§ 5292. IMMUNITIES
(a) No person shall be subject to civil or criminal liability or professional disciplinary action for participating in good faith compliance in accordance with this chapter. This includes being present when a qualified patient takes the prescribed medication to hasten his or her death in accordance with this chapter.
(b) No professional organization or association or health care provider may subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for participating or refusing to participate in good faith compliance with this chapter.
(c) No request by a patient for or provision by an attending physician of medication in good faith compliance with the provisions of this chapter shall constitute neglect for any purpose of law.
(d) No request by a patient for medication under this chapter shall provide the sole basis for the appointment of a guardian or conservator.
(e) No health care provider shall be under any duty, whether by contract, by statute, or by any other legal requirement, to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter. If a health care provider is unable or unwilling to carry out a patient’s request in accordance with this chapter and the patient transfers his or her care to a new health care provider, the previous health care provider, upon request, shall transfer a copy of the patient’s relevant medical records to the new health care provider. A decision by a health care provider not to participate in the provision of medication to a qualified patient shall not constitute the abandonment of the patient or unprofessional conduct under section 1354 of Title 26.
§ 5293. HEALTH CARE FACILITY EXCEPTION
Notwithstanding any other provision of law, a health care facility may prohibit an attending physician from writing a prescription for medication under this chapter for a patient who is a resident in its facility and intends to use the medication on the facility’s premises, provided the facility has notified the attending physician in writing of its policy with regard to such prescriptions. Notwithstanding subsection 5292(b) of this title, any health care provider who violates a prohibition established under this section may be subject to sanctions otherwise allowable under law or contract.
§ 5294. LIABILITIES AND PENALTIES
(a) Nothing in this chapter shall be construed to limit liability for civil damages resulting from negligent conduct or intentional misconduct by any person.
(b) Nothing in this chapter or in section 2312 of Title 13 shall be construed to limit criminal prosecution under any other provision of law.
(c) A health care provider is subject to review and disciplinary action by the appropriate licensing entity for failing to act in accordance with this chapter, provided such failure is not in good faith.
§ 5295. FORM OF THE REQUEST
A request for medication as authorized by this chapter shall be substantially in the following form:
TO HASTEN MY DEATH
I am suffering from _______________, which my attending physician has determined is a terminal disease and which has been confirmed by a consulting physician.
I have been fully informed of my diagnosis, prognosis, the nature of medication to be prescribed and potential associated risks, the expected result, and the feasible end-of-life services, including comfort care, hospice care, and pain control.
I request that my attending physician prescribe medication that will hasten my death.
_____ I have informed my family or others with whom I have a significant relationship of my decision and taken their opinions into consideration.
_____ I have decided not to inform my family or others with whom I have a significant relationship of my decision.
_____ I have no family or others with whom I have a significant relationship to inform of my decision.
I understand that I have the right to change my mind at any time.
I understand the full import of this request, and I expect to die when I take the medication to be prescribed. I further understand that although most deaths occur within three hours, my death may take longer, and my physician has counseled me about this possibility.
I make this request voluntarily and without reservation, and I accept full moral responsibility for my actions.
Signed: _________________________ Dated: ____________
(c) Appears to be of sound mind and not under duress, fraud, or undue influence;
(d) Is not a patient for whom either of us is the attending physician.
Witness 1/Date ______________________________________
Witness 2/Date ______________________________________
NOTE: Neither witness may be a relative (by blood, marriage, civil union, or adoption) of the person signing this request, may be entitled to any portion of the person’s estate upon death, or may own, operate, or be employed at a health care facility where the person is a patient or resident. A knowing false declaration by a witness may result in criminal penalties.
§ 5296. STATUTORY CONSTRUCTION
Nothing in this chapter shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing, or active euthanasia. Action taken in accordance with this chapter shall not be construed for any purpose to constitute suicide, assisted suicide, mercy killing, or homicide under the law.
Sec. 3. 13 V.S.A. § 2312 is added to read:
§ 2312. Violation of PATIENT CHOICE AND CONTROL AT END OF
(a)(1) No person shall:
(A) willfully alter or forge a patient’s request for medication under chapter 113 of Title 18, with the intent or effect of causing the patient’s death; or
(B) conceal or destroy a rescission of a patient’s request for medication under chapter 113 of Title 18, with the intent or effect of causing the patient’s death.
(2) No person shall coerce or exert undue influence on a patient:
(A) to request medication under chapter 113 of Title 18; or
(B) to destroy a patient’s rescission of a request for medication under chapter 113 of Title 18.
(b) A person who violates this section and thereby causes the death of the patient shall be guilty of first degree murder and subject to the penalties provided in subsection 2303(a) of this title.
Sec. 4. 13 V.S.A. § 2004 is added to read:
§ 2004. FALSE WITNESSING
A person who knowingly violates the requirements of subsection 5281(d) of Title 18 shall be imprisoned for not more than 10 years or fined not more than $2,000.00, or both.
Rep. Marek of Newfane, for the committee on Judiciary, recommended the bill be amended by striking all after the enacting clause and inserting in lieu thereof the following:
(1) “Attending physician” means the physician who the patient has designated to have primary responsibility for the care of the patient and who is willing to participate in the provision to a qualified patient of medication to hasten his or her death in accordance with this chapter.
(3) “Consulting physician” means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient’s illness and who is willing to participate in the provision of medication to a qualified patient to hasten his or her death in accordance with this chapter.
(B) is not suffering from impaired judgment.
(5) “Good faith” shall mean objective good faith.
(6) “Health care provider” shall have the same meaning as in subdivision 9432(8) of this title.
(7) “Informed decision” means a decision by a patient to request and obtain a prescription to hasten his or her death based on the patient’s understanding and appreciation of the relevant facts and was made after the patient was fully informed by the attending physician of all the following:
(8) “Patient” means a person who is 18 years of age or older, a resident of Vermont, and under the care of a physician.
(9) “Physician” means a physician licensed pursuant to chapters 23 and 33 of Title 26.
(10) “Qualified patient” means a patient with capacity who has satisfied the requirements of this chapter in order to obtain a prescription for medication to hasten his or her death. No individual shall qualify under the provisions of this chapter solely because of age or disability.
(11) “Terminal condition” means an incurable and irreversible disease which would, within reasonable medical judgment, result in death within six months.
(b) Oral requests for medication by the patient under this chapter shall be made in the presence of the attending physician.
(c) A written request for medication shall be signed and dated by the patient and witnessed by at least two persons, at least 18 years of age, who, in the presence of the patient, sign and affirm that the principal appeared to understand the nature of the document and to be free from duress or undue influence at the time the request was signed. Neither witness shall be any of the following persons:
(1) The patient’s attending physician, consulting physician, or any person who has provided counseling for the patient pursuant to section 5284 of this title.
(2) A person who knows that he or she is a relative of the patient by blood, marriage, civil union, or adoption.
(3) A person who at the time the request is signed knows that he or she would be entitled upon the patient’s death to any portion of the estate or assets of the patient under any will, by operation of law, or by contract.
(d) A person who knowingly fails to comply with the requirements in subsection (c) of this section is subject to prosecution under section 2004 of Title 13.
(e) The written request shall be completed after the patient has been examined by a consulting physician as required under section 5283 of this title.
(f) Under no circumstances shall a guardian or conservator be permitted to act on behalf of a ward for purposes of this chapter.
(5) Refer the patient for counseling under section 5284 of this chapter.
No medication to end the patient’s life shall be prescribed until:
(1) the patient receives counseling as defined in subdivision 5280(4) of this title; and
(2) the person performing the counseling determines that the patient has capacity and is not suffering from impaired judgment.
The attending physician shall recommend that the patient notify the patient’s next of kin or someone with whom the patient has a significant relationship of the patient’s request for medication in accordance with this chapter. A patient who declines or is unable to notify the next of kin or the person with whom the patient has a significant relationship shall not be refused medication in accordance with this chapter.
The attending physician shall write a prescription no sooner than 48 hours after all of the following events have occurred:
(a) The following shall be documented and filed in the patient’s medical record:
(b) Medical records compiled pursuant to this chapter shall be subject to discovery only if the court finds that the records are necessary to resolve issues of compliance with or immunity under this chapter.
(c) The department of health shall make rules to facilitate the collection of information regarding compliance with this chapter. Individual medical information collected and reports filed pursuant to subsection (a) of this section shall not be public record and shall not be made available for inspection by the public.
§ 5290a. SAFE DISPOSAL OF UNUSED MEDICATIONS
(a) The department of health shall adopt rules providing for the safe disposal of unused medications prescribed under this chapter.
(b) Expedited rulemaking. Notwithstanding the provisions of chapter 25 of Title 3, the department of health may adopt rules under this section pursuant to the following expedited rulemaking process:
(1) Within 90 days after the date this act is passed, the department shall file proposed rules with the secretary of state and the legislative committee on administrative rules under 3 V.S.A. § 841 after publication in three daily newspapers with the highest average circulation in the state of a notice that lists the rules to be adopted pursuant to this process and a seven-day public comment period following publication.
(2) The department shall file final proposed rules with the legislative committee on administrative rules 14 days after the public comment period.
(3) The legislative committee on administrative rules shall review and may approve or object to the final proposed rules under 3 V.S.A. § 842, except that its action shall be completed no later than 14 days after the final proposed rules are filed with the committee.
(4) The department may adopt a properly filed final proposed rule after the passage of 14 days from the date of filing final proposed rules with the legislative committee on administrative rules or after receiving notice of approval from the committee, provided the department:
(A) has not received a notice of objection from the legislative committee on administrative rules; or
(B) after having received a notice of objection from the committee, has responded pursuant to 3 V.S.A. § 842.
(5) Rules adopted under this section shall be effective upon being filed with the secretary of state and shall have the full force and effect of rules adopted pursuant to chapter 25 of Title 3. Rules filed with the secretary of state pursuant to this section shall be deemed to be in full compliance with
3 V.S.A. § 843 and shall be accepted by the secretary of state if filed with a certification by the secretary of human services that a rule is required to meet the purposes of this section.
(a) No person shall be subject to civil or criminal liability or professional disciplinary action for actions taken in good faith reliance on the provisions of this chapter. This includes being present when a qualified patient takes the prescribed medication to hasten his or her death in accordance with this chapter.
(b) No professional organization or association or health care provider may subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for actions taken in good faith reliance on the provisions of this chapter or refusals to act under this chapter.
(c) No provision by an attending physician of medication in good faith reliance on the provisions of this chapter shall constitute patient neglect for any purpose of law.
Notwithstanding any other provision of law, a health care facility may prohibit an attending physician from writing a prescription for medication under this chapter for a patient who is a resident in its facility and intends to use the medication on the facility’s premises, provided the facility has notified the attending physician in writing of its policy with regard to such prescriptions. Notwithstanding subsection 5292(b) of this title, any health care provider who violates a policy established by a health care facility under this section may be subject to sanctions otherwise allowable under law or contract.
(a) With the exception of the immunities established by section 5292 of this title and with the exception of the provisions of section 5296 of this title, nothing in this chapter shall be construed to limit liability for civil damages resulting from negligent conduct or intentional misconduct by any person.
(b) With the exception of the immunities established by section 5292 of this title and with the exception of the provisions of section 5296 of this title, nothing in this chapter or in section 2312 of Title 13 shall be construed to limit criminal prosecution under any other provision of law.
§ 5295. FORM OF THE WRITTEN REQUEST
A written request for medication as authorized by this chapter shall be substantially in the following form:
AFFIRMATION OF WITNESSES
We affirm that, to the best of our knowledge and belief:
(a) that the person signing this request:
(1) is personally known to us or has provided proof of identity;
(2) signed this request in our presence;
(3) appears to understand the nature of the document and to be free from duress or undue influence at the time the request was signed; and
(b) that neither of us:
(1) is under 18 years of age;
(2) is a relative (by blood, marriage, civil union, or adoption) of the person signing this request;
(3) is the patient’s attending physician, consulting physician, or a person who has provided counseling for the patient pursuant to section 5284 of this title;
(4) is entitled to any portion of the person’s assets or estate upon death; or
(5) owns, operates, or is employed at a health care facility where the person is a patient or resident.
NOTE: A knowingly false affirmation by a witness may result in criminal penalties.
Nothing in this chapter shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing, or active euthanasia. Action taken in accordance with this chapter shall not be considered tortious under law, and shall not be construed for any purpose to constitute suicide, assisted suicide, mercy killing, or homicide under the law.
A person who violates chapter 113 of Title 18 with the intent to cause the death of a qualified patient as defined in subdivision 5280(9) of that title shall be prosecuted under chapter 53 of this title (homicide).
A person who knowingly violates the requirements of subsection 5281(c) of Title 18 shall be imprisoned for not more than 10 years or fined not more than $2,000.00, or both.
This act shall take effect on September 1, 2007.
The bill, having appeared on the Calendar one day for notice, was taken up and read the second time.
Thereupon, Rep. Frank of Underhill asked and was granted leave of the House to withdraw the report of the committee on Human Services.
Pending the question, Shall the House amend the bill as recommended by the committee on Judiciary? Rep. Frank of Underhill moved to amend the report of the committee on Judiciary as follows:
First: in Sec. 1, by striking out subdivision (1) in its entirety and inserting in lieu thereof a new subdivision (1) to read as follows:
(1) The state of Oregon has been implementing its Death with Dignity Act since 1998. According to the Ninth Annual Report on Oregon’s Death with Dignity Act, Oregon, in nine years, has seen a total of 456 terminal patients receive prescriptions to hasten death and, of those, 292 patients took the medication and died pursuant to the act. Oregon’s annual report on the act shows that in 2006, 65 prescriptions were written, and 46 patients died after ingesting the medication.
Second: in Sec. 1, by striking out subdivision (3) in its entirety and inserting in lieu thereof a new subdivision (3) to read as follows:
(3) In the past decade, Oregon has seen its hospice enrollment increase significantly. In 1993, only 20 percent of dying patients were enrolled in hospice. By 2005, enrollment increased to 54 percent. In 2005, 92 percent of the patients who used medication under the Death with Dignity Act were in hospice care. In 2006, 76 percent of the patients who used medication under the Death with Dignity Act were in hospice care.
Third: in Sec. 2, 18 V.S.A. § 5281, by striking out subsection (f) in its entirety and inserting in lieu thereof a new subsection (f) to read as follows:
(f)(1) Under no circumstances shall a guardian or conservator be permitted to act on behalf of a ward for purposes of this chapter.
(2) Under no circumstances shall an agent under an advance directive be permitted to act on behalf of a principal for purposes of this chapter.
Fourth: by striking out Sec. 3 in its entirety and inserting in lieu thereof a new Sec. 3 to read as follows:
A person who violates chapter 113 of Title 18 with the intent to cause the death of a patient as defined in subdivision 5280(8) of that title shall be prosecuted under chapter 53 of this title (homicide).
Thereupon, the report of the committee on Judiciary, as amended, was agreed to.
Pending the question, Shall the bill be read a third time? Rep. McAllister of Highgate demanded the Yeas and Nays, which demand was sustained by the Constitutional number. The Clerk proceeded to call the roll and the question, Shall the bill be read a third time? was decided in the negative. Yeas, 63. Nays, 82.
Aswad of Burlington
Barnard of Richmond
Chen of Mendon
Cheney of Norwich
Clarkson of Woodstock
Condon of Colchester
Copeland-Hanzas of Bradford
Davis of Washington
Deen of Westminster
Dostis of Waterbury
Emmons of Springfield
Fallar of Tinmouth
Fisher of Lincoln
Frank of Underhill
French of Randolph
Grad of Moretown
Haas of Rochester
Head of S. Burlington
Heath of Westford
Hosford of Waitsfield
Hube of Londonderry
Hunt of Essex
Hutchinson of Randolph
Jewett of Ripton
Johnson of South Hero
Kitzmiller of Montpelier
Klein of East Montpelier
Komline of Dorset
Larson of Burlington
Lenes of Shelburne
Lippert of Hinesburg
Lorber of Burlington
Maier of Middlebury
Manwaring of Wilmington
Marek of Newfane
Martin, C. of Springfield
Masland of Thetford
McCullough of Williston
Miller of Shaftsbury
Minter of Waterbury
Mitchell of Barnard
Mrowicki of Putney
Nease of Johnson
Nuovo of Middlebury
Ojibway of Hartford
Orr of Charlotte
Partridge of Windham
Pearson of Burlington
Pellett of Chester
Peltz of Woodbury
Pillsbury of Brattleboro
Pugh of S. Burlington
Rodgers of Glover
Shand of Weathersfield
Sharpe of Bristol
Smith of Morristown
Spengler of Colchester
Stevens of Shoreham
Sweaney of Windsor
Trombley of Grand Isle
Weston of Burlington
Zenie of Colchester
Zuckerman of Burlington
Acinapura of Brandon
Adams of Hartland
Ainsworth of Royalton
Allard of St. Albans Town
Ancel of Calais
Andrews of Rutland City
Atkins of Winooski
Audette of S. Burlington
Baker of West Rutland
Bissonnette of Winooski
Bostic of St. Johnsbury
Botzow of Pownal
Branagan of Georgia
Bray of New Haven
Brennan of Colchester
Browning of Arlington
Canfield of Fair Haven
Clark of St. Johnsbury
Clark of Vergennes
Clerkin of Hartford
Consejo of Sheldon
Corcoran of Bennington
Courcelle of Rutland City
Devereux of Mount Holly
Donaghy of Poultney
Donahue of Northfield
Donovan of Burlington
Errecart of Shelburne
Evans of Essex
Fitzgerald of St. Albans City
Flory of Pittsford
Gervais of Enosburg
Gilbert of Fairfax
Godin of Milton
Howard of Rutland City
Howrigan of Fairfield
Hudson of Lyndon
Jerman of Essex
Johnson of Canaan
Keenan of St. Albans City
Keogh of Burlington
Kilmartin of Newport City
Koch of Barre Town
Krawczyk of Bennington
Kupersmith of S. Burlington
Larocque of Barnet
LaVoie of Swanton
Lawrence of Lyndon
Livingston of Manchester
Malcolm of Pawlet
Marcotte of Coventry
Martin of Wolcott
McAllister of Highgate
McCormack of Rutland City
McDonald of Berlin
McFaun of Barre Town
Milkey of Brattleboro
Monti of Barre City
Mook of Bennington
Moran of Wardsboro
Morley of Barton
Morrissey of Bennington
Myers of Essex
Obuchowski of Rockingham
O'Donnell of Vernon
Otterman of Topsham
Oxholm of Vergennes
Peaslee of Guildhall
Perry of Richford
Peterson of Williston
Potter of Clarendon
Randall of Troy
Scheuermann of Stowe
Shaw of Derby
Sunderland of Rutland Town
Turner of Milton
Valliere of Barre City
Westman of Cambridge
Wheeler of Derby
Winters of Williamstown
Wright of Burlington
Those members absent with leave of the House and not voting are:
Edwards of Brattleboro
Helm of Castleton
Larrabee of Danville
Rep. Zuckerman of Burlington explained his vote as follows:
I fully respect folks who have come to their peace with this vote based on moral, religious or personal beliefs. I am concerned, however, when people base their votes on constituent calls that were, in part, derived through misinformation.
I have heard of numerous instances and read petitions that vastly misled the public with respect to the ramifications of this bill. When parishioners are told that seniors going to their doctor for a hip replacement will be met by a doctor who will instead kill them, I understand when the calls are so overwhelmingly opposed. In my own district the calls were a ratio of 4 to 1 against. Yet, as a lead sponsor of the bill for the last six years, I was not removed from office.
I do not believe the calls were indicative of the feelings of the silent majority.
Instilling fear through misinformation is a powerful tool. I am sorry that that those in positions of trust have chosen to use that tool.”
Message from the Senate No. 36
S. 34. An act relating to humane treatment of animals in schools and the right to an instructional alternative to dissection.
H. 73
Rep. Deen of Westminster, for the committee on Fish, Wildlife and Water Resources, to which had been referred House bill, entitled
An act relating to water management types for state waters;
(1) It is the settled policy of the state as set forth in section 1250 of this title to protect and enhance the existing quality, character, and usefulness of surface water and to seek over the long term to upgrade the quality of the surface waters of the state.
(2) The adoption of any water management types within the classifications of state surface waters shall conform to the state water policy.
(3) During the process preceding adoption of revised basin plans for the state, the secretary of natural resources shall maximize public participation and public input in a manner consistent with the department of conservation’s 2004 Vermont watershed initiative guidelines for watershed planning.
(4) Basin plans or water management type designations and redesignations proposed by the agency of natural resources shall include sufficient information and documentation to ensure transparency regarding agency decision-making.
(5) The agency of natural resources is expected to and should strive to update all 17 basin plans for the state by the 2010 deadline authorized by this act.
Sec. 2. 10 V.S.A. § 1251a(c) is added to read:
(c) The secretary of natural resources shall propose for point source discharges to state waters an implementation process for the antidegradation policy of the water quality standards of the state and shall seek the concurrence of the water resources panel of the board prior to initiating rulemaking for adoption of an implementation process.
Sec. 3. 10 V.S.A. § 1253(d) is amended to read:
(d) The board shall determine what degree of water quality and classification should be obtained and maintained for those waters not classified by it before 1981 following the procedures in sections 1254 and 1258 of this title. Those waters shall be classified in the public interest. The secretary shall revise all 17 basin plans by January 1, 2006 December 31, 2010, and update them every five years thereafter. Prior to July 1, 2008, the secretary may adopt revised basin plans without including proposals for water management types in Class B waters to ensure that the strategies to improve and restore waters contained in the basin plans are available to the people of the state. On or before January 1 15 of each year, the secretary shall report to the house committees on agriculture and natural resources and energy on fish, wildlife and water resources and to the senate committees on agriculture and on natural resources and energy regarding the progress made and difficulties encountered in revising basin plans. By January 1, 1993, the secretary shall prepare an overall management plan to ensure that the water quality standards are met in all state waters.
The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on Fish, Wildlife and Water Resources agreed to and third reading ordered.
H. 154
Rep. Shaw of Derby, for the committee on Fish, Wildlife and Water Resources, to which had been referred House bill, entitled
An act relating to stormwater management;
Sec. 1. 10 V.S.A. § 1264(f) is amended to read:
(f)(1) In a stormwater-impaired water, the secretary may issue:
(A) An individual permit in a stormwater-impaired water for which no TMDL, water quality remediation plan, or watershed improvement permit has been established or issued, provided that the permitted discharge meets the discharge standard set by rule;
(B) A watershed improvement permit, provided that the watershed improvement permit provides reasonable assurance of compliance with the Vermont water quality standards in five years;
(C) A general or individual permit that is implementing a TMDL or water quality remediation plan; or
(D) A statewide general permit for new discharges that the secretary deems necessary to assure attainment of the Vermont water quality standards.
(2) An authorization to discharge regulated stormwater runoff pursuant to a permit issued under this subsection shall be valid for a time period not to exceed five years. A person seeking to discharge regulated stormwater runoff after the expiration of that period shall obtain an individual permit or coverage under a general permit, whichever is applicable, in accordance with subsection 1263(e) of this title.
(3) By September 30, 2007 January 15, 2010, the secretary shall issue a watershed improvement permit, submit a TMDL to the EPA for approval issue a general or individual permit implementing a TMDL approved by the EPA, or establish issue a general or individual permit implementing a water quality remediation plan for each of the stormwater-impaired waters on the Vermont Year 2004 Section 303(d) List of Waters required by 33 U.S.C.
§ 1313(d). In developing a TMDL or a water quality remediation plan for a stormwater-impaired water, the secretary shall consult “A Scientifically Based Assessment and Adaptive Management Approach to Stormwater Management” and “Areas of Agreement about the Scientific Underpinnings of the Water Resources Board’s Original Seven Questions” set out in appendices A and B, respectively, of the final report of the water resources board’s “Investigation Into Developing Cleanup Plans For Stormwater Impaired Waters, Docket No. Inv-03-01,” issued March 9, 2004. Beginning January 30, 2005 and until a watershed improvement permit, a general or individual permit implementing a TMDL, or a general or individual permit implementing a water quality remediation plan is set for each of the stormwater-impaired waters on the Vermont Year 2004 Section 303(d) List of Waters required by 33 U.S.C. § 1313(d), the secretary shall report annually to the general assembly on agency progress in establishing the watershed improvement permits, TMDLs, and water quality remediation plans for the stormwater-impaired waters of the state; on the accuracy of assessment and environmental efficacy of any stormwater impact fee paid to the state stormwater-impaired waters restoration fund; and on the efforts by the secretary to educate and inform owners of real estate in watersheds of stormwater-impaired waters regarding the requirements of the state stormwater law.
Sec. 2. 27 V.S.A. § 613(e) is amended to read:
(e) This section shall not apply to any impaired watershed for which the secretary of natural resources has issued a watershed improvement permit, submitted issued an individual permit under a total maximum daily load approved by the U.S. Environmental Protection Agency, issued a general permit implementing a total maximum daily load to approved by the U.S. Environmental Protection Agency, or established issued a general or individual permit implementing a water quality remediation plan.
Sec. 3. EXTENSION OF SUNSET OF INTERIM STORMWATER
PERMITTING PROGRAM AND CONVEYANCE OF REAL
ESTATE WITH STORMWATER PERMITS
Sec. 10 of No. 140 of the Acts of the 2003 Adj. Sess. (2004), as amended by Sec. 8 of No. 154 of the Acts of the 2005 Adj. Sess. (2006), is further amended to read:
Sec. 10. SUNSET
(a) Sec. 2 of this act (interim permitting authority for regulated stormwater runoff), except for subsection 1264a(e) of Title 10, shall be repealed on September 30, 2007 January 15, 2010.
(b) Sec. 4 of this act (local communities implementation fund) shall be repealed on September 30, 2012.
(c) Sec. 6 of this act (stormwater discharge permits during transition period) shall be repealed on September 30, 2007 January 15, 2010.
Sec. 4. AGENCY OF NATURAL RESOURCES REPORT ON IMPLEMENTATION OF STORMWATER TMDLS
Beginning January 15, 2009, and every two years thereafter, the agency of natural resources’ report required under 10 V.S.A. § 1264(f)(3) regarding agency progress in establishing watershed improvement permits, TMDLs, or water quality remediation plans for the stormwater‑impaired waters of the state shall include a review and analysis of the effectiveness of any TMDL implemented by the agency of natural resources for a stormwater impaired water of the state. Prior to issuing the report required under this section, the agency of natural resources shall hold a public hearing in each watershed of a stormwater impaired water for which a permit has been issued implementing a total maximum daily load. The review and analysis required by this section shall include:
(1) An assessment of the implementation plan for the TMDL based on available data, including an evaluation of the efficacy of the implementation plan;
(2) An assessment of the hydrologic targets of the TMDL based on available data, including an evaluation of the adequacy of the hydrologic targets of the TMDL;
(3) Recommendations, if any, for amending an implementation plan or reopening a TMDL.
Rep. Baker of West Rutland, for the committee on General, Housing and Military Affairs, to which had been referred House bill, entitled
An act relating to increasing funeral benefits under workers’ compensation;
Sec. 1. 21 V.S.A. § 639 is amended to read:
§ 639. -DEATH,; PAYMENT TO DEPENDENTS
In cases of the death of a person from any cause other than the accident during the period of payments for disability or for the permanent injury, the remaining payments for disability then due or for the permanent injury shall be made to the person's dependents according to the provisions of sections 635 and 636 of this title, or if there are none, the remaining amount due, but not exceeding $5,500.00 $10,000.00 for burial and funeral expenses and expenses for out-of-state transportation of the decedent to the place of burial not to exceed $1,000.00, shall be paid in a lump sum to the proper person.
The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on General, Housing and Military Affairs agreed to and third reading ordered.
An act relating to postretirement cost of living adjustments for state employees;
H. 518
H. 332
Rep. Trombley of Grand Isle, for the committee on General, Housing and Military Affairs, to which had been referred House bill, entitled
An act relating to sale and closure of mobile home parks;
Reported in favor of its passage when amended as follows:
By adding Secs. 1a and 3a to read as follows:
Sec. 1a. 10 V.S.A. § 6236(c), (d), and (e) are amended to read:
(c) A prospective resident shall be furnished with a copy of the proposed lease prior to any agreement to lease or occupy a mobile home lot, and upon acceptance of the lease terms the lease shall be signed by the lessor and lessee. Any provision in a lease governing rental and utility charges shall be effective for a minimum of one year, except in the case of a new tenant in a mobile home park in which there is a uniform rent schedule which affects all lots in that park simultaneously. The initial lease for a new tenant may include the anticipated increase in the rent and utility charge at the time it occurs for the other lots. A mobile home park owner shall provide residents with a minimum of 60 days notice prior to any rent increase. Rent increase notices shall not be given within six months prior to the issuance of a closure notice or any time during which the closure notice is in effect. All increases in rent received by the mobile home park owner during the six months prior to the issuance of a closure notice shall be returned to the affected residents within seven days of issuance of the closure notice. This subsection shall not apply to proprietary leases in mobile home parks owned by limited equity housing cooperatives established under chapter 14 of Title 11. The rental and utility charge may be increased during a year if the operating expenses of the park increase 20 percent or more during that year as the result of legislative action taken during that year and the increase could not have been anticipated. The rental and utility charge may be increased during a year only to the extent necessary to cover the increase in operating expenses of the park.
(d) No person shall sublease a mobile home resident may sublet the resident's mobile home without the express permission or a lot in a mobile home park without first obtaining the approval of the park owner, which shall not be unreasonably withheld. A violation of this subsection shall be grounds for eviction.
(e) All mobile home leases shall contain the following:
(5) The requirement of to obtain permission, if any, from the park owner for subletting a mobile home or a lot to another person.
Sec. 3a. 10 V.S.A. § 6240 is amended to read:
§ 6240. SALE OF HOMES LOCATED IN PARKS
(a) No person shall purchase a mobile home in a mobile home park without first obtaining approval from the park owner which shall not be unreasonably withheld. A violation of this section shall be grounds for eviction.
(b) Prior to selling a mobile home located in a mobile home park, the mobile home owner shall notify the park owner by certified or registered mail of the name of the prospective purchaser. The seller may be held liable by the purchaser or prospective purchaser for failure to comply with this section.
(b)(c) A purchaser or prospective purchaser of a mobile home located in a park shall not be refused entrance if the purchaser and his the purchaser’s household qualify under the lease terms admission policy of the park. Upon approval for entrance into the mobile home park, the purchaser or prospective purchaser shall be offered a written lease pursuant to section 6236 of this title.
(c)(d) A park owner shall not charge or collect any commission on the sale of a mobile home located in a park unless he the park owner contracts to sell the home.
H. 372
Rep. Jerman of Essex, for the committee on Government Operations, to which had been referred House bill, entitled
An act relating to the rendering of nursing and medical services by professional corporations;
In Sec. 2, 26 V.S.A. § 1585, by striking “as an advanced practice registered nurse” and inserting in lieu thereof to practice registered or licensed practical nursing.
The bill, having appeared on the Calendar one day for notice, was taken up, read the second time, report of the committee on Government Operations agreed to and third reading ordered.
At five o’clock and fifty-five minutes in the evening, on motion of Rep. Adams of Hartland, the House adjourned until tomorrow at one o’clock in the afternoon.