H. 141 An act relating to the Organ and Tissue Donation Working Group

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1 Here are the bills that came through the House this week. H. 141 An act relating to the Organ and Tissue Donation Working Group The bill reinstates an existing working group that was set to sunset. We created the group in 2013 to respond to a very low rate of registered organ and tissue donors in Vermont. The legislature created the Organ and Tissue Donation working group to research ways to increase voluntary donations and to educate the public on how to sign up. As a result, since 2013, the percentage of registered organ donors has increased from 4.4% to 31%. The Department of Motor Vehicles has promoted this voluntary option and better computer programming connects signing up at the DMV with the donor registry. The new goal is to have 50% of Vermonters as registered organ donors. Here s the charge to the working group: The Working Group shall develop recommendations regarding: (1) coordination of the efforts of all public and private entities within the State that are involved with the donation and transplantation of human organs and tissues; (2) the creation of a comprehensive statewide program for organ and tissue donations and transplants; (3) the establishment of goals and strategies for increasing donation rates of organs and tissues in Vermont, whether from a live or deceased donor; (4) issues related to health insurance and other relevant insurance types; (5) issues related to employment, including sick time, for those persons willing to be live donors of organs and tissue; and (6) other issues related to organ and tissue donation and transplantation. The bill passed on a unanimous voice vote. H. 62 An act relating to prohibiting a sentence of life without parole for a person who was under 18 years of age at the time of the commission of the offense This bill is one sentence long. It says A court shall not sentence a person to life imprisonment without the possibility of parole if the person was under 18 years of age at the time of the

2 commission of the offense. It also passed unanimously on a voice vote and is consistent with Vermont s legal approach to punishment of minors. H. 240 An act relating to miscellaneous technical corrections to laws governing motor vehicles, motorboats, and other vehicles Annually the Transportation committee makes non-controversial corrections to Vermont s vehicle laws. The changes are generally cleanups of language and statutes to make sure policy is clear, consistent and understandable to Vermonters. If you would like to read the bill here s the link: %20As%20Introduced.pdf Here are a few recent committee reports edited from colleagues contributions. The Health Care Committee heard testimony regarding the need for primary care, the importance of mental health integration, the Governor s recent proposals, the Medicaid cost shift and presentations on proposed bills for health care reform. Primary Care: Bills have been introduced that would centralize health care reform efforts around primary care physician practices. This would enhance the role of primary care and address an area negatively impacted by the Medicaid cost shift. The proposals aim to level the playing field between private practice physicians and hospital-based physicians and shrink the current differences in payment levels. Early research funded through the Robert Wood Johnson Association shows that states which addressed the cost shift using Affordable Care Act funds to raise Medicaid payments to Medicare levels found doctors were significantly more willing to take on new Medicaid patients. This resulted in reduced waiting times for the initial visit. Medicaid Cost Shift: The committee held a joint hearing with House Ways and Means on the cost shift and potential savings. Testimony by Al Gobeille and Zach Sullivan of the Green Mountain Care Board, discussed the effect closing the cost shift could have on medical costs and utilization. The presentation highlighted that a $90 million reduction in commercial healthcare costs results in a 5% reduction in the $1.7 billion currently spent on commercial health insurance.

3 Inside/Outside the Exchange: The committee has been discussing allowing individuals and businesses to purchase health care insurance directly from the carriers outside of the exchange. Currently small businesses can do so but not individuals. The desire or need for this is largely due to the technical challenges that remain in Vermont Health Connect. Additional proposals have been presented to encourage a free-market approach to allow for purchase of products not offered in the exchange and by various carriers. Any plan that is purchased would have to meet minimum federal requirements set by the ACA. The General, Housing and Military Affairs Committee has been concentrating on: housing, natural burial, and habitability of mobile home parks. Natural Burial. H.25 seeks to establish and regulate natural burial grounds in Vermont. We have heard from advocates and practitioners, funeral directors and town clerks. Concerns have been raised regarding the real estate involved and details on how and where the burial is registered, the effect on mortgages, and questions on property appraisal and resale value. We need to do more work before we can finish this bill. Corrections and Housing. In a joint meeting with the Corrections and Institutions Committee, we took testimony on the problems of housing furloughed offenders. We learned that there are B1 offenders at any given time in Vermont. The designation B1 means that the reason the offender is still incarcerated is that suitable housing cannot be found. Some of the B1 offenders have been placed in housing but were returned to jail for furlough violations. Not only can it be difficult to find suitable housing for furloughed offenders, the lack of affordable housing is a huge roadblock. Mobile Home Park Habitability. H.123 addresses statutory regulation of mobile home parks and their habitability. The committee aims to clarify compliance and enforcement with regulations and the concept of Habitability. The latter is being construed to deal with the safety and accessibility of common areas in mobile home parks, which could include playgrounds, laundry centers, picnic areas, fields, etc. We have paid a good deal of attention to the issue of making sure emergency vehicles and personnel have access to every mobile home in the park and the consequences if the park owner does not provide reasonable access. Ways & Means Committee has been considering Current Use. Current Use is often referred to as the most important, most successful conservation program in Vermont and it is one of the foundation blocks for Vermont s Working Landscape. Instead of adopting the governor s proposals to change Current Use (he sought to impose a 3 year moratorium on program enrollment and increase the farm building tax rate from 0 to 30% of assessed value), House Ways and Means has included provisions

4 related to the current use program into the Technical Tax Bill (H. 272) to strengthen the program by making it more fair and financially sustainable. There are four changes to the current use program proposed in H.272. First, it reinstates a meaningful penalty when owners withdraw land for development. Putting the teeth back into the penalty will help both re-balance the finances of this program and reduce abuse of current use by deterring short-term enrollment of land not intended for long-term agricultural and forestry use. Second, it provides for an Easy Out. Third, it creates a study committee to look at the municipal reimbursement rates. Finally, it asks the Division of Property Valuation and Review to create a consistent method of assessing conserved land and land enrolled in current use. We eliminated the painless withdrawal penalty, which was based on pro-rated value (which assumes all enrolled acres are of equal value) and replaces it with the original penalty of 10% of fair market value. Immediate family members will be able to step into the shoes of the previous owner allowing the land to be continuously enrolled. A new owner could keep the land in Current Use but would have to reenroll it and start the clock afresh. Every year we see 3-5,000 acres pulled out of current use. Current penalties amount to about $500,000. In the future, with the new fair market value penalty in place, and we return to normal real estate markets, we expect to see an increase in the penalties (called the Land Use Change Tax) of $2.7 to 3 million a year. Combined with the properties going back onto the grand list as a result of our Easy Out provisions, the FY16 budget is anticipated to see a $1.5 million increase. The bill asks for a study to examine the rate, which the state reimburses to our towns for land in Current Use. We have found the rates to be wildly inequitable, even among similar towns. For example: in 2009, Shelburne received a reimbursement of $35.43 per acre, while next door Charlotte received $6.83 per acre and St. George received $3.08 per acre. Similar disparities exist all over the state. We are asking Property Valuation and Review to provide guidance for consistent assessment of lands in Current Use and for conserved lands. Here is a recent note from Speaker Shap Smith regarding Vermont s economic condition and the relationship to this year s budget challenges. Note from Speaker Shap Smith Many legislators may be feeling overwhelmed as we approach another budget gap for the next fiscal year. After seven years we ask ourselves, will this ever end? Why are we dealing with another year of wrenching decisions when the stock market is roaring ahead, unemployment rates are low and

5 supposedly the economy is moving in the right direction? I have wondered, as have others, is it something peculiar to Vermont? Are we doing something wrong, when others have figured it all out? The answer is, not necessarily. The difficult challenges that we face exist in many other states - - Wisconsin, Kansas, Alaska, Illinois, New Jersey, Connecticut, Massachusetts and other states are dealing with declining revenues. While Vermont has challenges that are unique to it, many of the trends that other states are seeing are complicating our budgets too. One of those trends is that median household income peaked at least 15 years ago in 81 percent of U.S. counties. As this economy has recovered, the benefits have not been universally felt. GDP has grown, but wages have not and that has weighed on state revenues, particularly in states like VT that rely on a greater proportion of income taxes in its revenue mix. At the same time that our revenues have not recovered as quickly as economists predicted post-recession, we are starting to feel the effects of sequestration cuts. Discretionary spending is being cut at the federal level and this shows up in various places in our state budget. We are also seeing our Medicaid reimbursement rate go down, ironically because Vermont is doing better economically relative to other states. All of these elements are putting pressures on our state budget. Adding to all this, because of the success of the ACA, more Vermonters are getting affordable health coverage through Medicaid. That success alone has put a $15 million pressure on the budget. While we had hoped to have more reserves after tropical storm Irene, we used some surplus money to help with costs of the storm. I present these facts for context and perspective. Throughout the last six years, we have often made different decisions than other states. We have believed that it did not make economic sense to withdraw government dollars from a struggling economy, unless absolutely necessary. We have been committed to expanding health care coverage through Medicaid and private insurance. The health, safety and education of Vermonters have been our priority. And we have remained optimistic each session that if we use our resources carefully and make judicious cuts we can breathe easier when the recovery comes. The economic recovery is now taking hold throughout the country. Despite recent instances of bad news, it is also taking hold in Vermont, though it varies depending on where you are and who you are in Vermont. We have difficult challenges that result from national forces, but also forces within the state. Our decisions over the next few months will say a lot about what we value. It has been my experience that legislators in general believe that we must give those in need a hand up. We believe in making long term investments in the education and health of our people and in the infrastructure that is the economic backbone of the state. We must do all of these things while recognizing that our resources are limited.

6 A final note Town Meeting is Tuesday, March 3. Pownal and Woodford will hold their floor meetings on Monday, March 2. We will be voting on school, road and municipal budgets and we will be voting for numerous positions in town government. Early voting is available. Contact your town clerks for information. For Pownal call Karen Burrington For Woodford call Ron Higgins Here s wishing everybody a safe and productive week. Stay warm too! I understand we will see very cold temperatures again. Stay in touch, Bill Rep. Bill Botzow 1225 South Stream Rd. Bennington, VT botzow@sover.net bbotzow@leg.state.vt.us State House number (VT only)

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