Janet Ancel -Vermont House Representative- Legislative Report

Legislative Reports

Capitol Comment. April 10,2006

After a very busy few weeks, most of the action has now moved to the Senate where work is being done on a number of issues, including Health Care, the Transportation bill, and the Budget. Many of us are hoping that we are nearing the end of the session, although it always seems to take longer than it should to finish up.

Property taxes. As a result of work done this past summer, the House has passed a bill that would combine the property tax prebate and rebate into a single credit to be applied directly to the property tax bill. If you are eligible for an income sensitivity adjustment, you will no longer receive a check. Instead, the bill you receive will reflect what you actually owe.

Speaking of property taxes, here’s a reminder: You must file your 2005 Declaration of Homestead by April 18 if you own property in the state of Vermont. This form must be filed even if you don’t owe any income taxes and even if you aren’t eligible for income sensitivity. You can file online at https://secure.vermont.gov/hd/index.

Transportation. It seems likely there will be a disagreement between the House and Senate on how to come up with the state match needed for the Jeffords transportation money. As you know, the House voted to support an increase in motor vehicle fees and an increase in gas and diesel taxes. Although the increases were small, it is especially difficult for Vermonters to accept them with the substantial increases being imposed over the past few months by the fuel companies. I’m not sure how this will play out, although I think it’s important that whatever source of funding we select will be sustainable for the five years the Jeffords money is available.

Health Care. The Senate will probably vote on health care later this week. Generally, the Senate has been working from the House version of the bill, although there are also some significant changes. I expect that the most difficult issues will be the financing and whether some form of ESI (employer sponsored insurance, a proposal of the Governor’s) will survive. It has been interesting to watch developments in Massachusetts which relies on an individual mandate.

Impeachment. The Democratic State Committee has taken the position that the question of impeachment should not go to the Vermont Legislature but rather go directly to Congress where, of course, the ultimate decision would be made. I know this is frustrating to many people but I believe it is the right result. It is simply not possible for the legislature, in the time remaining, to do justice to the issue and tackle the important challenges we still face.

Capitol Comment, February 27, 2006

This has been an incredibly busy month.

Energy. After a contentious debate, the House easily defeated a moratorium on wind power proposed by legislators from the Northeast Kingdom. While I sympathize with these small towns who feel that wind towers are being imposed on them, we can’t ignore the very real challenge of finding alternative sources of energy and wind should be part of that mix. For those reasons, I voted against the moratorium.

Sexual Violence Prevention. Again, a contentious debate. There were several efforts to add civil commitment and mandatory minimums to a bill that addressed sexual violence. These efforts were defeated. The bill itself builds on other significant criminal justice legislation adopted over the past two years and focuses on proven measures for preventing, prosecuting, sentencing, treating, and ultimately reintegrating perpetrators of crimes of sexual violence in Vermont. I voted against civil commitment and mandatory minimums. Both are poorly conceived and expensive and not likely to achieve the result Vermonters want -- which is to feel safe in their own communities.

Health Care. Although the health care bill that will be considered this coming week isn’t everything many of us had hoped, I believe it is well worth doing and that if enacted it will make a substantial difference. The overriding goal of the bill (H861) is to make health care affordable for every Vermonter. It does this in two ways. It makes coverage available for the uninsured, and it dramatically changes the way we manage chronic care. There continues to be disagreement about how to finance these reforms. The House will be voting whether to use tobacco settlement money and the cigarette tax as a source of revenue. I’ve been asked to report this section of the bill – quite a responsibility for a freshman!

Open Government. It was very satisfying to have this legislation, which was sponsored by Rep. Tony Klein and myself, adopted by the House with a strong vote – again, after a contentious debate. The bill blocks state government’s use of the “deliberative process privilege” – a vague and potentially sweeping new exception to the Public Records Act – to withhold records from the public. Tony and I sponsored this bill when two constituents, both state employees, were denied records that would help them deal with health issues in their workplace. The bill now goes to the Senate.

Transportation. The current proposal is to raise the gas tax by 6 cents in order to adequately fund the Transportation Agency and to provide enough revenue to match the federal grant money secured by Senator Jeffords. This proposal is now in the House Ways and Means Committee. There are many substantial benefits from the Jeffords money and we need to find a way to raise enough state money for the match. However, several of us have concerns about using only the gas tax (and not fees) for this purpose.

Farm to School. This bill will provide mini-grants for schools to take advantage of local produce, to provide regional training for food service workers, and access curriculum funds for classrooms and assistance to farmers to integrate “healthy” product into the lives of our children. It passed the House easily and is on its way to the Senate.

Community Forum. Here is a notice Peter Youngbaer asked me to include: There will be a Community Forum on Tuesday, March 21, from 5:30 to 7:00 at the Barre Elks Club, sponsored by the Vermont Developmental Disabilities Council & Central Vermont Community. The purpose of the Forum is to discuss how Vermont is doing in supporting people with disabilities and how can our communities be more inclusive. For more information or if you need transportation or child care, call 479-4284.

Town Meeting. I plan to be at Town Meeting, starting with Marshfield, then Plainfield and ending in Calais. I hope to see you there!

Capitol Comment, February 11, 2006

Hello all, Although there are many other important issues to write about, I've focused this time exclusivelly on health care. I hope you will find this helpful and that you will let me know if you have further questions. Janet

Health Care

The centerpiece of the House Health Care Committee’s initiative is a comprehensive package of benefits available to the uninsured at a price they can afford. This program (known as X Health for now) will offer the full range of services available under a traditional insurance policy, including both in-hospital and out of hospital care. Building on the chronic care initiative, X Health benefits will be constructed to encourage appropriate screening and effective management of chronic conditions. Premiums will be based on ability to pay.

X Health benefits and costs will be comparable to the most popular health insurance plan available to state employees. It will be administered by one of our Vermont insurance companies, just as the state employee plan is administered. Premiums will be subsidized with state dollars, on a sliding fee scale, and the subsidies will be phased out, probably at 350% of poverty.

Some details

How is this different from H.524 (last year’s health care bill)?

H.524 set out a staged plan for affordable health care for all Vermonters, focusing in the first step on primary and preventive care for the uninsured. H.524 would have resulted in significant benefits to uninsured Vermonters, using revenue from individuals and businesses not currently contributing to the system. Unfortunately, the bill was vetoed by the Governor. Since then, we’ve traveled the state and learned a lot from Vermonters. We’ve also leaned from proposals put forward by many different groups. This year, we are offering a bill that takes the first step of covering the uninsured, but with comprehensive coverage. We will also lay out a plan for further reforms, although probably in a separate bill or resolution.

This bill focuses on the uninsured and the chronically ill; what about the underinsured – people who have $10,000 deductibles and worry how to pay their monthly premium every month?

If you now pay for health insurance, you are also paying for the care received by the uninsured. Bringing as many of the uninsured as possible into the system by offering them coverage reduces this cost shift. In addition, there are plans to increase Medicaid reimbursement for primary care doctors which will also reduce the cost shift.

Why should I care about chronic disease? Isn’t this just another public education initiative?

A key to cost control throughout the health care system and the affordability of X Health in particular is the focus on chronic conditions. The legislature’s consultant Dr Ken Thorpe has advised us that savings can be realized with a state of the art system for management of chronic disease. More than 70% of the $3.5 billion Vermonters spent on health care in 2005 was spent on chronic conditions. As obesity rates climb, with attendant increases in diabetes and congestive heart failure, that figure will only increase. Chronic conditions include not just diabetes, but high blood pressure, asthma, congestive heart failure, cancer – basically anything expected to last longer than a year and requiring active management.

The Health Care Committee will be proposing to make the necessary investments in chronic disease management. This is not just a matter of better education or greater efficiency. It’s a different payment system, with providers paid for the time necessary to ensure, for example, that a person with diabetes is reminded to come in for needed extremity checks and vision checks and hemoglobin checks. Typically, this will involve someone, probably a nurse, to call the patient, perhaps go to his or her home, and do the necessary follow-up. Under our current system, none of this is paid for and so none (or too little) gets done. In time, failure to manage a chronic condition results in more extreme interventions later, such as loss of vision or limb amputations. Underlying what we know about better management will be information technology that tracks medications and appointments as well as the best thinking about how to treat chronic conditions.

· The results of these investments, and the system for managing chronic disease, should be made available to every Vermonter, including those on private insurance, those in publicly-financed health care programs and those currently without insurance. This is simply a matter of getting better value for our health care dollar.

How does this system differ from an HMO?

It’s dramatically different. In an HMO, doctors need to get approval from the HMO to provide treatment to patients. HMO’s are in the position of constantly second-guessing decisions that should be made between doctors and patients. In effect, the HMO is like a door through which doctors and patients have to walk in order for the patient to receive treatment. This system opens that door and gives decision-making power back to where it belongs: to doctors and patients.

Is there a cost to small business?

Unlike the Governor’s plan, this plan does not rely on employers who are already doing the right thing by providing health care to their employees. The Governor’s proposal amounts to a $45 million cost shift to these employers.

What happened to last year’s bill (H.524)? Why not just pass it again?

Our goal is to make progress for Vermonters. This bill is a significant step forward – it covers the uninsured, establishes an exemplary system of chronic disease management, and sets a foundation for future reforms.

Where do we go from here?

This is the beginning, not the end, of health care reform in Vermont. This bill focuses our first step where costs are greatest – the care of Vermonters with chronic illnesses – and where the need is greatest – the uninsured. There is more to be done but I believe that these changes make substantial improvements today and create the right foundation to continue to address the twin challenges of access and affordability.

Capitol Comments, January 17, 2006

Greetings All,

The session started off incredibly quickly and, from my perspective disappointingly, with the rejection of the strict liability amendment to the Farmer Liability Act. The bill will now go to a conference committee where it has a chance of being strengthened.

Judge Cashman. There are always one or two issues each session that catch us by surprise and I think Judge Cashman has given us the 2006 version. Judge Cashman has made good and important points about the lack of sentencing and treatment options for sex offenders and has set off a public debate that we absolutely need to have. Unfortunately, his decision has been mischaracterized by the media and by some elected officials. Sadly, this all seems to ignore the fact that a young girl has been violated in the worst possible way, by a person she trusted. I am, as always, interested in your thoughts.

Property Taxes. Now that Im on the Ways and Means Committee, I have the advantage of much more information on this issue than I had last year. We have heard briefly from the administration on their proposal to reduce income sensitivity. This would have the effect of increasing the property tax burden on people whose incomes are below $110,000 and reduce the burden on those whose incomes are over $110,000. Based on the information weve received from the legislatures own economist, I could not support such a change. In fact, it moves us further away from an income-based source of funds for education and appears to penalize exactly those people who are getting the smallest share of our economic growth.

Health Care. We received a preliminary report from our consultant Dr. Thorpe this past week. He suggests building on the initiatives in chronic disease management and making this new model of care available to every Vermonter, whether uninsured, privately insured or insured through a public-financed program such as Medicare or Medicaid. There are many issues still to be resolved but my goal is to find a way to make real progress this year. A proposal like Dr. Thorpes, which builds on the Governors proposal and improves on it, may be the best way to do this.

Public Records. Rep. Tony Klein and I have introduced a bill that would restrict the use of the so-called deliberative process privilege which is increasingly being relied on by the executive branch to withhold records from the public. In addition to several news articles, there was also a positive editorial this past week in the Burlington Free Press. The bill will be the subject of testimony this coming week.

Local issues. Good news for two local projects! Marshfield received a transportation enhancement grant of $188,000 for the historic Martin covered bridge. This is a great project which will include a recreation path providing access to the Cross Vermont Trail. The Kent Museum also received an enhancement grant in the amount of $190,000. This moves us closer to an eventual opening date for the Museum. These are important local projects, both receiving significant state support.

Capitol Comment. December 11, 2005

Committee Assignment. The Speaker has made several changes in committee assignments. As a result, I will move to the House Ways and Means Committee. I will continue on the Health Care Reform Commission and the plan is that I will be working on Health Care on my new committee. If anything, this new assignment will be even more challenging and I am really excited about being able to work on this issue from a different perspective.

GMO Liability. Many of you have written to me about the Farmer Protection or GMO liability bill. It will be one of the first issues debated in January. I am planning to vote for the strict liability amendment that will be offered on the floor – I feel that farmers should not have to defend against the consequences of a product they don’t even own.

Civil Commitment. The House Judiciary Committee has been holding hearings on the administration’s proposed civil commitment procedure for sexual and violent offenders. This is a process that would commit sexual and violent offenders to further confinement after they have served their prison terms. Although 15 states have such a program for sex offenders, Vermont would be the first to civilly commit violent offenders.

The administration’s fiscal analysis of their proposal projects 19 inmates over the next 10 years at a maximum annual cost of $597,000. The legislature’s own analysis suggests that these estimates are low. In North Dakota, for example, 28 persons are civilly committed at an annual cost of $3.8 million. North Dakota does not target violent offenders. In Virginia, ten offenders were committed at a first year cost of $6 million.

This is a program that would require substantial state funds for a very small group of people. Finding these funds may require doing less in some important areas, such as support for victims, community notification and enhanced monitoring.

There is also the significant question whether a person who has served his sentence should be incarcerated because of a risk of future danger.

This is a tough issue. I’m likely to vote against the proposal as it’s been presented by the administration. I would very much like to hear your thoughts.

Good wishes: For those who observe Christmas, may it be merry. And for everyone, I offer my hope for peace and good health now and in the New Year.

Capitol Comment. October 30, 2005

Health Care Reform Public Engagement Meeting. You are invited to participate in a public engagement meeting beginning at 6:30 PM on Tuesday, November 1 at the Barre Technical Center and Spaulding High School Auditorium. This is the sixth and last of our sessions around the state. We are using a somewhat different approach than a traditional hearing, which has allowed us to have a real dialog with Vermonters about health care. The exchange of information has been informative and lively. I hope you'll attend!

Governor's Health Care Summit. Here is my perspective on the Governor's Health Care Summit which I attended a couple of weeks ago. While the list of attendees was weighed in favor of business interests, the actual presentations and the reports back from table discussions were quite balanced. There was broad agreement that we should tackle chronic care, encourage wellness and prevention, support information technology, and control health care costs. In fact, these were all addressed in H.524 which was vetoed by the Governor.

There wasn't agreement that this was all we should do. Many speakers suggested disconnecting employment from health care. Many also suggested that every Vermonter should have health care coverage. Many suggested that terms like single payer and rationing distract us from the real question: what system will best assure that Vermonters have access to the care they need when they need it.

The most encouraging moment of the summit for me was to look around the room at 200 or so community and business leaders and see everyone actively engaged in a discussion about their hopes and fears about health care reform. It seems to me that change is inevitable. My hope is that we will be able to move beyond the easy issues and listen to what Vermonters are telling us.

Eminent Domain. I will be cosponsoring a bill that would limit the use of eminent domain to confer a private benefit on a particular private party or for the purposes of economic development, (with an exception for urban renewal). This is in response to the Kelo v. New London case decided by the US Supreme Court this summer, which held that the US Constitution does not prohibit states from taking private property for purposes of economic development.

On a personal note. In case I had any doubts, the number and intensity of meetings and conferences and events confirm that summer is over and the next legislative session is about to begin. I'm looking forward to it!

Janet

Capitol Comment July 14, 2005

Dear Friends and Neighbors,

Here are some highlights of legislation passed this year. Please feel free to contact me if you have any comments or questions about these or any other legislative initiatives.

Health Care. As a first step, beginning July 2006, Green Mountain Health would provide primary and preventive health care coverage to all uninsured Vermonters who don't qualify for Medicaid. Upon meeting certain cost containment and performance benchmarks Green Mountain Health would expand to offer: primary and preventive health care coverage to all Vermonters in July 2007; hospital coverage to all Vermonters in October 2008; and a common benefit to all Vermonters in July 2009.
Cost control initiatives address financing, delivery, and quality of health services. These include the expansion of primary care health centers and free clinics, more stringent control of hospital budgets, improving the management of chronic disease and financial support for integrated systems of care.
Financing for Green Mountain Health is based on the conviction that everyone should have health care, and everyone should help pay for it. Employers will pay a "health effort tax" which is calculated by taking 1% of payroll for the first $50,000 and 3% of the remainder and then subtracting whatever is spent on health benefits. For most employers who provide benefits, the health effort tax will be zero.
Individuals without health coverage would have their "health effort tax" calculated at 1% of their adjusted gross income.
A legislative Commission on Health Care Reform will be established. The Commission will enable health care reform to make progress even in the face of a veto of H.524. Vermonters will have opportunities to provide input through a public engagement process through the summer and fall of 2005. Studies will be conducted with the Commission's oversight during the summer of 2005 to examine economic impacts, financing options, governance, and administration of Green Mountain Health.

Transportation. Vermont's infrastructure of roads and bridges is in need of more funding than is currently available. Our paving budget is less than half of what it would need to be to keep pace with road deterioration. Our investment in bridge re-decking should be doubled if we are to avoid very costly bridge replacements in the not-too-distant future. The legislature's transportation budget made a start at increasing funding for paving and bridge maintenance on local and state roads. It also established a new program within the transportation agency to address bridge maintenance. Through this program, VTrans will fund repairs to bridges before the bridges become so damaged that they need more costly full replacements.

The legislature also supported the needs of our public transit providers who are increasingly serving our senior citizens, and whose operating costs are escalating dramatically due to increasing gas and insurance costs.

Farmer Protection Act. The Senate's version of the Farmer Protection Act would place strict liability on the manufacturer of genetically modified seeds (GMOs) in the event that the genetic material spread to another farmer's crop and caused an economic loss. The Agriculture and Judiciary committees of the House took hours of testimony and decided instead that Vermont farmers should be protected as consumers of seed and other agricultural goods. This consumer protection affords a higher level of protection than current law, but doesn't reach the strict liability standard of the Senate version. This proposal will be up for a vote by the full House when the legislature reconvenes in January 2006.

Budget. The 2006 state budget is balanced and our "rainy day" reserves are filled. The general fund growth was held to 4%. The budget does not shift fiscal burden onto local communities, it invests in Vermont's future growth and it protects our vulnerable and aging Vermonters.

The budget lives up to promises to our communities by removing arbitrary caps on the state's share of special education costs, adding money to pave town and state highways and to repair failing bridges, and not diverting funds from the Education Fund as had been proposed by the administration.

One of the most difficult budget challenges was the $80M shortfall in Medicaid, driven primarily by federal cutbacks and increasing health care costs. House and Senate budget writers worked closely with the Douglas administration all winter to address this deficit. The administration has been negotiating a waiver with the federal government throughout the past five months. Their deficit reduction plan relies over time on that waiver.

Renewable Energy. The Renewable Energy Bill, sets out a goal that Vermont meets all its growth in electricity usage from 2005 to 2013 with renewable energy resources and efficiency. It also includes incentives for investment in energy efficiency and conservation.

This legislation will reduce our need to purchase electricity during peak demand, through efficiency measures and by generating more electricity in state. This will help keep electricity rates lower than they otherwise would have been and it will help lower the total energy bill for the State. In addition, by producing our own electricity we keep money in Vermont to support our economy, create good paying jobs and protect the environment.

Education Finance. Recognizing that Act 68 was recently adopted, the legislature approached education funding this session with the notion that it would iron out the troublesome aspects of the law, but would not fundamentally change the financing mechanisms. H. 504 raises the income sensitivity eligibility ceiling from $75,000 to $85,000 in 2007 and $90,000 in 2008. This ceiling had not been lifted since Act 60 was adopted. Because of wage inflation, many who were eligible to pay for education based on income when Act 60 was first passed were no longer able to do. The bill also raises the amount of the household value that can be used in the income sensitivity calculation to $200,000 for those whose incomes are above the ceiling.

H 504 also recognizes the difficulties that listers and appraisers are having in this market maintaining the grand lists that are the basis for the education funding system. The bill provides funding for lister training. The bill also recognizes that because of the growth in property values, towns need to appraise more frequently. Currently towns are appropriated $6.50 per parcel to assist them with their reappraisals. The bill increases that amount to $8.50 to live up to the state's commitment to reimburse towns for approximately 50% of their reappraisals.

Finally, the bill removes statutory caps that limit the amount that towns are reimbursed for the costs of special education. Currently, the state pledges to reimburse schools for approximately 60% of their eligible special education expenses. However if the rate of inflation for the aggregate special education spending is too high, the state reduces its reimbursement percentage for special education at all schools. This cap was instituted as a method to keep special education costs down, but it has the effect of reducing reimbursement to school districts even if they have kept their special education spending under control. This blunt instrument has been removed. The House Education committee will be looking at more effective methods of reducing special education spending next year.

Extensive testimony was taken regarding the Common Level of Appraisal ("CLA"). The legislature considered a number of options to address the impact of the CLA. Many legislators suggested that the legislature adopt a method of appraising property called the replacement cost method. The bill authorizes a study of a replacement cost appraisal method to see if this method could be used to alleviate pressures resulting from the frothy property market. The study will also determine what the impact of the reappraisal method would have on the education fund.

Minimum Wage. About 15,000 Vermonters will see an increase in their paychecks starting January 1, 2006. That's because the Legislature approved a 25-cent hourly increase in the minimum wage from the current $7.00 to $7.25. Beginning in 2007, the minimum wage will keep pace with inflation through an annual cost-of-living (COLA) increase. This is the first time a COLA has been added to the minimum wage in Vermont. The COLA is based on the national Consumer Price Index, which is presently 2.5%.

Smoking Ban. H.241 removes the cabaret and private club exemptions that were part of the clean indoor air law of 1992. As of September 1, 2005, all private clubs, bars and restaurants in Vermont are to be smoke free. This is a significant achievement for the health of Vermonters.

Capitol Comment June 14, 2005

Hello All,

Here are my thoughts on the budget impasse. The budget passed overwhelmingly in the House, with a strong bi-partisan vote. The vote in the Senate was similar. Very late in the negotiations, the administration voiced concerns about the section of the budget dealing with the Vermont State College labor dispute. That section does two things: it requires the parties to continue to negotiate over the retirement benefits and sends them to binding arbitration if the talks fail. It also changes the statute that gives the legislature the final word in VSC labor disputes.

I think the rhetoric on this issue has been unfortunate. This section of the budget was a reasonable response to the situation, especially given the fact that current law gives the legislature the final say over Vermont State College negotiations. However, the VSC union is recommending that the faculty retreat on the issue. In spite of all that, it looks as if we will be back at the State House on June 16 to deal with a governor's veto and to ensure that state government can operate.

The veto on health care, while not unexpected, is also disappointing. Our Health Care Committee worked long and hard on a roadmap to move us closer to universal (which is not necessarily single payer) health care. The final bill is a modest first step, raising $40 million from those who don't currently contribute in order to make primary and preventive care available to those without insurance. Any expansion of Green Mountain Health will require a determination that certain benchmarks are met and will take several years as well as further action by the legislature.

In spite of the promised veto, we will continue to work on the issue over the summer and fall and, in particular, want to hear from Vermonters about their wishes and concerns. There will also be studies on financing options and the potential economic impacts of health care reform.

On a more positive note, the home health bill that I reported on the floor the last week of the session passed the House on a voice vote, then went to a Conference Committee where our differences with the Senate were worked out. The bill is now on its way to the governor's desk and as far as I know, the bill will be signed. The bill addresses the issues raised by the Department of Justice investigation and permits some competition in a highly regulated environment. Overall, the bill is a strong endorsement of our current system of providing home health care.

I will be writing a longer note on several issues that were dealt with at the close of the session as soon as the budget impasse is resolved. Please let me know if there are particular issues you'd like to hear about. I am happy to explain the positions I've taken.

Capitol Comment May 30, 2005

Hello All,
Finally, the session seems to be coming to an end - there is less time in committee and work on the floor comes in fits and starts. I think everyone is ready.

At the same time, there are still some pressing issues in front of us: health care, advanced directives, dry cask storage, farmer liability, home health agencies, Medicaid and other budget issues. I'm sure I've left out a few but it's clear there is a great deal of work remaining.

I have been continuing my work on health care. I've attended all of the health care Conference Committee meetings and members of our committee are very involved behind the scenes. I am still hopeful that we will do something that responsibly begins to address our very major problems with health care, not just for the uninsured but also for those who may have insurance but still can't access health care because of high deductibles.

Our committee has spent the past few weeks taking testimony on the Home Health Agencies and the legislation that would address issues raised by the Department of Justice investigation. I've been asked to report the bill on the floor - I'm especially honored because it is an important and complex piece of legislation.

Our bill recognizes the positive contribution of the existing homes health agencies, addresses the issues in the Department of Justice's anti-trust investigation, and permits limited competition in some specific circumstances. The pending Certificate of Need for Professional Nurses Services is not affected. The Vermont Assembly of Home Health Agencies has said that they are pleased with the results.

On local issues, the Marshfield Village water system received $200,000 in the capital bill and the Kent Museum received a total of $280,000 (assuming that a grant application is successful). There is money as well for broadband grants (although the more immediate good news is that the Marshfield/Plainfield/Calais effort will receive money through Senator Leahy's efforts).

Many of you have asked about the status of the Iraq Resolution. It is in the Senate and again, the committee is split. Ben Scotch has been keeping me up to date on what is happening with it.

Many of you have kept in touch during the session with your concerns - sometimes personal and sometimes policy. I can't tell you how much I appreciate the communication I have with you - it makes this experience so much more meaningful. Please continue to keep in touch: You can reach me at janetancel@earthlink.net or jancel@leg.state.vt.us or call 2235350(H) or 828-2228 where you can leave a message.

Capitol Comment May 1, 2005

Hello All,

We’re beginning the home stretch for the legislative session – at least I hope we are – and there is much more floor action and less committee work. I spent much of last week observing the Senate’s work on the Health Care bill. My primary concern is that there isn’t a clear statement of commitment to public funding of a package of health care benefits for every Vermonter. Instead, their approach relies to a much greater extent on the insurance market and addresses only the uninsured without considering the impact of under-insurance on a growing number of Vermonters. For the time being, I am withholding judgment and I am eager to see what the coming week brings.

Some other highlights:

The House Agriculture Committee continues to work on the Farmer Protection Act. Getting the bill out of the committee won’t be easy because they are split on the issue. I’ve talked to members of the committee and offered encouragement and support. This may be something that won’t get resolved until the closing days of the session.

The House Appropriations Committee has voted on a one-year Medicaid funding solution. This is really just for one year and relies on increased revenues to fund the shortfall as well as a reduction in provider payments (although substantially less than the administration’s proposed reductions). Many of us feel that Medicaid changes need to be part of larger health care reform.

We have also been briefed on the administration’s newest effort at negotiating a global Medicaid waiver from the federal government. There are advantages and disadvantages to the latest proposal but it is very difficult to analyze constructively without knowing what baseline and what growth rate the federal government will agree to.

I am sure you all have seen the reports of the East Montpelier’s Selectboard’s decision to put a signal at the Rte 14/Rte 2 intersection. I had hoped that there would be more consideration of a roundabout but ultimately the decision is East Montpelier’s and I assume that timing and safety were primary concerns.

The legislation on Renewable Portfolio Standards passed the House last week. The bill relies on renewable energy credits rather than standards as a mechanism to achieve a sufficient percentage of renewable energy but would enact standards if the credits don’t work. I was convinced by the House Natural Resources Committee presentation that this was a better way to go. The bill will now go back to the Senate and a Conference Committee will probably be appointed.

The resolution on the Iraq War (which I cosponsored) has received attention in the House General Committee but as you may have read is opposed by Adjutant General Martha Rainville. I am not sure whether it will be sent to the floor.

The Senate version of the Capitol Construction bill does not include money for broadband grants. This will be a subject of discussion in the Conference Committee where differences between the House and Senate are worked out.

At the request of a constituent, I introduced a bill that would permit a person to obtain after-market tinted glass for the driver and passenger side windows when there is a medical need for tinted glass. The bill was approved by the House Transportation Committee and will be on the House floor for action on Tuesday. It is strongly supported by the Lupus Foundation since individuals with lupus cannot be exposed to the sun and in some cases sunblock and clothing do not provide sufficient protection.

Also at the request of a constituent, I introduced a bill that would establish an ongoing committee to advise and set policy on chemical sensitivities and particularly the use of carpeting in state buildings. It looks like the bill will get a hearing in the House Institutions Committee sometime next week.

Please keep in touch! As the session comes to an end, there are always issues that come up very quickly -- your thoughts are important to me. You can use this email or jancel@leg.state.vt.us or call me at 223-5350. If you need to find me during the week, call 828-2228 and leave a message with the Sergeant at Arms.

Capitol Comment April 16, 2005

First, a personal note: I broke my arm cross-country skiing almost four weeks ago (at least I was having fun!) and am discovering how awkward it is to type or work on the computer with a cast on. So, for anyone who has written and hasn’t heard back from me, please resend and I’ll do my best to respond quickly. And for all those who eagerly await these notes, my apologies for the recent silence.

This will be a big week at the State House for Health Care. Our committee voted a bill out on April 8 and we have spent this past week working with other House committees on their questions and concerns. Next week will be the floor debate in the House. I’ve been assigned to report the sections dealing with reorganization of state government and with medical malpractice – both will be controversial so my first report on the floor should be exciting!

I attended the public hearing on the Death with Dignity legislation and was very moved by people who spoke on both sides of the issue. It seems unlikely that the House will vote on the bill this year but instead will continue to work on it this summer and fall.

On a few local issues: The Capitol Bill (as voted out by Senate Institutions) has money for the Marshfield water system ($200th) and the Kent Museum (total of $180th). These amounts will be considered in Senate Appropriations and then by the full Senate, after which they go back to the House for the final conference committee. Senator Phil Scott has been very supportive and helpful but there is still a ways to go.

Given the attention on Health Care, I wanted to give you some of my thoughts about the bill. H.524 sets out a vision for universal health care and a roadmap to get us there. Two important questions will wait until next year: what should the package of essential services (primary care/prevention and hospital care) consist of and how much are Vermonters willing to pay? The bill calls for an ambitious process to engage Vermonters in a discussion of these issues.

The timetable calls for implementation of universal coverage for primary care and prevention by July 1, 2007 and hospital care by October 1, 2007. Other essential services (such as prescription drug coverage) will be made available by July 1, 2009.

There has been considerable misinformation about the cost of universal health care. Public financing of health care (primarily through broad-based taxes) will take the place of current systems of funding, specifically premiums and property taxes. Health care reform won’t lower the costs of health care but we believe it will reduce the rate of growth. Significantly, of the $3.4 billion spent on health care in Vermont in 2004, about half came from tax revenue. This includes Medicaid, Medicare, and state and local taxes to provide health care for state employees, school employees and municipal employees. We currently have a public/private system of financing and that will continue – although in substantially different proportions – when universal care is fully implemented.

I am convinced that our system is in crisis and that we will not begin to bring costs down and make universal access a reality until we move away from the current system that depends largely on the insurance market and employment status.

On our committee wall, we have a sign: “Insanity is defined as doing the same thing in the same way over and over and expecting a different result.” Shoring up the insurance system and depending on the “market’ to solve our health care crisis fits that definition. No system is perfect and there will be many challenges along the way. But leaving things as they are is not an option.

Legislative Report. March 13. 2005

Health Care. Now that Town Meeting week has passed, the legislative session is moving into higher gear. In the Health Care Committee – where I seem to be spending ALL my time – we are beginning to establish a framework for this year’s proposals and next. There is a consensus on the committee to support a publicly financed universal health care system with various tools to control costs, including global budgets for hospitals. I think we are all convinced that we need to create a system for health care in order to bring the growth in health care costs under control.

The public hearing on health care was very well attended and we received the strong message that Vermonters want us to be bold and courageous while taking care not to do harm to those areas that are working well. For those of you who are interested in learning more about the challenges and opportunities we have in Vermont, I strongly recommend reading the new book by Con Hogan and Dr. Deb Richter, At the Crossroads: the Future of Health Care in Vermont.

Education Fund. I want to address an issue that came up at Town Meeting: the question of using the Education Fund for non-education purposes. The House Appropriations Committee has heard from many of us that the Education Fund should be used for education purposes and not for other parts of state government, no matter how worthy.

The likely exceptions are lister training which one could argue is a local education expense and Adult Education. The Governor’s budget includes other items such as Corrections Department education expenses and an appropriation to the state Vision computer system. The Appropriations Committee is spending this week and next putting together their version of the budget so I don’t have final information on what we will be voting on in the House.

Route 14/Route 2. Many of you have identified the Route 14/Route 2 intersection as a high priority. It is quite dangerous and the waits, especially on the Route 2 side, can be quite long. I’ve been told that the traffic signal project is on the list to begin next year. It is a substantial project, not just signals but a reconfiguration of the road as well. And for those of you who missed the announcement, Route 2 between Plainfield and Marshfield is first on the list for spring paving projects this year.

Other legislative issues: We will be voting on a minimum wage bill sometime in the next week or two – at least the plan is for House General Committee to vote the bill out soon. The advance directives bill has come out of the House Human Services Committee and gone to the Judiciary Committee.

Legislative Pages. We are very fortunate to have a legislative page from Twinfield this year – Elsa Raker from Marshfield. Elsa has been doing a great job. Being a page is a wonderful opportunity for an 8th-grader to learn about our state and state government first hand. If you know of someone who might be interested for next year’s group – 7th-graders now – let me know. There is a process for selection that starts with the Sergeant at Arms.

Legislative Report – March,11 - 2005

Health Care Reform

Vermont’s health care system is at the point of collapse. It is fairly easy to state the problem: health care costs too much and too many people do not have insurance coverage. In Vermont, there are 63,000 people with no coverage at all; an additional 40,000 have no coverage for prescription drugs. Health care costs are rising 9-10% per year, more than double the rate of inflation. Even people who have health insurance may find that health care is inaccessible because of high deductibles and copays.

Speaker Symington has reshuffled the House committee structure and created a new panel – called the Health Care Committee – to focus exclusively on health care reform. An important first step was the recently passed law that will allow Vermonters to purchase safe affordable prescription drugs from Canada and the United Kingdom. Other steps will follow.

One thing we know is that comprehensive health care reform will not be easy; if it were, we would have done it by now. Health care is a $3.2 billion industry in Vermont. Efforts to enact meaningful reform will need to proceed carefully, with significant input from many people -- consumers and providers, doctors and hospitals, businesses and employees, just to name a few. Some components that are likely to be included in a reform package are:

Make primary and preventive care more available to more people and, eventually, to everyone
Provide incentives for people to live healthier lifestyles
Work with hospitals to maintain quality care, but keep costs under control
Reduce paperwork, claims hassles, and administrative overhead
Address the availability and costs of long-term and end-of-life care
Encourage more effective care for people with chronic illnesses like diabetes and heart disease
Lower the costs of health care insurance premiums
The first pieces of a comprehensive plan will emerge by May. Extended conversations with Vermonters over the summer and fall will fill in the details and provide a sense of whether people believe the proposals are heading in the right directions.

State Budget

The state budget outlook is mixed and contains significant long-term challenges that need immediate attention if drastic cuts in important state programs are to be avoided in the coming years. The good news is that the economy is growing and revenue is exceeding expectations. The bad news is that federal cuts coupled with the growing crisis in health care have put the state in financial peril.

In almost every area of state government, the federal government has reduced grants, cut programs, and audited state spending resulting in disallowed expenditures that had been approved in the past. As a result, the Department of Employment and Training is contemplating office closures, funding for 10 state police positions has been eliminated, clean water funds have been significantly reduced, and cuts in funding for health care programs are numerous.

Vermont's system of comprehensive public health care programs, including Medicaid, have long provided important services to our children, low income adults with children, the working poor, the disabled and the elderly. That system is now at the point of collapse with familiar problems challenging the system. The cost of health insurance continues to rise dramatically. Utilization is up, pharmacy costs are out of control and an aging population requires more and expensive health care. Revenue to support these programs – federal funds and the cigarette tax – is declining dramatically. As a result, the deficit in Vermont’s health access trust fund for 2006 is over $70 million dollars and, if unchecked, it will grow to over $300 million by 2009. The governor has proposed to fix this problem by charging beneficiaries more, reducing payments to doctors, hospitals, dentists and nursing homes and trying to negotiate a block grant with the federal government.

To balance the budget the governor has also proposed cuts in housing programs for the elderly, the Legal Aid budget, programs for Vermonters with developmental disabilities, and the teacher's retirement system, just to name a few. The legislature will be challenged to find ways to develop a budget that is both balanced and fair but we remain committed not to balance the budget on the backs of the most vulnerable Vermonters.

Education Funding

The legislature has approved an eight-cent reduction in education property taxes in both the residential or non-residential rate. The bill also lowered the rate from 2% to 1.85% for Vermonters who pay their education taxes based on their income. These cuts reduce property taxes by approximately $44 million. These tax rate reductions prudently maintain an education reserve of 3.5 to 5%. After school budget votes on Town Meeting Day the legislature will have more accurate information to see if there is excess revenue and whether further property tax cuts are warranted.

Some additional areas the Ways and Means Committee is examining include:

State reimbursement of Special Education -- Using a formula created in 2000 the administration is planning on reducing the amount of money it will reimburse to all towns for Special Ed by approximately $4 million. This shifts the burden to the local level, increasing education taxes. The committee is examining whether such a penalty, based on an out-dated and artificial formula, is fair and appropriate.

Increasing The Reappraisal Per Parcel Payment To Towns -- Currently the state sends from the Education Fund $7.00 per parcel to every town to offset the cost of reappraisal. While the need for and costs of reappraisals have increased dramatically since this was enacted in 1997, the payment has not grown. It is now estimated that the average cost of a reappraisal is from $60 to $120 per parcel. The committee is examining raising the payment, which would result in lower municipal property taxes.

Mitigating the Impact of the Common Level Of Appraisal (CLA) -- The committee has spent a significant amount of time examining the equalization process known as the CLA. There is a general agreement that, in order to ensure fairness from town to town, there needs to be a process by which all property is assessed at 100% of fair market value. Because many towns do not reappraise their property on a yearly basis, the CLA is used to equalize to the property values in those towns. The committee is examining ways to mitigate the effect of high property values, school budget increases, and the need to equalize property values.

Rural Economic Development Working Group

The Speaker of the House has identified rural economic development as a priority issue and has established a working group of legislators to identify these emerging possibilities. The group meets once a week to hear from Vermonters who have been working in a specific area and ultimately to develop legislation to support these efforts. Areas of particular interest are expansion of telecommunications and broadband to rural areas, promoting value added agriculture and forestry, and enhancing cultural life. The group will also look into work force development, downtowns, villages and growth centers, housing, specialty products and small businesses, heritage trails and many other initiatives.

Transportation

Vermont’s transportation system is facing significant challenges in the years ahead. Deferred maintenance has resulted in a serious infrastructure crisis in Vermont.

Most of the legislature’s work to date has been dedicated to funding issues. The House has approved legislation that advances over $3 million dollars in early paving projects as well as to fund the emergency relief road repairs that communities incurred after this summer’s flood damage. Early paving allows the Agency of Transportation to begin the bidding and construction process earlier in the construction season thereby saving the state money.

Despite this savings, the budget challenges to our transportation system continue to grow while infrastructure rapidly deteriorates. For example, many bridges -- on local, state, and interstate highways -- have far exceeded their design lifespan. Furthermore, thirty five percent of Vermont’s state roads are classified as either "poor" to "very poor."

The legislature is working hard to meet these challenges. We are examining innovative financing opportunities in order to address the growing imbalance between anticipated expenditures and forecasted revenues. We are also working to support the needs of our public transit providers who are increasingly serving our senior citizens, and whose operating costs are escalating dramatically due to increasing gas and insurance costs.

The challenges are many, but Vermont’s transportation infrastructure is of central importance to the state’s economy and the quality of life of its citizens.

Legislative Report
February 15, 2005

The Drug Reimportation bill passed the House 129-8 after two long days of debate. Several amendments were proposed but none passed. The bill now goes to the Senate which has already indicated that it will agree with the House changes. This is unusual but it's an indication that everyone is ready to have this program begin as quickly as possible. We are hoping to have information available to distribute on I-Save RX, the Reimportation program, by Town Meeting Day.

My role in the debate was to serve as the committee's point person on the legal and liability issues, which gave me my first opportunity to speak on a bill on the House floor. Although I've spent years in the State House, it is a thrilling experience to actually have a voice there on an issue that will make a difference in people's lives.

In the Health Care committee, we are continuing to hear from people who have a special expertise and experience in health care - giving us more grounding in the issues and the challenges.

Medicaid is both a reason for change and a barrier. The Douglas administration is negotiating with the federal government for a 5-year block grant which would guarantee a level of funding and additional flexibility but would also cap the federal government's contribution. Many legislators, including myself, are concerned about the effect of a Medicaid block grant and will be watching this effort closely. Flexibilty is great but capping the federal Medicaid contribution may be too risky a trade-off.

On other fronts: The House Appropriations Committee will hear from Vermont citizens, including advocacy groups, on the fiscal year 2006 appropriations on Wednesday, February 23, 2005 from 1:30 p.m. to 4:30 p.m. in Room 11 at the State House. Testimony will be scheduled in advance for 5-minute intervals. To reserve a time slot, call 802/828-2251.

I will be stopping by to say hello and answer questions at Town Meeting, first in Marshfield, then Plainfield and ending in Calais. I hope to see you there. In the meantime, call me at 828-2228 and leave a message during the week, or at 223-5350 evenings or weekends, or email me at janetancel@earthlink.net or jancel@leg.state.vt.us. I enjoy hearing from you!

Janet

Legislative Report – January 22, 2005

This past week included our first floor votes of the session. Of special interest was a bill that lowered the statewide property tax rates for residential property to $1.02 and for nonresidential property to $1.51. The bill is the result of a mechanism in Act 68 that requires lowering the property tax rates in the event of a surplus in the education fund. In addition to lowering the tax rates, the bill reduces the percentage of income a person will pay under income sensitivity from 2% to 1.85%. The bill passed the House on a voice vote.

There is a surplus in the fund because property values are still increasing at double-digit rates. What this means is that the common level of appraisal will continue to negatively impact property tax bills in spite of the lower rates. A bill has been introduced in the Senate to eliminate the common level of appraisal and require instead a rolling system of reappraisals on a three-year cycle. While Act 68 definitely brought improvements in our system of education funding, we need a predictable and fair way to account for changes in fair market value and differences in appraisal timing and standards.

In the Health Care Finance Committee, we continued to take testimony on drug re-importation and on health care generally. We heard a presentation on Medicaid and the new Medicare prescription drug plan (which raised many more questions than it answered) and Secretary Charles Smith presented the administration’s plan to deal with the Medicaid deficit. In addition, representatives from the pharmaceutical industry appeared before the committee to present their concerns about mail-order prescriptions and drug safety. They have been asked for data to support their assertion that drugs re-imported from Canada present unacceptable risks to consumers.

On local issues, I have expressed concern to Secretary Terrill about the administration’s plan to reduce the number of AOT districts, which would specifically impact Washington County. This is an issue for several counties and will be carefully scrutinized by the legislature.

And, ending on a positive note, the Kent Museum would receive $250,000 under the Governor’s proposed Capital Bill. This, along with an ADA grant, should be sufficient to open the doors by 2007. There will be the inevitable negotiations between the different committees but we have never before started the session with this substantial an amount in the Capital Bill.

Legislative Report – January 22, 2005

Legislative Report – January 17

If our first week was full of pomp and ceremony our second was full of meetings and work! It felt good to get down to it.

The Health Care Committee has really hit the ground running with immediate work on a Drug Re-importation Bill. We heard a powerful presentation from Peter Rost, MD, a Marketing Vice-president for Pfizer. He left no doubt that re-importation is the right thing to do – it will not hurt the company, it is done in Europe without safety risks and when the choice is between saving jobs and saving lives, our choice should be saving lives.

I am amazed at the number of invitations a new legislator receives for various events – all advocacy groups wanting to get their story heard. Significant meetings this past week included the Vermont Association of Fire Chiefs, a breakfast with the BI-State Primary Care Association, and lunch with the Commission on Women – each with an important story to tell.

I also had the opportunity to meet with the Plainfield Select Board and to hear directly their concerns and hopes for the session. Property taxes, roads and health care top the list.

And, we heard good news for the restoration of the Kent Museum. According to Buildings Commissioner Tom Torti, the Governor’s budget will include a $250,000 capital budget appropriation!

As always, please keep in touch. You can write to me at Box 123, Calais 05648 or janetancel@earthlink.net. Or call at 223-5350 or leave a message at 828-2228. Your views are important to me.