reglab/statecodes huggingface dataset:
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9443. Expiration of certificates of need

§ 9443. Expiration of certificates of need
(a) Unless otherwise specified in the certificate of need, a project shall be implemented within five years or the certificate shall be invalid.
(b) Not later than 180 days before the expiration date of a certificate of need, an applicant that has not yet implemented the project approved in the certificate of need may petition the Board for an extension of the implementation period. The Board may grant an extension in its discretion.
(c) Certificates of need shall expire on the date the Board accepts the final implementation report filed in connection with the project implemented pursuant to the certificate.
(d) An action or expenditure that is related to a service or expenditure that was the subject of a certificate of need shall not be considered a material or nonmaterial change to that project if the original certificate of need expired, as provided in this section, at least two years before the action is proposed. The proposed action shall require a certificate of need only if the change itself would be considered a new health care project under section 9434 of this title. (Added 1979, No. 65, § 1; amended 1985, No. 234 (Adj. Sess.), § 9; 1987, No. 96, § 1; 1991, No. 160 (Adj. Sess.), § 35, eff. May 11, 1992; 1995, No. 180 (Adj. Sess.), § 31; 2009, No. 49, § 12; 2011, No. 171 (Adj. Sess.), § 20d, eff. Jan. 1, 2013; 2013, No. 192 (Adj. Sess.), § 25; 2023, No. 6, § 239, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9444. Revocation of certificates; material change

§ 9444. Revocation of certificates; material change
(a) The Board may revoke a certificate of need for substantial noncompliance with the scope of the project as designated in the application, or for failure to comply with the conditions set forth in the certificate of need granted by the Board.
(b)(1) In the event that after a project has been approved, its proponent wishes to materially change the approved project, all such changes are subject to review under this subchapter.
(2) Applicants shall notify the Board of a nonmaterial change to the approved project. If the Board decides to review a nonmaterial change, the Board may provide for any necessary process, including a public hearing, before approval. Where the Board decides not to review a change, such change will be deemed to have been granted a certificate of need. (Added 1979, No. 65, § 1; amended 1987, No. 96, § 17; 1991, No. 160 (Adj. Sess.), § 38(a), eff. May 11, 1992; 1995, No. 180 (Adj. Sess.), § 38(a); 2003, No. 53, § 26; 2007, No. 139 (Adj. Sess.), § 6; 2009, No. 49, § 14; 2011, No. 171 (Adj. Sess.), § 21, eff. Jan. 1, 2013.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9446. Home health agencies; geographic service areas

§ 9446. Home health agencies; geographic service areas
The terms of a certificate of need relating to the boundaries of the geographic service area of a home health agency may be modified by the Board, in consultation with the Commissioner of Disabilities, Aging, and Independent Living, after notice and opportunity for hearing, or upon written application to the Board by the affected home health agencies or consumers, demonstrating a substantial need for the modification. Service area boundaries may be modified by the Board to take account of natural or physical barriers that may make the provision of existing services uneconomical or impractical, to prevent or minimize unnecessary duplication of services or facilities, or otherwise to promote the public interest. The Board shall issue an order granting such application only upon a finding that the granting of such application is consistent with the purposes of 33 V.S.A. chapter 63, subchapter 1A and the Health Resource Allocation Plan established under section 9405 of this title and after notice and an opportunity to participate on the record by all interested persons, including affected local governments. (Added 2005, No. 57, § 6, eff. June 13, 2005; amended 2011, No. 171 (Adj. Sess.), § 22, eff. Jan. 1, 2013; 2017, No. 167 (Adj. Sess.), § 6.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9451. Definitions

§ 9451. Definitions
As used in this subchapter:
(1) “Hospital” means a hospital licensed under chapter 43 of this title, except a hospital that is conducted, maintained, or operated by the State of Vermont.
(2) “Volume” means the number of inpatient days of care or admissions and the number of all inpatient and outpatient ancillary services rendered to patients by a hospital. (Added 1983, No. 93, § 1, eff. May 4, 1983; amended 1991, No. 160 (Adj. Sess.), § 9, eff. May 11, 1992; 1995, No. 180 (Adj. Sess.), § 33; 2019, No. 140 (Adj. Sess.), § 2, eff. July 6, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9453. Powers and duties

§ 9453. Powers and duties
(a) The Board shall:
(1) adopt uniform formats that hospitals shall use to report financial, scope-of-services, and utilization data and information;
(2) designate a data organization with which hospitals shall file financial, scope-of-services, and utilization data and information; and
(3) designate a data organization or organizations to process, analyze, store, or retrieve data or information.
(b) To effectuate the purposes of this subchapter, the Board may adopt rules under 3 V.S.A. chapter 25. (Added 1983, No. 93 § 1, eff. May 4, 1983; amended 1991, No. 160 (Adj. Sess.), § 11, eff. May 11, 1992; 1995, No. 180 (Adj. Sess.), §§ 34, 38(a); 2003, No. 53, §§ 22, 26; 2011, No. 171 (Adj. Sess.), § 23, eff. May 16, 2012.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9454. Hospitals; duties

§ 9454. Hospitals; duties
(a) Hospitals shall file the following information at the time and place and in the manner established by the Board:
(1) a budget for the forthcoming fiscal year;
(2) financial information, including costs of operation, revenues, assets, liabilities, fund balances, other income, rates, charges, units of services, and wage and salary data;
(3) scope-of-service and volume-of-service information, including inpatient services, outpatient services, and ancillary services by type of service provided;
(4) utilization information;
(5) new hospital services and programs proposed for the forthcoming fiscal year;
(6) known depreciation schedules on existing buildings, a four-year capital expenditure projection, and a one-year capital expenditure plan; and
(7) such other information as the Board may require.
(b) Hospitals shall adopt a fiscal year that shall begin on October 1. (Added 1983, No. 93, § 1, eff. May 4, 1983; amended 1991, No. 160 (Adj. Sess.), § 17, eff. May 11, 1992; 1995, No. 180 (Adj. Sess.), § 38; 2003, No. 53, § 23; 2011, No. 171 (Adj. Sess.), § 23, eff. May 16, 2012; 2015, No. 97 (Adj. Sess.), § 51a.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9457. Information available to the public

§ 9457. Information available to the public
(a) Information required to be filed under this subchapter shall be made available to the public upon request in accordance with 1 V.S.A. chapter 5, subchapter 3 (Public Records Act), except that information that directly or indirectly identifies individual patients or health care practitioners shall be kept confidential.
(b) Notwithstanding 1 V.S.A. chapter 5, subchapter 2 (Vermont Open Meeting Law) or any provision of this subchapter to the contrary, the Board may examine and discuss confidential information outside a public hearing or meeting. (Added 1983, No. 93, § 1, eff. May 4, 1983; amended 2019, No. 159 (Adj. Sess.), § 9, eff. Nov. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9461. Quality measures

§ 9461. Quality measures
(a) The Department of Financial Regulation shall develop performance quality measures to evaluate and ensure that health insurers, including managed care organizations that contract with health insurers to administer the insurers’ mental health benefits, comply with the provisions of 8 V.S.A. § 4089b and related rules.
(b) The Departments of Health and of Mental Health shall develop clinical and performance quality measures to evaluate and ensure that health care professionals and health care facilities in Vermont provide high quality mental health and substance abuse treatment services to their patients. (Added 2011, No. 171 (Adj. Sess.), § 11b, eff. May 16, 2012; amended 2015, No. 11, § 20.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9462. Quality improvement projects

§ 9462. Quality improvement projects
In addition to reviewing mental health and substance abuse treatment data pursuant to subdivision 9375(b)(12) of this title, the Green Mountain Care Board shall consider the results of any quality improvement projects not otherwise confidential or privileged undertaken by managed care organizations for mental health and substance abuse care and treatment pursuant to 8 V.S.A. § 4089b(d)(1)(B)(vii) and subsection 9414(i) of this title. (Added 2011, No. 171 (Adj. Sess.), § 11b, eff. May 16, 2012.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9471. Definitions

§ 9471. Definitions
As used in this subchapter:
(1) “Beneficiary” means an individual enrolled in a health plan in which coverage of prescription drugs is administered by a pharmacy benefit manager and includes his or her dependent or other person provided health coverage through that health plan.
(2) “Health insurer” is defined by section 9402 of this title and shall include:
(A) a health insurance company, a nonprofit hospital and medical service corporation, and health maintenance organizations;
(B) an employer, labor union, or other group of persons organized in Vermont that provides a health plan to beneficiaries who are employed or reside in Vermont; and
(C) the State of Vermont and any agent or instrumentality of the State that offers, administers, or provides financial support to State government.
(3) “Health plan” means a health benefit plan offered, administered, or issued by a health insurer doing business in Vermont.
(4) “Pharmacy benefit management” means an arrangement for the procurement of prescription drugs at a negotiated rate for dispensation within this State to beneficiaries, the administration or management of prescription drug benefits provided by a health plan for the benefit of beneficiaries, or any of the following services provided with regard to the administration of pharmacy benefits:
(A) mail service pharmacy;
(B) claims processing, retail network management, and payment of claims to pharmacies for prescription drugs dispensed to beneficiaries;
(C) clinical formulary development and management services;
(D) rebate contracting and administration;
(E) certain patient compliance, therapeutic intervention, and generic substitution programs; and
(F) disease or chronic care management programs.
(5) “Pharmacy benefit manager” means an entity that performs pharmacy benefit management, except an entity that provides pharmacy benefit management services for Vermont Medicaid. The term includes a person or entity in a contractual or employment relationship with an entity performing pharmacy benefit management for a health plan.
(6) “Maximum allowable cost” means the per unit drug product reimbursement amount, excluding dispensing fees, for a group of equivalent multisource generic prescription drugs.
(7) “Pharmacy benefit manager affiliate” means a pharmacy or pharmacist that, directly or indirectly, through one or more intermediaries, is owned or controlled by, or is under common ownership or control with, a pharmacy benefit manager. (Added 2007, No. 80, § 8; amended 2013, No. 79, § 21, eff. Jan. 1, 2014; 2015, No. 54, § 2, eff. June 5, 2015; 2021, No. 131 (Adj. Sess.), § 2, eff. January 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9474. Enforcement

§ 9474. Enforcement
(a) Except as provided in subsection (d) of this section, in addition to any remedy available to the Commissioner under this title and any other remedy provided by law, a violation of this subchapter shall be considered a violation of the Vermont Consumer Protection Act in 9 V.S.A. chapter 63, subchapter 1. Except as provided in subsection (d) of this section, all rights, authority, and remedies available to the Attorney General and private parties to enforce the Vermont Consumer Protection Act shall be available to enforce the provisions of this subchapter.
(b) In connection with any action for violation of the Vermont Consumer Protection Act, the Commissioner’s determinations concerning the interpretation and administration of the provisions of this subchapter and any rules adopted pursuant to this subchapter shall carry a presumption of validity. The Attorney General and the Commissioner shall consult with each other prior to the commencement of any investigation or enforcement action with respect to any pharmacy benefit manager.
(c) The Commissioner may investigate, examine, or otherwise enforce a violation of this subchapter by a pharmacy benefit manager under section 9412 of this title as if the pharmacy benefit manager were a health insurer.
(d) The Commissioner shall have the exclusive authority to investigate, examine, and otherwise enforce the provisions of this subchapter relating to a pharmacy benefit manager in connection with the pharmacy benefit manager’s contractual relationship with, and any other activity with respect to, a health insurer defined by subdivision 9471(2)(A) of this title.
(e) Notwithstanding any provision of this section to the contrary, the Commissioner and the Attorney General may bring a joint enforcement action against any person or entity for a violation of this subchapter. (Added 2007, No. 80, § 8; amended 2007, No. 89 (Adj. Sess.), § 6; 2013, No. 144 (Adj. Sess.), § 13, eff. May 27, 2014; 2017, No. 113 (Adj. Sess.), § 110; 2023, No. 6, § 241, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9484. Public education and information

§ 9484. Public education and information
(a) Each large health care facility shall publicize its financial assistance policy widely by:
(1) making the financial assistance policy and application form easily accessible online through the facility’s website and through any patient portal or other online communication portal used by the facility’s patients;
(2) providing paper copies of the financial assistance policy and application form upon request at no charge, both by mail and at the facility’s office; for hospitals, copies shall also be available in the hospital’s patient reception and admissions areas and in the locations in which patient billing and financial assistance services are provided;
(3) providing oral and written translations of the financial assistance policy upon request;
(4) notifying and informing members of the community served by the facility about the financial assistance policy in a manner reasonably calculated to reach the members of the community who are most likely to need financial assistance, including members who are non-native English speakers, provided that these efforts shall be commensurate with the facility’s size and income; and
(5) conspicuously displaying notices of and information regarding the financial assistance policy in the facility’s offices; for hospitals, the notices and information shall be posted in the hospital’s patient reception and admissions areas and in the locations in which patient billing and financial assistance services are provided.
(b) Each large health care facility shall directly notify individuals who receive care from the facility about the facility’s financial assistance policy by, at a minimum:
(1) offering a paper copy of the financial assistance policy to each patient as part of the patient’s first visit or, in the case of a hospital, during the intake and discharge processes; and
(2) including a conspicuous written notice on billing statements, whether sent by the facility or by a medical debt collector, stating that financial assistance is available to some patients based on income and including:
(A) a telephone number that the patient can call to request a financial assistance application and to receive information about the financial assistance policy and the application process; and
(B) the specific website address at which copies of the policy and application are available.
(c) All written or oral attempts by a medical creditor or medical debt collector to collect a medical debt arising from health care services delivered by a large health care facility shall include information for the patient about the relevant financial assistance policy or policies. (Added 2021, No. 119 (Adj. Sess.), § 1, eff. July 1, 2022.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9486. Prohibition of waiver of rights

§ 9486. Prohibition of waiver of rights
Any waiver by a patient or other individual of any protection provided by or any right of the patient or other individual under this subchapter is void and shall not be enforced by any court or any other person. (Added 2021, No. 119 (Adj. Sess.), § 1, eff. July 1, 2022.)
2023 Vermont Statutes › Title 18 - Health › Chapter 221 - Health Care Administration › § 9487. Enforcement

§ 9487. Enforcement
The Office of the Attorney General has the same authority to make rules, conduct civil investigations, enter into assurances of discontinuance, and bring civil actions for violations of this subchapter as is provided under 9 V.S.A. chapter 63, subchapter 1. (Added 2021, No. 119 (Adj. Sess.), § 1, eff. July 1, 2022.)
2023 Vermont Statutes › Title 18 - Health › Chapter 222 - Access to Health Care Professionals › § 9491. Health care workforce; strategic plan

§ 9491. Health care workforce; strategic plan
(a) The Director of Health Care Reform in the Agency of Human Services shall maintain a current health care workforce development strategic plan that continues efforts to ensure that Vermont has the health care workforce necessary to provide care to all Vermont residents.
(b)(1) The Director or designee shall consult with an advisory group composed of the following 11 members, at least one of whom shall be a nurse, to develop and maintain the strategic plan:
(A) one representative of the Green Mountain Care Board’s primary care advisory group;
(B) one representative of the Vermont State Colleges;
(C) one representative of the Area Health Education Centers’ workforce initiative;
(D) one representative of federally qualified health centers;
(E) one representative of Vermont hospitals;
(F) one representative of physicians;
(G) one representative of mental health professionals;
(H) one representative of dentists;
(I) one representative of naturopathic physicians;
(J) one representative of home health agencies; and
(K) one representative of long-term care facilities.
(2) The Director or designee shall serve as the chair of the advisory group.
(c) The Director of Health Care Reform shall ensure that the strategic plan includes recommendations on how to develop Vermont’s health care workforce, including:
(1) the current capacity and capacity issues of the health care workforce and delivery system in Vermont, including the shortages of health care professionals, specialty practice areas that regularly face shortages of qualified health care professionals, issues with geographic access to services, and unmet health care needs of Vermonters;
(2) how State government, universities and colleges, the State’s educational system, entities providing education and training programs related to the health care workforce, and others may develop the resources in the health care workforce and delivery system to educate, recruit, and retain health care professionals to achieve Vermont’s health care reform principles and purposes; and
(3) assessing the availability of State and federal funds for health care workforce development. (Added 2011, No. 48, § 12a; amended 2017, No. 85, § E.300.3, eff. June 28, 2017; 2017, No. 113 (Adj. Sess.), § 111; 2017, No. 200 (Adj. Sess.), § 20; 2019, No. 14, § 59, eff. April 30, 2019; 2019, No. 155 (Adj. Sess.), § 1, eff. Nov. 1, 2020; 2021, No. 20, § 74.)
2023 Vermont Statutes › Title 18 - Health › Chapter 222 - Access to Health Care Professionals › § 9492. Non-emergency walk-in centers; nondiscrimination

§ 9492. Non-emergency walk-in centers; nondiscrimination
(a) A non-emergency walk-in center shall accept patients of all ages for diagnosis and treatment of illness, injury, and disease during all hours that the center is open to see patients. A non-emergency walk-in center shall not discriminate against any patient or prospective patient on the basis of insurance status or type of health coverage.
(b) As used in this section, “non-emergency walk-in center” means an outpatient or ambulatory diagnostic or treatment center at which a patient without making an appointment may receive medical care that is not of an emergency, life threatening nature. The term includes facilities that are self-described as urgent care centers, retail health clinics, and convenient care clinics. (Added 2013, No. 144 (Adj. Sess.), § 11, eff. May 27, 2014.)
2023 Vermont Statutes › Title 18 - Health › Chapter 223 - Reproductive Rights › § 9493. Purpose and policy

§ 9493. Purpose and policy
(a) The State of Vermont recognizes the fundamental right of every individual to choose or refuse contraception or sterilization.
(b) The State of Vermont recognizes the fundamental right of every individual who becomes pregnant to choose to carry a pregnancy to term, to give birth to a child, or to have an abortion. (Added 2019, No. 47, § 2, eff. June 10, 2019.)
2023 Vermont Statutes › Title 18 - Health › Chapter 223 - Reproductive Rights › § 9494. Interference with reproductive choice prohibited

§ 9494. Interference with reproductive choice prohibited
(a) A public entity as defined in section 9496 of this title shall not, in the regulation or provision of benefits, facilities, services, or information, deny or interfere with an individual’s fundamental rights to choose or refuse contraception or sterilization or to choose to carry a pregnancy to term, to give birth to a child, or to obtain an abortion.
(b) No State or local law enforcement shall prosecute any individual for inducing, performing, or attempting to induce or perform the individual’s own abortion. (Added 2019, No. 47, § 2, eff. June 10, 2019.)
2023 Vermont Statutes › Title 18 - Health › Chapter 223 - Reproductive Rights › § 9496. Definitions

§ 9496. Definitions
As used in this subchapter:
(1) “Health care provider” means a person, partnership, or corporation, including a health care facility, that is licensed, certified, or otherwise authorized by law to provide professional health care services in this State to an individual during that individual’s medical care, treatment, or confinement.
(2) “Public entity” means:
(A) the Legislative, Executive, or Judicial Branch of State Government, or any agency, department, office, or other subdivision of State government, or any elective or appointive officer or employee within any of those branches; or
(B) any municipality, or any agency, department, office, or other subdivision of municipal government, or any elective or appointive officer or employee within municipal government. (Added 2019, No. 47, § 2, eff. June 10, 2019.)
2023 Vermont Statutes › Title 18 - Health › Chapter 223 - Reproductive Rights › § 9497. Abortion; restricting access prohibited

§ 9497. Abortion; restricting access prohibited
A public entity shall not:
(1) deprive a consenting individual of the choice of terminating the individual’s pregnancy;
(2) interfere with or restrict, in the regulation or provision of benefits, facilities, services, or information, the choice of a consenting individual to terminate the individual’s pregnancy;
(3) prohibit a health care provider, acting within the scope of the health care provider’s license, from terminating or assisting in the termination of a patient’s pregnancy; or
(4) interfere with or restrict, in the regulation or provision of benefits, facilities, services, or information, the choice of a health care provider acting within the scope of the health care provider’s license to terminate or assist in the termination of a patient’s pregnancy. (Added 2019, No. 47, § 2, eff. June 10, 2019.)
2023 Vermont Statutes › Title 18 - Health › Chapter 223 - Reproductive Rights › § 9498. Enforcement

§ 9498. Enforcement
(a) An individual injured as a result of a violation of this chapter shall have a private right of action in Superior Court against a public entity for injunctive relief arising from the violation.
(b) In addition to any injunctive relief awarded, the court may award costs and reasonable attorney’s fees to an injured person who substantially prevails in an action brought under this section. (Added 2019, No. 47, § 2, eff. June 10, 2019.)
2023 Vermont Statutes › Title 18 - Health › Chapter 225 - Tobacco Prevention, Cessation, and Control › § 9501. Definitions

§ 9501. Definitions
As used in this chapter:
(1) [Repealed.]
(2) “Secretary” means the Secretary of Human Services.
(3) “Agency” means the Agency of Human Services, unless the context requires otherwise.
(4) “Commissioner” means the Commissioner of Health.
(5) “Department” means the Department of Health, unless the context requires otherwise.
(6) “Eligible activity” means any activity that will carry out either or both of the dual purposes of freeing Vermonters from addiction to tobacco and ensuring that the youth of Vermont in this generation and in generations to come are free from tobacco addiction. Eligible activities include the following:
(A) establishing anti-addiction programs that are accessible to all Vermonters;
(B) creating and fostering anti-tobacco educational programs for use in Vermont schools;
(C) creating and fostering anti-tobacco advertising;
(D) establishing community outreach programs;
(E) supporting tobacco control enforcement activities; and
(F) evaluating the effectiveness of tobacco cessation, prevention, and control programs.
(7) “Litigation Settlement Fund” means the Vermont Tobacco Litigation Settlement Fund established by 32 V.S.A. § 435a.
(8) “Program” means the Vermont tobacco prevention and treatment program established under this chapter.
(9) “Tobacco litigation settlement” means the Master Settlement Agreement between members of the tobacco industry and the State of Vermont, approved by the Vermont Superior Court on December 14, 1998 and finalized in Vermont on January 13, 1999.
(10) “Trust Fund” means the Tobacco Trust Fund established by this chapter. (Added 1999, No. 152 (Adj. Sess.), § 271, eff. May 29, 2000; amended 2019, No. 82, § 4; 2023, No. 6, § 242, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 225 - Tobacco Prevention, Cessation, and Control › § 9502. Tobacco Trust Fund

§ 9502. Tobacco Trust Fund
(a)(1) The Tobacco Trust Fund is established in the Office of the State Treasurer for the purposes of creating a self-sustaining, perpetual fund for tobacco cessation and prevention that is not dependent upon tobacco sales volume.
(2) The Trust Fund shall comprise:
(A) appropriations made by the General Assembly;
(B) transfers from the Litigation Settlement Fund pursuant to subdivision (b) of this section; and
(C) contributions from any other source.
(3) The State Treasurer shall not disburse monies from the Trust Fund, except upon appropriation by the General Assembly. In any fiscal year, total appropriations from the Trust Fund shall not exceed seven percent of the fair market value of the Fund at the end of the prior fiscal year.
(4) The Trust Fund shall be administered by the State Treasurer. The Treasurer may invest monies in the Fund in accordance with the provisions of 32 V.S.A. § 434. All balances in the Fund at the end of the fiscal year shall be carried forward. Interest earned shall remain in the Fund. The Treasurer’s annual financial report to the Governor and the General Assembly shall contain an accounting of receipts, disbursements, and earnings of the Fund.
(b) Unless otherwise authorized by the General Assembly on or before June 30, 2000, and on June 30 of each subsequent fiscal year, any unencumbered balance in the Litigation Settlement Fund shall be transferred to the Trust Fund. (Added 1999, No. 152 (Adj. Sess.), § 271, eff. May 29, 2000.)
2023 Vermont Statutes › Title 18 - Health › Chapter 225 - Tobacco Prevention, Cessation, and Control › § 9503. Vermont tobacco prevention and treatment

§ 9503. Vermont tobacco prevention and treatment
(a) Except as otherwise specifically provided, the tobacco prevention and treatment program shall be administered and coordinated statewide by the Department of Health, pursuant to the provisions of this chapter. The program shall be comprehensive and research-based.
(b) The Department shall establish goals for reducing adult and youth smoking rates, including performance measures for each goal in conjunction with the Substance Misuse Prevention Oversight and Advisory Council established pursuant to section 4803 of this title. The services provided by a quitline approved by the Department of Health shall be offered and made available to any minor, upon his or her consent, who is a smoker or user of tobacco products as defined in 7 V.S.A. § 1001.
(c) The Department of Liquor and Lottery shall administer the component of the program that relates to enforcement activities.
(d) The Agency of Education shall administer school-based programs.
(e) The Department shall pay all fees and costs of the surveillance and evaluation activities, including the costs associated with hiring a contractor to conduct an independent evaluation of the program.
(f) [Repealed.] (Added 1999, No. 152 (Adj. Sess.), § 271, eff. May 29, 2000; amended 2007, No. 26, § 1; 2013, No. 92 (Adj. Sess.), § 258, eff. Feb. 14, 2014; 2019, No. 73, § 26; 2019, No. 82, § 4.)
2023 Vermont Statutes › Title 18 - Health › Chapter 225 - Tobacco Prevention, Cessation, and Control › § 9505. General powers and duties

§ 9505. General powers and duties
The Department shall have all the powers necessary and convenient to carry out and effectuate the purposes and provisions of this section, and shall do all of the following:
(1) establish the selection criteria for community grants and review and recommend the grants to be funded;
(2) select a contractor responsible for countermarketing activities;
(3) perform ongoing evaluations of tobacco cessation efforts and publish the evaluation measures on the Department’s website;
(4) execute a memorandum of understanding developed with the Agency of Education for school-based programs funded through the Tobacco Program Fund;
(5) consult with the Department of Liquor and Lottery concerning enforcement activities administered in accordance with the provisions of this chapter; and
(6) propose strategies for program coordination and collaboration with other State agencies, health care providers and organizations, community and school groups, nonprofit organizations dedicated to anti-tobacco activities, and other nonprofit organizations. (Added 1999, No. 152 (Adj. Sess.), § 271, eff. May 29, 2000; amended 2013, No. 92 (Adj. Sess.), § 260, eff. Feb. 14, 2014; 2013, No. 131 (Adj. Sess.), § 122; 2019, No. 73, § 27; 2019, No. 82, § 4; 2023, No. 6, § 243, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 225 - Tobacco Prevention, Cessation, and Control › § 9506. Allocation system

§ 9506. Allocation system
In determining the allocation of funds available for the purposes of this chapter, the Department shall consider all relevant factors, including:
(1) the level of funding or other participation by private or public sources in the activity being considered for funding;
(2) what resources will be required in the future to sustain the program;
(3) geographic distribution of funds; and
(4) the extent to which the goals of the project can be measured by reductions in adult or youth smoking rates. (Added 1999, No. 152 (Adj. Sess.), § 271, eff. May 29, 2000; amended 2013, No. 131 (Adj. Sess.), § 123; 2015, No. 11, § 23; 2019, No. 82, § 4.)
2023 Vermont Statutes › Title 18 - Health › Chapter 227 - All-Payer Model and Accountable Care Organizations › § 9571. Definitions

§ 9571. Definitions
As used in this subchapter:
(1) “Accountable care organization” and “ACO” means an organization of health care providers that has a formal legal structure, is identified by a federal taxpayer identification number, and agrees to be accountable for the quality, cost, and overall care of the patients assigned to it.
(2) “Health care provider” means a person, partnership, or corporation, including a health care facility, that is licensed, certified, or otherwise authorized by law to provide professional health care services in this State to an individual during that individual’s medical care, treatment, or confinement. (Added 2017, No. 59, § 2.)
2023 Vermont Statutes › Title 18 - Health › Chapter 227 - All-Payer Model and Accountable Care Organizations › § 9573. Medicaid advisory rate case

§ 9573. Medicaid advisory rate case
(a) On or before December 31 of each year, the Green Mountain Care Board shall review any all-inclusive population-based payment arrangement between the Department of Vermont Health Access and an accountable care organization for the following calendar year. The Board’s review shall include the number of attributed lives, eligibility groups, covered services, elements of the per member, per month payment, and any other nonclaims payments. The Board’s review may include deliberative sessions to the same extent permitted for insurance rate review under 8 V.S.A. § 4062.
(b) The review shall be nonbinding on the Agency of Human Services, and nothing in this section shall be construed to abrogate the designation of the Agency of Human Services as the single State agency as required by 42 C.F.R. § 431.10.
(c) The Board shall review the payment arrangement prior to the finalization of a contract between the Department and the accountable care organization and shall maintain the confidentiality of information as needed to preserve the parties’ contract negotiations. The Board shall release its advisory opinion within 30 days following the finalization of the contract between the parties.
(d) The Department of Vermont Health Access shall provide the Board and its contractors with all data and information that the Board requests for its review within the time frame set forth by the Board. (Added 2017, No. 167 (Adj. Sess.), § 14, eff. May 22, 2018.)
2023 Vermont Statutes › Title 18 - Health › Chapter 229 - Office of the Health Care Advocate › § 9601. Definitions

§ 9601. Definitions
As used in this chapter:
(1) “Green Mountain Care Board” or “Board” means the Board established in chapter 220 of this title.
(2) “Health insurance plan” means a policy, service contract, or other health benefit plan offered or issued by a health insurer and includes beneficiaries covered by the Medicaid program unless they are otherwise provided with similar services.
(3) “Health insurer” shall have the same meaning as in section 9402 of this title. (Added 2013, No. 79, § 35a, eff. Jan. 1, 2014.)
2023 Vermont Statutes › Title 18 - Health › Chapter 229 - Office of the Health Care Advocate › § 9602. Office of the Health Care Advocate; composition

§ 9602. Office of the Health Care Advocate; composition
(a) The Agency of Human Services shall maintain the Office of the Health Care Advocate by contract with any nonprofit organization.
(b) The Office shall be administered by the Chief Health Care Advocate, who shall be an individual with expertise and experience in the fields of health care and advocacy. The Advocate may employ legal counsel, administrative staff, and other employees and contractors as needed to carry out the duties of the Office. (Added 2013, No. 79, § 35a, eff. Jan. 1, 2014; amended 2017, No. 85, § E.300.4, eff. June 28, 2017.)
2023 Vermont Statutes › Title 18 - Health › Chapter 229 - Office of the Health Care Advocate › § 9604. Duties of State agencies

§ 9604. Duties of State agencies
All State agencies shall comply with reasonable requests from the Office of the Health Care Advocate for information and assistance. The Agency of Human Services may adopt rules necessary to ensure the cooperation of State agencies under this section. (Added 2013, No. 79, § 35a, eff. Jan. 1, 2014; amended 2017, No. 85, § E.300.7, eff. June 28, 2017.)
2023 Vermont Statutes › Title 18 - Health › Chapter 229 - Office of the Health Care Advocate › § 9605. Confidentiality

§ 9605. Confidentiality
In the absence of written consent by a complainant or an individual using the services of the Office or by his or her guardian or legal representative or the absence of a court order, the Office of the Health Care Advocate, its employees, and its contractors shall not disclose the identity of the complainant or individual. (Added 2013, No. 79, § 35a, eff. Jan. 1, 2014.)
2023 Vermont Statutes › Title 18 - Health › Chapter 229 - Office of the Health Care Advocate › § 9606. Conflicts of interest

§ 9606. Conflicts of interest
The Office of the Health Care Advocate, its employees, and its contractors shall not have any conflict of interest relating to the performance of their responsibilities under this chapter. For the purposes of this chapter, a conflict of interest exists whenever the Office of the Health Care Advocate, its employees, or its contractors or a person affiliated with the Office, its employees, or its contractors:
(1) has a direct involvement in the licensing, certification, or accreditation of a health care facility, health insurer, or health care provider;
(2) has a direct ownership interest or investment interest in a health care facility, health insurer, or health care provider;
(3) is employed by or participating in the management of a health care facility, health insurer, or health care provider; or
(4) receives or has the right to receive, directly or indirectly, remuneration under a compensation arrangement with a health care facility, health insurer, or health care provider. (Added 2013, No. 79, § 35a, eff. Jan. 1, 2014.)
2023 Vermont Statutes › Title 18 - Health › Chapter 229 - Office of the Health Care Advocate › § 9607. Funding; allocation of expenses

§ 9607. Funding; allocation of expenses
(a) The Office of the Health Care Advocate shall specify in its annual report filed pursuant to this chapter the sums expended by the Office in carrying out its duties, including identifying the specific amount expended for actuarial services.
(b)(1) Expenses incurred by the Office of the Health Care Advocate for services related to the Green Mountain Care Board’s and Department of Financial Regulation’s regulatory and supervisory duties shall be borne as follows:
(A) 27.5 percent by the State from State monies;
(B) 24.2 percent by the hospitals;
(C) 24.2 percent by nonprofit hospital and medical service corporations licensed under 8 V.S.A. chapter 123 or 125; and
(D) 24.2 percent by health insurance companies licensed under 8 V.S.A. chapter 101.
(2) Expenses under subdivision (1) of this subsection shall be billed to persons licensed under Title 8 based on premiums paid for health care coverage, which for the purposes of this section shall include major medical, comprehensive medical, hospital or surgical coverage, and comprehensive health care services plans, but shall not include long-term care or limited benefits, disability, credit or stop loss, or excess loss insurance coverage.
(3) The Green Mountain Care Board shall administer the bill back authority created in this subsection on behalf of the Agency of Human Services in support of the Agency’s contract with the Office of the Health Care Advocate pursuant to section 9602 of this title to carry out the duties set forth in this chapter.
(c) It is the intent of the General Assembly that the Office of the Health Care Advocate shall maximize the amount of federal and grant funds available to support the activities of the Office. (Added 2013, No. 79, § 35a, eff. Jan. 1, 2014; amended 2015, No. 134 (Adj. Sess.), § 28; 2017, No. 85, § E.300.5, eff. June 28, 2017.)
2023 Vermont Statutes › Title 18 - Health › Chapter 231 - Advance Directives for Health Care, Disposition of Remains, and Surrogate Decision Making › § 9700. Purpose and policy

§ 9700. Purpose and policy
The State of Vermont recognizes the fundamental right of an adult to determine the extent of health care the individual will receive, including treatment provided during periods of incapacity and at the end of life. This chapter enables adults to retain control over their own health care through the use of advance directives, including appointment of an agent and directions regarding health care and disposition of remains. During periods of incapacity, the decisions by the agent shall be based on the express instructions, wishes, or beliefs of the individual, to the extent those can be determined. This chapter also allows, in limited circumstances in which a patient without capacity has neither an agent nor a guardian, for a surrogate to provide or withhold consent on the patient’s behalf for a do-not-resuscitate order or clinician order for life-sustaining treatment. (Added 2005, No. 55, § 1; eff. Sept. 1, 2005; amended 2015, No. 136 (Adj. Sess.), § 1, eff. Jan. 1, 2018.)
2023 Vermont Statutes › Title 18 - Health › Chapter 231 - Advance Directives for Health Care, Disposition of Remains, and Surrogate Decision Making › § 9705. Duty to deliver

§ 9705. Duty to deliver
An individual possessing a duly executed advance directive to whom it becomes known that the terms of the advance directive may be applicable shall deliver the advance directive to the principal’s clinician, other health care provider, health care facility, or residential care facility, unless the individual knows that another copy has previously been delivered and is available. (Added 2005, No. 55, § 1, eff. Sept. 1, 2005.)
2023 Vermont Statutes › Title 18 - Health › Chapter 231 - Advance Directives for Health Care, Disposition of Remains, and Surrogate Decision Making › § 9706. When advance directive becomes effective

§ 9706. When advance directive becomes effective
(a) An advance directive regarding health care shall become effective:
(1) when a principal’s clinician:
(A) determines, after speaking with an interested individual if one is reasonably available, that the principal lacks capacity, and makes specific findings regarding the cause, nature, and projected duration of the principal’s lack of capacity;
(B) has made reasonable efforts to notify the principal of the determination; and
(C) has made reasonable efforts to notify the principal’s agent or guardian of the determination; or
(2) when the circumstance or condition specified pursuant to subdivision 9702(a)(3) of this title has been met; or
(3) upon execution, if specified pursuant to subdivision 9702(a)(4) of this title.
(b) When a principal has a clinician, the clinician shall certify in the principal’s medical record the facts that have caused an advance directive to become effective.
(c) Upon a determination of need by the principal’s clinician, or upon the request of the principal, agent, guardian, ombudsman, a mental health patient representative, health care provider, or any interested individual, the principal’s clinician, another clinician, or a clinician’s designee shall reexamine the principal to determine whether the principal has capacity. The clinician shall document the results of the reexamination in the principal’s medical record and shall make reasonable efforts to notify the principal and the agent or guardian, as well as the individual who initiated the new determination of capacity, of the results of the reexamination, if providing such notice is consistent with the requirements of HIPAA.
(d) The authority of an agent to make health care decisions for a principal shall cease in accordance with subsection 9711(c) of this title.
(e) An advance directive regarding disposition of the principal’s remains shall become effective upon the death of the principal. (Added 2005, No. 55, § 1, eff. Sept. 1, 2005; amended 2013, No. 192 (Adj. Sess.), § 19; 2017, No. 121 (Adj. Sess.), § 2a, eff. May 3, 2018.)
2023 Vermont Statutes › Title 18 - Health › Chapter 231 - Advance Directives for Health Care, Disposition of Remains, and Surrogate Decision Making › § 9710. Consent for hospice care

§ 9710. Consent for hospice care
(a) A family member of a patient or a person with a known close relationship to the patient may elect hospice care on behalf of the patient if the patient does not have an agent or guardian or the patient’s agent or guardian, or both, if applicable, are unavailable. Decisions made by the family member or person with a known close relationship shall protect the patient’s own wishes in the same manner as decisions made by an agent as described in subsection 9711(d) of this title.
(b) As used in this section, “hospice care” means a program of care and support provided by a Medicare-certified hospice provider to help an individual with a terminal condition to live comfortably by providing palliative care, including effective pain and symptom management. Hospice care may include services provided by an interdisciplinary team that are intended to address the physical, emotional, psychosocial, and spiritual needs of the individual and his or her family. (Added 2013, No. 127 (Adj. Sess.), § 1, eff. May 10, 2014.)
2023 Vermont Statutes › Title 18 - Health › Chapter 231 - Advance Directives for Health Care, Disposition of Remains, and Surrogate Decision Making › § 9714. Failure to follow advance directive; unauthorized access of registry; administrative penalties

§ 9714. Failure to follow advance directive; unauthorized access of registry; administrative penalties
(a) A health care provider, health care facility, residential care facility, funeral director, crematory operator, or cemetery official, or an employee of any of them having actual knowledge of an advance directive or an instruction of the principal, agent, or guardian is subject to review and disciplinary action by the appropriate licensing entity for failing to act in accordance with the advance directive or instruction or with subsection 9707(b) of this title.
(b) A health care provider, health care facility, residential care facility, funeral home director, crematory operator, cemetery official, probate division official, or procurement organization, or an employee of any of them, who accesses the registry without authority or when authority has been denied specifically by the principal, agent, or guardian is subject to review and disciplinary action by the appropriate licensing, accreditation, or approving entity.
(c) Nothing in this section shall be construed as limiting any other available remedies.
(d) Liability for the cost of health care, disposition of remains, anatomical gifts, or funeral goods and services provided pursuant to an advance directive or pursuant to an instruction of the agent, guardian, or individual designated in an advance directive to make decisions regarding disposition of remains shall be the same as if the services were provided pursuant to the principal’s decision. (Added 2005, No. 55, § 1, eff. Sept. 1, 2005; amended 2005, No. 215 (Adj. Sess.), § 337.)