Vermont Legislature SmartTranscripts:

[Speaker Jill Krowinski]: Will the house please come to order and members kindly take their seats? Good morning. Good morning. In lieu of a devotional today, will you please join me in a moment of silence? Are there any announcements? Seeing oh, member from Fairfax. Member from Fairfax.

[Representative Ashley Bartley (Fairfax)]: I hope the member from Georgia doesn't mind, but today I would like to take a page from her history book. Let us travel back to 2003. Skype had just launched, so many might now consider it a relic of the past. If you were listening to the radio, 50 Cent's in the club sat at number one on the billboard chat charts. And while I was only in third grade, something far more important was happening here in Vermont. The member from Georgia was sworn into this very body. While her legislative service began in 2003, her commitment to Vermont started long before she took oath to this office. The member from Georgia is a lifelong Vermonter, raised on a dairy farm and educated in our public schools. She earned both her bachelor's and master's degree from the University of Vermont and dedicated her early career to education, serving as a teacher in Fairfax and Fairfield before coming becoming a principal in Fairfield. But public service for the member from Georgia has never been confined to one role or one title. She has served her committee or her community as a school board chair, select board chair, town moderator, church leader, historical society member, trustee, volunteer, and advocate. She's lent her time in leadership to organizations supporting housing, health care, food security, history, and community life throughout Franklin County and beyond. In 2010, she was recognized as Vermont Mother of the Year, an honor that speaks volumes about the values she has carried through every chapter of her life. Her her legislative career reflects that same dedication. The member from Georgia served in the house from 2003 to 2016, in the senate from 2017 to 2019, returned to this chamber in 2023 to continue serving the people she loves so dearly. Madam speaker, I had the privilege of meeting the member from Georgia in 2022 when we both announced our candidacies for the house. I was running for the first time, and the member from Georgia was making her return. I still remember sitting at her kitchen table. Before I knew it, a mug of hot tea had been firmly placed in my hand, and she scooped up my daughter and carried on as though we had known each other forever. That was how our partnership has begun as running mates, but over time, we have become so much more than that. My children lovingly call her Nana Carolyn. She's become not only a mentor and a colleague, but a trusted friend and part of our extended family. Oh, boy. And that, madam speaker, may be the greatest testament of who the member from Georgia is. Because beyond titles, beyond the elections, and the years of service, she has always led with kindness, conviction, and care for others. She has shown us that public service is not about recognition. It's about showing up, doing the work, and leading our community better than how you found it. I don't do this. I'm so sorry. To the member from Georgia, thank you. Thank you for your years of service, for your steady leadership, for the history you have helped shape and taught us, and for the example you leave behind for all of us who have had the honor of serving beside you. Madam speaker, I ask the body to join me in recognizing and celebrating the remarkable service and retirement of the member from Georgia, Carolyn Branagan.

[Speaker Jill Krowinski]: We wish you all the best member. Member from Georgia.

[Representative Carolyn Branagan (Georgia)]: Thank you, Madam Speaker. And what a very nice piece to read. Thank you, Ashley. Many of you know that I don't want to leave here. I'm leaving here because similar to what happened to our topper, my husband is sick and so he's starting cancer treatments in July. I need to be home with him. So I don't know how long that will last. I'm 72 now. I may not run again, but you know, I may. So I'm thinking of fees of the TIF districts, current use, Ed Fund. I may be back. So anyway, really, really appreciate your comments. Thank you.

[Speaker Jill Krowinski]: Are there any further announcements? Member from Hartford.

[Unidentified Member from Hartford]: Madam speaker, as we see the end of this session, however dimly in the distance, I'd like to reflect in my year as a newly appointed member. Being appointed to this body was a great honor and privilege. I hope that I'm given the opportunity to come back. I'd like like to thank all the members who've eased my transition from random new guy to actual legislator. You've all been wonderful, and I made many new friendships. I'd like especially to thank the members of the environment committee and its chair in particular for welcoming me and showing me the ropes. My parents served in this body and for the executive branch of Vermont for three decades. I grew up watching them and believing that public service was a sacred undertaking no matter how slow and arduous and frustrating it can be. They would be thrilled to see me here. Madam speaker, I grew up in Norwich, but was born in Lebanon, New Hampshire. I've never forgiven my parents for that. Despite the grievous error, they were great people. They loved Vermont and instilled to me the strong conviction that there's nothing more important than serving your neighbors. Being a human face and connection in what can seem like a vast and confusing labyrinth of government. My mom served up the final year of a resigning legislator's term in 2014. My dad served in the body for nearly ten years in the seventies and eighties before quitting in a huff in 1983 when he was stripped of the chair ship of the judiciary committee. His time here marked him deeply and he had strong convictions about when the body should adjourn. He felt a great irritation if the session stretched past April, and this irritation manifest itself physically. Towards the end of April, it starts suddenly and violently sneezing. First week of May, the tennis elbow and the trick knee began acting up. Longer than that, there'd be steam rolling out of his ears. He was particularly irritated when my mom was secretary of administration. She was stuck here while he was at home. The year act 60 was enacted, he was apoplectic as the session stretched to June. He wrote a letter to our local newspaper disparaging the body and urging a German. He quoted from Oliver Cromwell's speech when with arms for centuries, forcibly dissolved the English rump parliament in 1653. Madam Speaker, may I quote from Lord Cromwell's speech?

[Speaker Jill Krowinski]: You may.

[Unidentified Member from Hartford]: You have sat too long for any good that you have done. In the name of God, go. Thank you, Madam Speaker and members of this body. I hope to work with you again.

[Speaker Jill Krowinski]: Are there any further announcements? Member from Essex.

[Representative Golrang "Rey" Garofano (Essex)]: Madam speaker, I know we are not happy to be still here at the end of May, but I'm really excited that we are here to give special guests that are here in the gallery with us today. Young students from Founders Memorial School, which is my daughter's school, welcome. Please help me welcome them to the State House as they get to watch us in action today.

[Speaker Jill Krowinski]: Will the guest and the member from Essex please rise and be recognized? Are there any further announcements? Mayor Hyde Park.

[Representative Richard Bailey (Hyde Park)]: Madam speaker, could we journalize the comments from the rep from Fairfax, please?

[Speaker Jill Krowinski]: The member from Hyde Park, moves that we journalize the request of the member from fair Fairfax every time. My apologies, Fairfax. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. The ayes appear to have it. The ayes do have it and you have journalized the remarks of the member from Fairfax. Are there any further announcements? Member from Brattleboro.

[Representative Mollie S. Burke (Brattleboro)]: Thank you madam speaker. I hope that members will get a chance to see or maybe you've seen already the big, mural that's in the card room, the work of, a number of members and staff and pages who created small collages having to do with Vermont state symbols or what they deemed to be their own symbols of Vermont and wrote some reflections. And there's some really great things that people wrote and that people made and it's hanging there. The title of it is these Green Hills Vermont State Symbols and Personal Reflections. And thanks to everybody who participated.

[Speaker Jill Krowinski]: Are there any further announcements? Seeing none. Orders of the day. Member, I have an update for you on resolution bill order for this morning. We will start with JRH 12, which is a resolution authorizing remote joint committee voting through the remainder of the calendar year. After that, we will move to house bill nine thirty five, which is an act relating to emergency management. Following that, we will take up house bill nine fifty two, which is an act relating to capital construction and state bonding budget adjustment. Then we will turn to senate bill 64, which is an act relating to amendments to the scope of practice for optometrists. And then finally, we will take up house bill nine forty two, which is an act relating to miscellaneous agricultural subjects. So JRH 12, H nine thirty five, H nine fifty two, S 64, and h nine forty two. So as I said members, we will begin with our joint house resolution 12 which is a joint resolution authorizing remote joint committee voting through the remainder of the calendar year of 2026 and the application of the ADA thereto. This resolution has been read and appears in yesterday's journal. It was introduced by the committee on rules, house committee on rules, member from Essex Junction. Representative Dolan will speak for the committee, member from Essex Junction.

[Representative Karen Dolan (Essex Junction)]: Madam speaker. This joint resolution builds on previous resolutions regarding remote voting. The language before you provides limited flexibility for remote voting and joint legislative committees through the remainder of the calendar year 2026. Under the resolution, members of joint committees may participate and vote remotely for up to three days during the remainder of the calendar year. Members using remote voting must notify the committee chair or co chairs and the committee clerk. And those votes will be recorded as remote votes. The clerk will also track the number of days each member utilizes this authority. Members voting remotely under the resolution will continue to count toward quorum requirements. The resolution also addresses accessibility needs under the Americans with Disabilities Act. Specifically, it allows a member with a disability who is physically present at the site of a joint committee meeting but unable to access the meeting room due to the physical condition of the building or space to participate and vote remotely from the site without using one of their allotted remote voting days. This provision applies in circumstances where the meeting cannot be relocated to an accessible space on-site. This is a limited and targeted resolution intended to provide reasonable flexibility while ensuring committee operations remain transparent, accountable, and accessible. Madam speaker, your house rules committee met yesterday and voted this resolution out favorably on a unanimous vote, and we respectfully request the support from the body.

[Speaker Jill Krowinski]: So the question is, shall the house adopt the resolution on its part? Are you ready for the question? If so, member from Waterbury.

[Representative Thomas Stevens (Waterbury)]: Madam speaker, could I just ask a clarifying question of the presenter of the resolution?

[Speaker Jill Krowinski]: The member from Essex Junction is interrogated.

[Representative Thomas Stevens (Waterbury)]: Madam speaker, the accessibility accommodations, is that only for joint hearings with two committees or with the house and the senate?

[Representative Karen Dolan (Essex Junction)]: Yes. In this resolution specifically, I was anticipating this question. I didn't think to ask. Did we also pass at the same time? I don't know if it was a resolution or a house rule that it's we allow this accessibility piece for other voting as well, but that's separate from this resolution.

[Representative Thomas Stevens (Waterbury)]: Okay. So just to be clear, a member who is in the building but not we've had elevators outages this year and I know in my committee we've had issues with accessibility. So Yes. So that's permissible already.

[Unidentified Member from Essex]: Is that what you're saying?

[Representative Karen Dolan (Essex Junction)]: As of yesterday. Yes.

[Representative Thomas Stevens (Waterbury)]: As of yesterday. Okay. Thank you.

[Speaker Jill Krowinski]: The question is, shall the house adopt the resolution on its part? Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. The ayes appear to have it. The ayes do have it and you have adopted the resolution. Member from Pulte, can you please offer us a motion to suspend our rules to message our action on joint house resolution 12 to the senate forthwith.

[Representative Patricia McCoy (Poultney)]: Madam speaker, I make a motion to suspend rules in order to message our actions on JRF 12 to the senate forthwith.

[Speaker Jill Krowinski]: Member from Pulte moves that we suspend our rules to message our action on JRH 12 to the Senate forthwith. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. The ayes appear to have it. The ayes do have it and you have suspended rules to message our action on JRH 12 to the senate forthwith. Now a member from Pultely on our notice calendar is senate proposal of amendment on house bill nine thirty five which is an act relating to emergency management. Can you please offer us a motion to suspend rules to take up house bill nine thirty five off the notice calendar for immediate consideration?

[Representative Patricia McCoy (Poultney)]: Madam speaker, I make a motion to suspend rules in order to take up off the notice calendar h nine three five for immediate consideration.

[Speaker Jill Krowinski]: The member from Mollie we moves suspend our rules to take up House Bill nine thirty five off the notice calendar for immediate consideration. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. The ayes appear to have it. The ayes do have it and you have suspended rules to take up House Bill nine thirty five for immediate consideration. House bill nine thirty five is an act relating to emergency management. The bill passed the senate in concurrence with a proposal of amendment that is printed in today's calendar. Member from Berkshire.

[Representative Lisa Hango (Berkshire)]: Madam speaker, your house government operations and military affairs committee heard the following amendments to h nine thirty five, an act relating to emergency management proposed by the senate government operations and senate appropriations committees. Section one established the Ready Response Grant program administered through the division of emergency management, funding for which was removed by senate appropriations. Section 13 a spells out that this program is not required to be implemented if the Department of Public Safety does not have funds available, but the statutory language enables the program. Section two established the Technical Rescue Grant Program to assist rescue agencies with the improvement of operational readiness and investment in specialized equipment. Section 2A was added by SGO that the urban search and rescue team program manager will administer the program. With no funding, section 13 a spells out that this program also is not required to be implemented if the agency of administration does not have funds available. While we regret that funding was removed from the bill and ultimately from the budget, we understand that this is a particularly challenging budget cycle and hope that funding sources can be identified for these purposes going forward. Section three adds a new definition in chapter one, emergency management subdivision 13 for terminology that is recognized by both state and federal entities to be inclusive of the disability community as well as other vulnerable populations. Whole community means the collective of residents, emergency management practitioners, organizational and community leaders, and local, state, and federal government officials. Section four directs the division of emergency management when advising on emergency shelter sites that the division and the municipality are to work with the whole community as defined in the previous section. Sections seven through 11 on updating fire statutes remain unchanged. Section 11 is session law that creates the increasing wildland fire response capacity task force, which will determine how best to increase Vermont's capacity to respond to wire land fire emergencies. This task force will be administered by the Department of Forests, Parks, and Recreation, and we will report back to both government operations committees and to the house committee on agriculture, food resiliency, and forestry, and the senate committee on natural resources and energy in February and in July of two twenty twenty seven. The senate also made changes to appropriations in section 12 d by removing the provision for the Department of Public Safety to return to the legislature after three years to request the use of any remaining monies previously appropriated or held in reserve under this section. Lastly, on request of the agency of natural resources, the senate added section 13 c to amend three VSA eight forty four emergency rules, which is part of the Vermont Administrative Procedures Act three VSA chapter 25. This authorizes a state agency during an emergency situation to use the emergency rule making process instead of the normal process if an amendment to a federal stat ute, rule, or policy will materially conflict with or threaten the ability of the agency to implement a statutory or regulatory program required under Vermont law. Please note that emergency rules are valid only for 180, and LCAR can object to the proposed emergency rule on the basis that it does not qualify for emergency rulemaking. Section 13 d is session law titled Sunset of Agency Emergency Rulemaking Authority that will repeal three VSA eight four four h from section 13 c on 07/01/2028. We heard from the reporter of the bill, senate committee on government operations, legislative council, office of legislative council, associate fiscal officer, joint fiscal office. Your government operations and military affairs committee approved this proposal of amendment on a straw poll of eight zero three and respectfully requests your support.

[Speaker Jill Krowinski]: So the question is, shall the house concur in the senate proposal of amendment? Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. Aye. The ayes appear to have it. The ayes do have it and you have concurred in the senate proposal of amendment. Now a member from Pulte on our notice calendar is the committee of conference report on house bill nine fifty two which is an act relating to capital construction and state bonding budget adjustment. Can you please offer us a motion to suspend rules to take up house bill nine fifty two off the notice calendar for immediate consideration?

[Representative Patricia McCoy (Poultney)]: Madam speaker, I make a motion to suspend rules in order to take up h nine five two off the notice calendar for immediate consideration.

[Speaker Jill Krowinski]: The member from Pultely moves that we suspend our rules to take up House Bill nine fifty two off the calendar for immediate consideration. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed please say nay. The ayes appear to have it. The ayes do have it and you have suspended rules to take up House Bill nine fifty two for immediate consideration. House Bill nine fifty two is an act relating to capital construction and state bonding budget adjustment. The bill was referred to the committee of conference on the disagreeing votes of the two chambers. The committee of conference has met and considered the same and recommends that the house adopt its report which is printed in today's calendar. Member from Springfield.

[Representative Alice M. Emmons (Springfield)]: Madam speaker, before you is our conference committee report. We went into conference committee last week with the other body. There were some minor, additions that the other body had done in terms of the money piece. There were a couple of items that they put in that were not eligible for bonded dollars. We agreed to zero those out. And while we were in conference, there was a line item in our corrections piece that dealt with a project that's happening up at the St. Johnsbury facility. And that bid came in about $4,000,000 more than what we had already allocated. So we moved some money around. The biggest piece that occurred was we had money in the three acre parcel for stormwater remediation within the Department of Buildings and General Services. And working with the department, it came to light that they had enough money appropriated from previous capital bills and only needed about half $1,000,000 in this bill. So that freed up quite a bit of money that we could put towards the Saint Johnsbury facility to meet the obligation of the bid that came in. The other piece that the senate put in during testimony when they had the capital bill was work that really need maintenance work that really needs to be done at the current Saint the current Chittenden County facility for the women's facility. There's approximately $1,100,000 that has been put in to do maintenance, particularly in the bathrooms and showers of that facility, and we agreed to that. The other piece that deals with corrections, we had put in money to start the process of installation of Wi Fi within our correctional facilities. We worked both with the Department of Buildings and General Services, the Department of Corrections, as well as the agency of digital digital services to really figure out what we can get accomplished particularly in this next fiscal year. We had put in almost $3,000,000. The senate had cut that to 250,000 and we added on another 500,000 to that. So there's 750,000. And we have language that would, have ADS and DOC and BGS start working on implementation of a plan to start providing Wi Fi installation within our correctional facilities. So next session, we will be spending more time on this particular issue because it is going to be expensive. Outside of that, there's a few language changes. One piece was we have allowed Department of Forests and Parks to enter into a lease with Vermont Huts to renovate a building on Little River State Park. The senate was concerned that we wouldn't have a final say in when that lease was agreed to, so we put in language that the two chairs of the institutions committees would be notified. So Madam Speaker, that is our report of the conference committee. And we ask that the body support its that we support it. Thank you.

[Speaker Jill Krowinski]: The question is, shall the house adopt the report of the committee of conference on its part? Are you ready for the question? If so, all those in favor please say aye. Aye. All those opposed please say nay. The ayes appear to have it. The ayes do have it and you have the ayes do have it and the report of the committee of conference is adopted. Next up, member from Pulteney on our notice calendar is Senate Bill 64 which is an act relating to amendments to the scope of practice for optometrist. Can you please offer us a motion to suspend rules to take up senate bill 64 off the notice calendar for immediate consideration?

[Representative Patricia McCoy (Poultney)]: Madam speaker, I make a motion to suspend rules in order to take up off the notice calendar for immediate consideration s 64.

[Speaker Jill Krowinski]: The member from Pulte moves that we suspend our rules to take up senate bill 64 off the notice calendar for immediate consideration. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. No. The ayes appear to have it. The ayes do have it, and you have suspended rules take up senate bill 64 up for immediate consideration. Senate bill 64 is an act relating to amendments to the scope of practice for optometrists. The bill was referred to the committee on healthcare which recommends that the bill ought to pass in concurrence. The member from Barrytown, representative Susie will speak for the committee. The bill was then committed to the committee on government operations and military affairs which also recommends that the bill ought to pass in concurrence. The member from Bergen's representative Birong will speak for that committee. And then affecting the revenue of the state, the bill was referred to the committee on ways and means which also recommends that the bill ought to pass in concurrence. The member from the member from Barrie City, representative will speak for that committee. And the committee on appropriations which also recommends that the bill ought to pass in concurrence. The member from Putney, representative will speak for that committee. Please listen to the second reading of the bill.

[House Reading Clerk (staff)]: S 64, an act relating to amendments to the scope of practice for optometrists.

[Speaker Jill Krowinski]: Member from Barrytown.

[Representative Gina Galfetti (Barre Town)]: Thank you madam speaker. S 64 is an act relating to amendments to the scope of practices for optometrists to include minor surgical, laser, and injection procedures through a new specialty credential that any optometrist may elect to obtain. Optometrists are regulated through the Office of Professional Regulations or OPR. This bill will allow optometrists to safely practice to the fullest extent of their education in advance training to the eye procedures allowed in S 64. As we have all seen, there have been a lot of eyes on this bill. This bill will increase eye care access to all Vermonas, not just those living in Chichenden County. The bill has four areas where it will improve the eye health of our residents. Safety, access, cost, and workforce development. Safety. OPR produced a 258 page report on expanding the scope of optometrists in S 60 4. I can read the report to you, but to save time, I've already read it. Summary of OPR's recommendations. The Vermont Office of Professional Regulations recommends expanding optometrists scope of practice to include specific injections, laser and non laser surgical procedures. Only optometrists with a specialty endorsement license should be permitted to perform these advanced procedures. To obtain the specialty endorsement license, optometrists should be required to complete a post degree preceptorship that includes experience in performing the advanced procedures on live human patients. And pass examinations in the performance of optometric laser and non laser surgeries and injection procedures. Optometrists performing advanced procedures should be required to report the outcomes of all advanced procedures performed to OPR biennially. And to report any adverse events to the board. There's been no evidence presented that optometrists who are educated and trained in the advanced therapeutic procedures in this bill create a danger or inflict harm to others. One study reviewed 146,000 procedures performed by optometrists and found two adverse events. One example and proof, I believe, that shows that it is optometrists performing these procedures is safe. Liability or malpractice insurance does not go up when they are legally allowed to perform these. And we all know that insurance companies, if they saw a risk, they would raise the rate. Access. There are approximately 30 ophthalmologists in the state, at least 20 of them in Chittenden County. That leaves around 10 ophthalmologists for the rest of the state. Chitney County has one ophthalmologist for every 8,500 residents. The US ratio is one in 19,000. The rest of the state, there is one ophthalmologist for 48,000 residents. I don't know if there's a proper ratio between ophthalmologists to people. Like everything, it depends on a lot of factors. Age, health, environment. But with Vermont being one of the oldest states in the country, I'm sure that eye care is gonna be a needed commodity. We do have an issue with health care in rural Vermont. We recently passed legislation making it easier for internationally licensed physicians to practice in Vermont, hoping to fill the need in our rural areas. I don't know if we're gonna be able to attract well, and frankly I do know. We're not gonna be able to attract 30 more ophthalmologists to come to the state of Vermont. I do know that we do have a solution and that is authorizing properly trained optometrists to perform the procedures in this bill. There has been some testimony it takes three to six months or longer to get an appointment with an ophthalmologist even in Chitney County. This bill will help shorten the time it takes to receive treatment. Multiple counties in Vermont have zero practicing ophthalmologists. There are approximately a 168 optometrists in the state. Some opponents have argued this bill won't increase access. I've seen estimates that up to 50 optometrists may apply for the advanced procedures license. Let's assume only 30 optometrists apply. Common sense tells you that if the number of duly licensed trained in advanced therapeutic specialist doubles, access has to increase especially in the rural areas of the state where it is needed the most. Cost. Currently, optometrists treating glaucoma with eye drops at a cost of approximately $200 a month. A laser procedure which also would solve that issue, costs around $300. Some patients won't want to have a laser procedure, but some will. They also have to travel distances to get to ophthalmologists. There are multiple counties that have no optometrist in the state. None. By not having to travel for treatment, residents will definitely save on travel time and expense. Whether or not the procedures are cheaper in Newport than they would be in Burlington is unknown. However, we have seen that medical procedures performed in the more rural hospitals are cheaper than they are performed in Chittenden County. And again, I have nothing in Chittenden County. I love Chittenden County. The issue is, can we provide the proper health care to our residents in the more rural areas? One aspect of this bill that is not often, brought up and that is workforce development. Vermont doesn't have an optometry school, so students typically get their bachelor degree here and then move out of state for optometry. And as we know, like most young professionals, they don't come back. And the reason they don't come back, the

[Speaker Jill Krowinski]: Autometry School, is

[Representative Gina Galfetti (Barre Town)]: the they

[Speaker Jill Krowinski]: can't perform at the highest

[Representative Gina Galfetti (Barre Town)]: don't level of how they've been trained and educated. I'll now summarize the sections of the bill. Section one twenty six VSA seventeen oh three, definition of optometry chapter. This section amends the definition of practice of optometry to add a list of procedures that are within the scope of practice of an optometrist holding the advanced therapeutic procedures specialty. Established in section four, including certain surgeries, laser procedures, and injections. It also adds definitions of adverse event and therapeutic pharmaceutical agent. Section two twenty six VSA 17 a is renewal of the optometrist license. This section would require that optometrists holding an advanced therapeutic pressure procedure specialty complete an additional five hours of continuing education in the advanced procedures during each two year licensing period. In addition to the forty hours currently required for all optometrists. Section three twenty six VSA seventeen twenty prohibited practice for optometrists. This section prohibits an optometrist from performing any ophthalmic surgeries or injection procedures other than those listed in section one. And it provides a list of 23 specific procedures or categories of procedures that optometrists are prohibited from performing even when even with rather this advanced license. It also prohibits optometrists from prescribing or administering a schedule one or two controlled substance except hydrocodone combined with analgesic I. E. Vicodin, which it would allow an optometrist prescribed or administer but with no refills and for not more than seventy two hour supply. Section four, twenty six VSA chapter 30, sub chapter five, advanced therapeutic procedures specialty. This section creates a new sub chapter in the optometry chapter for the advanced therapeutic procedure specialty. It authorizes the board of optometry to grant the specialty to an applicant who is a licensed optometrist, meets certain educational and demonstrated competency requirements and has completed specific examination requirements. For optometrists who graduated from optometric school, optometric school in 2019 or thereafter, there is no additional requirements. For those optometrists who graduated, they have already been trained in these techniques. For those who graduated, prior to 2019, they must take a board approved postgraduate course for at least thirty two hours that covers a list of specific topics. To demonstrate competency for the advanced therapeutic procedure specialty, an optometrist must complete clinical proficiency by performing certain procedures on live human patients. This section also requires an optometrist to report any adverse event related to any adverse any advanced procedure within thirty days following the event. Section five is a redesignation of 26 VSA 20 seventeen-twenty seven as 26 VAA VSA seventeen-five. This chapter moves the only remaining section, subchapter into subchapter one. The effective date would take effect 07/01/2028. I encourage everyone to vote I with me on this bill. Thank you, madam speaker.

[Speaker Jill Krowinski]: And now speaking for the committee on government operations and military affairs, member from Vergens.

[Representative Matthew Birong (Vergennes)]: Madam speaker, I'd like to start by thanking the member from Marytown for that very thorough section by section and primer on this conversation. This has been a policy discussion throughout this institution for the entire tenure of my legislative career, eight years and longer. So I would just like to thank all of the committees of jurisdiction that led up to this point for their hard work and focus on this conversation. Your committee on government operations and military affairs took possession of this bill, took a very notable amount of time with testimony over the course of weeks, staying more focused on the OPR components of this as that is our primary jurisdiction within this bill itself. With that, there was a lot of robust conversation about other safeguards that could be put into place. There were a few proposals of amendment, and one of which will be presented by a member of the committee in a short period of time that I believe addressed some of the concerns that were brought up with how to refine this bill. The committee on government operations and military affairs did does have a very robust witness list for me to run through. We heard from the reporter of the bill from the senate committee on health and welfare, deputy chief counsel, office of legislative counsel, principal fiscal analyst, joint fiscal office, senior policy specialist, health program, national conference of state legislatures, Deputy Secretary of State, Director of Office of Professional Regulation, General Counsel, Office of Professional Regulation, the Chair of the Board of Medical Practice, Executive Director, Vermont Board of Medical Practice, the president, Vermont Ophthalmological Society, a comprehensive ophthalmologist, ophthalmology resident and future Vermont ophthalmologist, associate chief for Education Massachusetts Eye and Ear, director of residency training program, Harvard Ophthalmology. That is two titles, one individual. We heard from two fellows from the American Academy of Optometry, the president of the Vermont Optometric Association, vice president Vermont Optometric Association, past president Vermont Optometric Association, founding president, American Society of Optometric Surgeons, associate professor, Southern College of Optometry, doctor of optometry, associate professor, director of continuing education, Oklahoma College of Optometry at Northeastern State University, and lived experience with molecular degeneration individual from Morrisville, the member from Morrisville. Your committee on government operations and military affairs voted this bill out as 64 favorably by a vote of seven four zero, and we ask for the body support.

[Speaker Jill Krowinski]: Members, we are briefly gonna go back to health care with the member from Barrytown and then we will move on to ways and means with the the member from Barry City, member from Barrytown.

[Representative Gina Galfetti (Barre Town)]: Madam speaker, I apologize. I was so excited about being finished that I finished too soon. I did not list the our witnesses that we, heard from in committee. It was the director of Medicaid policy, the agency of human services, the deputy chief counsel of the office of ledge counsel, director of office of professional regulations, deputy secretary of state of the secretary state's office, chair of the board of the metal practice, president of Vermont Optometric Association, President of the Vermont Ophthalmological Society, Doctor of Optometry and the Associate Professor of Oklahoma College of Optometry, Multiple Patients and the Bill Sponsor. And the committee voted ten one zero favorably for this bill. Thank you, madam speaker. My apologies.

[Speaker Jill Krowinski]: Members, just want to give you a heads up that there was a mistake in the calendar. It was listed as ten zero one. The member from Barrytown gave the correct vote which was ten one zero and we will correct that online. And now for the committee on ways and means, the member from Berry City.

[Representative Edward "Teddy" Waszazak (Barre City)]: Madam speaker, your committee on ways and means keeps a very keen eye on the revenues of the state, and so it was appropriate that we were referred to as 64. The report can be found on page thirty nine thirty of today's calendar, and a fiscal note is on our website. Just reading from the fiscal note, the bill would generate a minimal amount of revenue for the Office of Professional Regulation in the form of a $100 license fee, which would be paid by approximately 50 professionals who would adopt this new specialty. According, to JFO, highest fiscal impact would be the amount of $5,000 in fiscal year 2029. We heard from, JFO, Joint Fiscal Office, Legg Council, Office of Legislative Council, and on a vote of seven four zero, ask for the body support.

[Speaker Jill Krowinski]: And now for the committee on appropriations, member from Putney.

[Representative Mike Mrowicki (Putney)]: Thank you, madam speaker. Your house appropriations committee did hear testimony on this bill even though there is not an appropriation here, but because there was money being generated, we heard rather thorough digressions on on on this bill. But one of the questions that did come up was whether this would affect, Medicaid coverage, and, we did hear from the office of professional regulation that it would not. And so your committee vote from house appropriations was ten one zero, and we urge the body to concur and support this bill.

[Speaker Jill Krowinski]: And now the member from South Burlington, Representative Nugent offers a proposal of amendment that the first assistant clerk emailed to members at 09:18 this morning. This amendment is also posted on the house overview webpage and paper copies are available at the main table, member from South Burlington.

[Representative Kate Nugent (South Burlington)]: Madam Speaker, this amendment amends section one a 26 VSA 17 o seven. Optometrists are overseen by

[Representative Mike Mrowicki (Putney)]: the

[Representative Kate Nugent (South Burlington)]: optometry board comprised by optometrists and housed in the office of professional regulation. Ophthalmologists who are currently the only professionals who are licensed to carry out the procedures expanded in this bill are overseen by the medical board. This amendment to s 64 changes the composition of the optometry board that oversees optometrists. It expands the current board by two members, keeping it an odd number and requires that one of the new members be an ophthalmologist. Ophthalmologists have experience in the advanced procedures allowed in the bill and the second edition will be an additional optometrist. The amendment also modifies the qualifications of board members by requiring that one optometrist on the board have experience performing advanced procedures allowed in the bill by 2031. These changes strengthen oversight of these procedures by placing members with relevant skills and experience on the board that oversees them. We heard from the secretary of state on this amendment who supports this change, and I thank the committee for their time and consideration of this proposal and ask for your support.

[Speaker Jill Krowinski]: Member from Virgins.

[Representative Matthew Birong (Vergennes)]: Madam speaker, I'd like to thank the member from South Burlington for presenting this amendment to your committee on government operations and military affairs. It is felt that this is a good addition to the bill. It hones in oversight of the practice and expanded scopes. The committee heard from the sponsor of the amendment, deputy chief counsel, also office of legislative council, director of office of professional regulation, secretary of state's office, and the committee by straw poll found the amendment favorably by vote of ten zero j.

[Speaker Jill Krowinski]: So the question is, shall the house propose to the senate to amend the bill as offered by the member from South Burlington? Are you ready for the question? If so, all those in favor? Member from? Member from Linden. Sorry, member. Can you use your mic? I can't hear you.

[Representative Martha Feltus (Lyndon)]: I'm sorry. Are we voting on the amendment right now?

[Speaker Jill Krowinski]: Correct. Your point of inquiry, we are on the Nugent amendment.

[Representative Alice M. Emmons (Springfield)]: Thank you.

[Speaker Jill Krowinski]: Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay.

[Representative John O'Brien (Tunbridge)]: Aye. The

[Speaker Jill Krowinski]: ayes appear to have it. The ayes do have it and you have proposed to the senate to amend the bill. Now the question is, shall the bill be read a third time? Are you ready for the question? Division, has been requested. When the vote is taken, it will be taken by division. The question is shall the bill be read a third time? Member from Williston.

[Representative Golrang "Rey" Garofano (Essex)]: Thank you

[Representative Erin Brady (Williston)]: madam speaker. I am hoping to ask a few questions of the member from health care.

[Speaker Jill Krowinski]: The member from Barrytown is interrogated.

[House Clerk/First Assistant Clerk (roll call)]: I

[Representative Erin Brady (Williston)]: am wondering if, madam speaker, if you can point to point me to some detail more detail or data about the claim that this change would increase access to care?

[Representative Gina Galfetti (Barre Town)]: Madam speaker, there is no details to say there would x increase access to care. I will say that if there are optometrists who can perform this advanced therapeutic procedures in the rural areas of the state, it makes common sense that they would increase access for them.

[Representative Erin Brady (Williston)]: And one other question. Sorry to hear there's no data supporting that claim. I'm wondering if there are hard numbers regarding the, amount of training that the optometrist would receive to perform these, procedures and how that training that the optometrist would receive compares to the training that ophthalmologists receive to perform the same procedures.

[Representative Gina Galfetti (Barre Town)]: Madam Speaker, there is no data actually in ophthalmologists how many hours they are trained in these procedures. Anyone that has graduated from optometry school since 2019 in their four year postgraduate degree are trained in these procedures. So we don't even know how often ophthalmologists are trained in these procedures. So there is no data available, madam speaker.

[Representative Erin Brady (Williston)]: Okay. I thank the member. I thank the member, and I I will just say I'll be voting no on this proposal and for a number of reasons, but primarily that I don't I'm not hearing the data that I think is necessary to make such a significant decision given, the subject matter.

[Speaker Jill Krowinski]: Member from Burlington.

[Unidentified Member from Burlington]: Thank you, madam speaker. I rise to strongly share with you my disagreement with age 64. Inadequate training is just one of the issues. S64 requires very limited hands on supervised practice. And as few as two supervised procedures for a subset of the allowed surgeries before an optometrist may operate independently. There are very few optometry schools, I believe only three, One in Kentucky, one in Indiana, and one in Oklahoma that can train students on all of the S-sixty four surgeries. I don't like that this bill gets into detailed medical, what people can do and not do. Because we are not medical people here, and we're treading on dangerous territory when we're getting in between a doctor and a patient. Madam speaker, can I quote from the American Medical Association?

[Speaker Jill Krowinski]: You may.

[Unidentified Member from Burlington]: Thank you. State laws can expand scope of practice, but they do not change the underlying training gap between the two professions. Surgical competency is built through operative experience, not classroom instruction. Ophthalmologists perform over 1,000 procedures as the primary surgeon during their residency. Developing the hands on judgment, sterile technique, and complication management skills essential to safe surgery. This experience has no equivalent in optometry training. Managing complications requires training that goes beyond the procedure itself. Intraoperative complications such as bleeding, sudden pressure changes, demand immediate trained responses. That judgment develops only through supervised operative experience. It cannot be acquired through short courses or procedural modules added after graduation. Legislative authorization is not a substitute for clinical training. When states expand optometrist surgical scope through legislation, that authorization is not tied to any additional surgical training requirement. The training gap remains even as the legal scope expands. What can go wrong during these procedures is what keeps Doctor. Shriver up at night, she said during the session hosted by the litigation center of the American Medical Association and state medical societies. For example, she said, the risks of injecting periocular steroids include eye perforation, vascular occlusions that can lead to vision loss, conjunctival necrosis, fat atrophy, skin depigmentation, glaucoma, and the spread of an undiagnosed tumor. And there are risks of injecting anesthetics too. Eye perforation, the spread of an undiagnosed tumor, an allergy to the anesthetic, a reaction to epinephrine, and an oculocardiac reflex. Beyond that, doctor Shriver said, the robust training physicians receive better equips them to navigate the decisions that need to be made and procedures that need to be done. Damage to surrounding tissues, including the lacrimal drainage system, eyelid margin, and the eye can occur when procedures are performed on the eyelid, especially when someone hasn't had proper training. How to interpret pathology reports is important in ensuring patients' cancers don't get missed and proper treatment is provided. While some eyelid lesions clearly are not concerning, it isn't always easy to tell if lesions are cancerous or noncancerous. And so interpretation of the pathology report is important. Doctor. Shriver has had a number of patients who have had a delay in care of eyelid and orbital cancers by their local optometrist because eyelid and orbital malignancies are not commonly seen in optometric practices. An infant had an orbital rhiodomyosarcoma, which was misdiagnosed for several weeks as an eyelid sty. An adult patient had conjunctival lymphoma, which was observed for two years. Both patients had urgent biopsies and treatment initiated after being seen in her clinic. You don't know what you don't know, Doctor. Shriver said. If the most of what you do is regular eye exams, contact lenses, and refraction, these conditions are not on your radar. The absence of reported complications or malpractice lawsuits does not mean complications have not occurred. Madam speaker, ophthalmic lasers are surgical instruments that alter tissues inside the eye, characterizing them as safe and easy, understates the clinical risk and the training required. Madam speaker, may I read from the twenty twenty five veto message from the governor of New Mexico?

[Speaker Jill Krowinski]: You may.

[Unidentified Member from Burlington]: Thank you. I am vetoing this bill because it sets a dangerous precedent for allowing nonsurgeons to perform surgical procedures. There's no persuasive evidence that this bill would increase access to care. Data shows that expansion of laser authority for optometrists has not resulted in a statistically significant increase in access to these procedures. For patients, the bill's change in scope and practice would not increase or even maintain the current standard of care. The bill allows nonsurgeons to perform procedures that are currently performed by medical doctors with significantly more educational and hands on training requirements to receive their degrees. Those are not abstract concerns, the governor added, citing a case that happened in March. An optometrist in the neighboring state performed an unauthorized surgical procedure that this statute would legalize, resulting in complications so severe, the patient had to be transferred to the University of New Mexico for intervention by an ophthalmologist. In 2022, governor Newsom vetoed similar legislation in California, citing insufficient optometry education and training for surgical procedures. After undergraduate studies, ophthalmologists must complete eight or more years of medical school and specialized clinical training compared with four years of specialized education and training for optometrists. In trying to look at the research, there's a 2016 study published in JAMA Ophthalmology that reviewed a laser tribuculoplasty. I am not pronouncing these correctly, I'm sure. Researchers have analyzed Medicare claims data on eight ninety one patients with glaucoma who received laser tribacloplasty between 02/2013 in Oklahoma, where optometrists had been offering this treatment for more than two decades. According to that study that JAMA published in 2016, patients who saw an optometrist for laser treatment were about twice as likely to have to undergo additional laser procedures in the

[Speaker Jill Krowinski]: same

[Unidentified Member from Burlington]: eye compared with patients whose initial procedure was completed by an ophthalmologist. And a 2021 review found that optometrists had worse scores than ophthalmologists in Medicare's payment incentive program, rewarding physicians based on quality metrics. It's also been stated that surgical competency comes with ongoing volume. An optometrist in a general eye care practice will not have, the frequency needed to become and maintain proficiency. Vermont's existing caseload does not come close to supporting that. I've heard people say, oh, the ophthalmologists are trying to defend their turf. Look at the organizations who have come out against the bill. Vermont Medical Society, the American Academy of Pediatrics, Vermont Chapter, the Vermont Academy of Family Physicians, the Vermont Orthopedic Society, the Vermont Psychiatric Society, the Vermont Society of Anesthesiologists. We've already heard, from my colleague, who there's no evidence of improved access or lower costs. A 2023 JAMA article found that Oklahoma, Kentucky, Louisiana, Arkansas, and missus and Missouri scope expansion did not reduce travel time or improve access. Both the 2020 and 2023 OPR reports conclude OPR is unable to determine whether expanding the optometric scope of practice would improve patient access to care. Reimbursement rates are set by Medicare and mirrored by private insurers. Optometrists and ophthalmologists are already paid the same rate. There are no facility fee savings since S64 procedures are office based. The same day diagnosis and surgery model cited by proponents is largely unworkable due to prior authorization and reimbursement requirements. And separate surgical consultations also catch unnecessary or ill advised procedures, saving costs, not adding it. Madam Speaker, would you let an optometrist perform surgery on your eyes? Would you let them perform surgery on your family members? Or would you travel a couple of hours to have an expert with experience and a track record perform the surgery? I've had eye surgery. I propose that we amend this bill to do a five year pilot project and let optometrists perform the work outlined in age 64 only on legislators and their family members and see how that goes before we impose this on our Vermonters. Short of that, there should be a clear warning to Vermonters so that people can make an educated decision about who to go for further eye surgery. The stakes are too high. This bill treads on dangerous territory. We are legislating medical care that flies in the face of best practice. We have a shortage of a lot of professions in the state. Pretty soon, if we go down this route, we're gonna have people doing their college internships, doing all kinds of other medical procedures. I urge the body to join me in voting no on this bill.

[Speaker Jill Krowinski]: The question is, shall the bill be read a third time? Member from Montpelier.

[Unidentified Member from Montpelier]: Madam speaker, a 2018 survey conducted by the American Medical Association found that over half of respondents either did not know or were not sure if an optometrist was a physician. Many patients don't know the difference between optometrists and ophthalmologists. Optometrists go to optometry school where there is no required training on live human beings. Ophthalmologists are physician surgeons who learn surgery throughout medical school, after which they concentrate on eye surgery for four to six years. Proponents claim scope expansion will improve rural access and reduce costs, but the evidence does not support either claim. May I quote from governor Ayotte from New Hampshire?

[Speaker Jill Krowinski]: You may.

[Unidentified Member from Montpelier]: Governor Ayotte, vetoed h b three forty nine, which is a bill that's a little less expansive than s 64 and says authorizing non physician providers to perform eye surgeries has the potential to create unnecessary risks for patients, particularly if additional surgical intervention is necessary. S64 requires only eight hours of hands on supervised practice and as few as two supervised procedures for a subset of the allowed surgeries before an optometrist may operate independently. By contrast, ophthalmology residency requires hundreds of supervised procedures before independent practice. Vermont patients deserve surgical care from surgeons with rigorous training and experience. For this reason, I'm voting no and encourage the body to join me.

[Speaker Jill Krowinski]: Member from Linden.

[Representative Martha Feltus (Lyndon)]: Thank you, madam speaker. My optometrists have done these procedures hundreds of times when they lived in another state, and they cannot do them in this state. They are having difficulty with workforce hiring optometrists in rural Northeast Kingdom because they will not be allowed to do these procedures in Vermont as they've been trained to do and would be licensed to do in other states. This procedure many of these procedures could be done in the local office rather than having to get a referral, wait months and months for that referral, have someone drive you the hours away to an available ophthalmologist, and take the day off from work. So they just don't get the care. I will be voting yes on this bill. And if you do not want an optometrist to perform this procedure, you may still go to an ophthalmologist if you so choose. I would so I'm done.

[Speaker Jill Krowinski]: From Putney.

[Representative Mike Mrowicki (Putney)]: Thank you, madam speaker. I rise in support of this bill. I'll start by recognizing the history of when mid level medical practitioners fought the AMA to be licensed to provide medical care. Today, those mid level practitioners are the foundation of our medical system. Nurse practitioners, physician assistants are mostly who I see when I get go into the doctor. It's who I saw when I was having eye trouble. I was being in a rural area, I was referred to our regional hospital at Dartmouth, which took months to get an appointment. When I did get the appointment, I was diagnosed with a hole in my retina. Surgery was scheduled by an expert, by a trained ophthalmologist. By the time we got into to that though, I think that had an effect. Surgery didn't work. So we tried again by a trained expert ophthalmologist, and it didn't work. So the the training, the expertise is not necessarily guaranteed that a medical procedure will work. And I still have a hole in my retina. Would something like this have increased the access if ophthalmologists were not taking care of lesser concerns? Perhaps. We don't know. If I had gotten to see an ophthalmologist sooner, would that have helped the odds of the operations I had being successful? Again, we don't know. Will this increase the number? Well, we don't have data, but we do have the Office of Professional Regulation, who I believe canvassed current optometrists and that's why our our JFO report suggests there may be 50 that will sign up to do this. That would seem to increase incredibly the number of people who can do more procedures, freeing ophthalmologists to do and see patients sooner. There is a turf war going on, I believe, and I think it was proved by the member who listed all the medical organizations against this. And I believe it is our job here to make those kind of decisions in disputes like this. It's our job to make decisions every day, and it's our job to make a decision like that. That's why we get the big bucks. It's our job to make decisions like this, and and I'll be voting yes.

[Speaker Jill Krowinski]: Member from West Windsor.

[Representative Elizabeth Burrows (West Windsor)]: Thank you, madam speaker. I am standing here, standing up right now to stand up for my mother who is unable to have an MRI right now despite her occasional scares for for strokes. She's not able to get an MRI to confirm whether she's had a stroke or not.

[Representative Patricia McCoy (Poultney)]: Why is this important?

[Representative Elizabeth Burrows (West Windsor)]: It is important because the reason she can't get an MRI is that she had a poorly trained ophthalmologist who had not had enough practice on patients in Vermont who left a piece of metal in her eye. And as a result, that metal remains, and, her eyesight has decreased. I'm going to vote no on this bill because the impact on her actual health of a lack of training, of a lack of actual practice on patients, has impacted our family. And I don't see this bill as having any impact on the fact that we don't the fact that we don't have a school of optometry in Vermont, the fact that we lack optometrists in Vermont, what it does have the potential for is more bad medicine that can cause damage to eyes and bodies and communities and families. Thank you, madam speaker.

[Speaker Jill Krowinski]: Member from Stoke.

[Representative Jed Lipsky (Stowe)]: Madam speaker, today I wanna just take a moment to highlight the role of the Vermont Office of Professional Regulation or OPR in a process we rely on when considering whether to regulate a profession. OPR was created in 1989 to bring order and consistency to what had been a fragmented system of independent licensing boards. By placing these functions under one umbrella in the secretary of State's office, Vermont improved efficiency, strengthened enforcement, and made it easier for both professionals and the public to navigate our regulatory system. But at its core, OPR is not a bureaucracy for bureaucracy's sake. It is a public protection agency. Its job is to ensure that the people practicing in regulated professions meet minimum standards of competence and that when can misconduct occurs, there's a clear and fair path for investigation and discipline. The same time Vermont's law is explicit. Regulation should occur only when necessary and always at the least restrictive way that still protects the public. The principle is carried out through what we call the sunrise review process. Whenever a profession seeks a licensure or when a bill proposes new or expanded regulation, OPR is required to conduct a formal evidence based analysis under 26 VSA chapter 57. That review asks four essential questions. First, is regulation actually necessary? Is there real documented harm to the public? Second, what is the least restrictive approach that could address that harm? Third, what are the economic and workforce impacts? Will regulation create barriers or reduce acts access to services? And fourth, will regulation truly improve public safety or is it primarily benefiting the profession itself? At the end of that process, OPR provides the legislature with a recommendation ranging from no regulation at all to limited registration or certification to full licensure when warranted. And it is then up to us to decide how to proceed. The bottom line is this, Vermont's approach to professional regulation is careful, disciplined, and grounded in public protection, not in gatekeeping. The Sunrise process ensures that we regulate only when the evidence supports it and only to the degree necessary to keep Vermonters safe. Madam speaker, I will be voting to support this bill, and I I thank the all the committees of jurisdiction for their work.

[Speaker Jill Krowinski]: The question is, shall the bill be read a third time? Member from Essex.

[Representative Golrang "Rey" Garofano (Essex)]: Thank you, madam speaker. I just wanted to share a little bit of personal experience. I am someone with a very rare medical condition, and I have had laser surgery performed on my eyes. And despite receiving excellent care in Vermont, I have to receive my care in at Mass Eye and Ear because of my rare condition. And I'm really grateful for the experience and expertise of the medical professionals that give me that care since 2019. I am really disturbed by this bill. I am really weary of Vermonters not understanding the differences between professions and risking their health care and their eye care and their vision. And I'm worried about us making a decision that could be detrimental to Vermonters. Madam Speaker, may I quote from the testimony of Doctor. Jennifer Lindsey, who is a Residency Program Director for Ophthalmology and Vice Chair for Education at Mass Eye and Ear?

[Speaker Jill Krowinski]: You may.

[Representative Golrang "Rey" Garofano (Essex)]: There is no such thing as minor eye surgery. The term laser surgery sounds clean and simple, but a laser is a powerful surgical tool. If a laser is fired just a fraction of a millimeter off target, it can cause permanent blind spots, hemorrhages, and cataracts. Madam speaker, as other members have indicated and shared today, I think Vermonters deserve to know that when a surgeon approaches their eyes, that individual has had the full weight of medical and surgical residency training behind them. I think I agree with the great goal of increasing access and care, but we cannot do it by lowering standards of safety. I urge the body to vote now.

[Speaker Jill Krowinski]: Member from Barrie City.

[Representative Edward "Teddy" Waszazak (Barre City)]: Madam Speaker, may I read from the AMA website?

[Speaker Jill Krowinski]: You may.

[Representative Edward "Teddy" Waszazak (Barre City)]: There is certainly room for improvement in The U. S. Healthcare system. But allowing non physicians such as nurse practitioners or physician assistants to diagnose and treat patients without physicians oversight is a step in the wrong direction. The best way to support high quality care and lower cost is to keep physicians as the leaders. I I say this because they were against nurse practitioners doing primary care. My current doctor or my primary care physician is a nurse practitioner. So we've been here and years ago, AMA fought that, nurse practitioners trying that primary care. I dare say that AMA was wrong then and based on this website which says 03/11/2025, they were wrong now. And I rise in support of this bill, and I hope other members do as well.

[Speaker Jill Krowinski]: Member from Derby.

[Representative Richard Nelson (Derby)]: Thank you, madam speaker. Medical care, all forms of medical care. You have a PCR, patient client relationship. My primary medical care is a PA. When I go see him once a year, we spend more time talking about what I'm doing in here than what's wrong with me because I'm beyond help. Anyway, I have an optometrist. I don't wear glasses except late at night when I'm tired and trying to read or small print. I'm fortunate that way, but I see him once a year. I have a patient client relationship with this gentleman. Excellent, excellent man, excellent optometrist. One day, I was I do AI, the original AI, artificial insemination, and I dragged a AI gun across my eye. Looking through my unaffected eye, when my hand clamped over the other one to feel if I still had an eyeball, I saw there was some flesh on it. So I did what any good farmer do. I loaded the gun and went out and bred the cow one eye, squinting, water running down the other eye. And I called up my optometrist, and I said, what do I need to do? And he said, you need to be in my office as fast as you can. And I was in his office. In fifteen minutes, he had me in a chair. He had my head strapped down. He was throwing stain in my eye, then he threw that stuff in there to dilate it just to make me squint the rest of the day. And he looked and he said, that was close, Nelson. You're gonna be alright. We're gonna put you on some antibiotic. You're gonna wear this patch for a few days, and you'll be fine. If he hadn't been available up in Newport, I'd had to go to the ER and seen somebody who's not an ophthalmologist, who's not an optometrist, who probably would have referred me to an ophthalmologist. And at that time we did have a, well, prior to that, we had a great ophthalmologist in town. He's since retired. So I probably would have had to driven to Barrie or Burlington or Hanover or somewhere to be seen the next day. PCR, patient client relationship. You're going to go to who you trust. I trust my optometrist.

[Unidentified Member from Fairfield]: He's

[Representative Richard Nelson (Derby)]: a young man like myself. He's probably not gonna take up laser surgery at this stage of the game, but he is forward thinking, and he will hire people from away that are trained in this. And I have confidence in him because of our PCR. No one is gonna force you to go to an optometrist. You have choice. We all have choice. This just broadens our choice. For this reason, I will stand in support of this bill.

[Representative David Yacovone (Morristown)]: Thank you, madam speaker.

[Speaker Jill Krowinski]: Member from Fairfax?

[Representative Ashley Bartley (Fairfax)]: Thank you, madam speaker. May I interrogate the presenter of the bill?

[Speaker Jill Krowinski]: The member from Barrytown is interrogated.

[Representative Ashley Bartley (Fairfax)]: Madam speaker, I just wanna understand. I read through this bill pretty closely, but just wanna make sure just a point of clarification. If I'm currently seeing an an ophthalmologist, but an optometrist, this bill passes, the optometrist now has the ability to provide services I'm looking for. Is there anywhere that says I have to see the ophthalmologist? Would an insurance agency not cover me if I would if I chose the optometrist instead?

[Representative Gina Galfetti (Barre Town)]: Thank you for the question, member. There is no requirement that you stop seeing your ophthalmologist and then go to see an optometrist for any of these procedures.

[Representative Ashley Bartley (Fairfax)]: So at the end of the day, I would have full choice on who I I I choose to see. No pun intended.

[Representative Gina Galfetti (Barre Town)]: Absolutely. You would have full choice.

[Representative Ashley Bartley (Fairfax)]: Thank you, member.

[Speaker Jill Krowinski]: Member from Cambridge.

[Representative Lucy Boyden (Cambridge)]: Madam speaker, may I read directly from OPR's optometry scope of practice Sunrise report?

[Speaker Jill Krowinski]: You may.

[Representative Lucy Boyden (Cambridge)]: Regarding access, OPR cannot come to a conclusion regarding whether expansion of scope would improve patient access. After reviewing the provided comments and data, OPR is unable to determine whether expanding the whether expanding the scope of practice would improve patient access to care. Madam speaker, OPR's analysis of cost and safety is very similar. I respect the work of OPR. While OPR has recommended scope expansion so long as optometrists have the training necessary to perform the procedures safely, s 64 sets a low bar for competency in comparison to other states that have expanded scope and the substance within OPR's report provides an overall inconclusive recommendation. I will be voting no.

[Speaker Jill Krowinski]: The question is, shall the bill be read a third time member from Barrytown?

[Representative Gina Galfetti (Barre Town)]: Madam speaker, may I read from a email I received on s 64?

[House Clerk/First Assistant Clerk (roll call)]: You may.

[Representative Gina Galfetti (Barre Town)]: Representative, I urge you to support the passage of s 64. My mother is 84 years old and no longer can handle the journey of over an hour and a half to get the injections in her eyes that stop her vision from deteriorating. She is going blind because she cannot make the trip. Thank you. And I just want to leave one more with you guys. $128,171.90 is how much doctors of ophthalmology have spent trying to kill this bill. Thank you.

[Speaker Jill Krowinski]: The question is, shall the bill be read a third time? Member from Burlington.

[Unidentified Member from Burlington]: Madam speaker, I just have a a brief observation that, a number of the members urging a no vote on this bill have quoted from the veto messages from governors of several states, which means to me that both chambers of the legislatures of each of those states saw that it was in the best interest of their states to expand the scope of practice of optometrists. Thank you.

[Speaker Jill Krowinski]: The question is, shall the bill be read a third time? Member from Coventry.

[Representative Michael Marcotte (Coventry)]: Thank you, madam speaker. As we consider as 64, it's important to look squarely at the workforce realities facing Vermont. We're one of the oldest states in the nation and demand for medical eye care is rising every year. Yet our ophthalmology workforce is not growing with the need. In fact, in many parts of the state, particularly outside Chitney County, there are simply not enough specialists to meet patient demand. By allowing optometrists to practice to the full extent of their education and training, we expand the number of clinicians available to care for Vermonters. This is a practical immediate step to strengthen access in a system already stretched thin. We also know that provider shortages are not theoretical. Several Vermont counties have no resident ophthalmologist at all and national workforce trends show the number of ophthalmologists declining relative to population growth. Optometry by contrast is the only eye care profession that is expanding. Modernizing scope allows Vermont to rely on the workforce that is actually growing rather than continuing to depend on a shrinking specialty pool. Although your committee on commerce and economic development did not look at s 64, we do consistently review ways to recruit and retain new people in Vermont. It has been made clear that some optometrists have chosen not to move to move to Vermont or they have left because our scope laws are more restrictive than those in 16 other states. New graduates want to practice where they can use the full breadth of this training. Updating our laws helps Vermont compete for those clinicians, especially in our rural areas where recruitment is already difficult across all health professions. Perhaps most importantly for Vermont, expanded scope strengthens rural access. Optometrists are in far more communities than ophthalmologists, from The Kingdom to the Upper Valley to the Islands. When more of these providers are authorized to deliver medical eye care, patients can receive treatment closer to home. That reduces long travel times, missed work and delayed care, barriers that disproportionately affect rural Vermonters. Finally, passing as 64 positions, Vermont has the first state in the Northeast to adopt this advanced license. That matters. It signals that Vermont is forward looking, competitive, and committed to building a sustainable healthcare workforce. Because the advanced credentials will take time to implement, acting now ensures we are ready to recruit the next generation of providers rather than falling further behind our neighboring states. I hope you join me in voting yes for this bill. Thank you.

[Speaker Jill Krowinski]: Member from Linden.

[Representative Martha Feltus (Lyndon)]: Thank you, madam speaker. I endorse certainly this bill s 64, and I want to give just a personal touch to it, personal anecdote, and that my husband was a practicing optometrist for forty five years. Forty of those years in St. Johnsbury and the other five in the military and in the Veterans Administration. Many of those years he practiced alongside ophthalmologists often in a joint practice that was co owned And he has had a he had a very successful practice. He had a large patient group. When he retired twelve years ago, a young couple from out of state came and took over his practice. They had been trained in these procedures, but they came to Vermont, They set down roots. They raised their family. They have expanded their their practice. They have built a new building. They have brought in more practitioners, and now they're ready to expand even more. But they can't find practitioners, The young students who are coming from school, who have been trained in these procedures are not interested in coming to Vermont. They like the rural lifestyle, they like our recreation, they like living in small towns, but they do not want to come because they cannot practice to the full extent of their training. It's a workforce problem for us, and I view that as one of the major aspects of this bill. I am confident that OPR has done the thorough view that is necessary. The state can do a lot of things to try to encourage people to come. We talk about education. We talk about housing. We talk about tax policies, a variety of things to get people to come to Vermont and people that we want to have here. This is a workforce bill that I think will help us there. I encourage you to vote yes.

[Speaker Jill Krowinski]: Are you ready for the question? Member from Burlington?

[Representative Ashley Bartley (Fairfax)]: Madam speaker,

[Unidentified Member from Burlington]: I understand the argument that it's a workforce bill, but I am overwhelmed with the concerns that I have about the inadequate training that s 64 requires. It only requires eight hours of hands on supervised practice and as few as two supervised procedures for the subset of the allowed surgeries before an optometrist may operate independently. Most optometry schools provide no hands on surgical training on humans whatsoever. And Vermont's existing caseload does not come close to supporting that level of optometric practice. There's also no evidence of improved access or lower costs. In fact, OPR is in two reports in 2020 and 2023, those reports conclude that OPR is unable to determine whether expanding the optometrists scope of practice would improve patient access to care or costs. And safe outcomes claims always need to be scrutinized. The absence of reported complications or malpractice lawsuits does not mean serious complications have not occurred. These are points brought up in a letter to us as representatives dated today, May 28, and in our inboxes from Stephanie Winters who writes as executive director of the Vermont Ophthalmological Society and as the director deputy of the Vermont Medical Society. Madam speaker, I'm concerned. I'm very, very concerned, and I will vote no. I'm not willing to accept less less safety, less excellent eye care, less quality for rural Vermonters.

[Speaker Jill Krowinski]: Member from Clerton.

[Representative David "Dave" Bosch (Clarendon)]: Thank you, Madam Speaker. And thank you, Madam Speaker. In my lifetime, I have seen the evolution of medical care go from physicians to physician assistants and now nurse practitioners. And I have gone through the angst of Are you comfortable seeing a physician's Well, yeah. And we worked through that, and now, as I have developed some of the annoying things of aging, I have a team of people that regularly monitor me and all that, and only two of them are physicians, and they're both older than I am, which gives me pause. If it's the the question of the evolution of the technology in my lifetime. I have seen the evolution of the ambulance from a simple Cadillac beefed up station wagon, which interestingly enough, was the same frame and chassis as the hearse. I have seen that evolve into units that have mobile life support and cardiac care units in them and are essentially intensive care units on wheels. And yet, we still expect the first responders to have kept up their skills and developed their skills and to maximize the use of that equipment and to save lives, and in fact, that is usually what happens. So I am neither worried about the technology nor the change in credential or title, if you will. And on a personal note, this very morning, I should be in my optometrist chair trying to decide whether number one or number two is sharper, and I have had to postpone that so I could be here discussing this with you today. My optometrist gives me a regular full diabetic eye exam, and last year when he did so, he saw something that concerned him and immediately referred me to an ophthalmologist, and I was able to get another set of eyes on it, and we're continuing to monitor that, and I expect the same this year. My optometrist, however, is one of three in the Rutland area that has plans to retire, and he cannot find a purchaser for his very busy, very profitable practice because, as the member from Coventry stated, the younger generation of optometrists is not willing to move to Vermont where they cannot optimize their education and their training and make use of the skills they have. So if he shuts down his business, he being my optometrist, I will lose access to that optometry, and three people will be put out of work. I am in support of this bill, and I hope that my colleagues can see clearly to do the same.

[Speaker Jill Krowinski]: Now the question is, shall the bill be read a third time? Member from Tunbridge.

[Representative John O'Brien (Tunbridge)]: Thank you, madam speaker. We often discuss in house ag how it's a good rule never to be the first state to do something, to either ban something or expand something. On our bill on baby food and infant formula, we are we are going to follow California or other states before we enact it. And somebody might say, well, about Paraguat? You banned Paraguat, you're the first state in the country to do that. And we would say, well, we're following 70 other countries in the world who banned Paraquat. We're not the first. S 64 is not the first to expand the scope that optometrists can do. 16 other states are ahead of us. I'd feel differently if we were the first but we are following boots on the ground procedures here. The ophthalmology lobby has the advantage here of fear because we're dealing with our eyes here which I think we're all queasy about if anything goes wrong to them. I think the ophthalmologist would think we're soon to become the state with we'll be known as the state with a lot of blind people maimed by optometrists or the state where Uncle Bob with his exacto knife can fix you up in a weekend. The optometrist I know are exceptionally conservative and caring. They are not, both as a profession and anecdotally the ones I know are not the sort of professionals who would take any risk at all and they've had a history of rigorous training. These are not vinyl ciders. To me, s sixty four checks all the boxes of a good bill. It's working in other states, 16 other states and none of them have rolled back the scope of what was of the expansion. It expands affordable healthcare to Vermont and especially affordable when you when I hear a colonoscopy say cost three times as much at UVM Health Center than it does in say Maine, UVM is not noted for being affordable. So I would assume, maybe we don't have data but I would assume that procedure done in Derby or Royalton or Putney or Rutland by an optometrist will cost a lot less than one done by ophthalmologist at UVM. That's affordable. This bill is also friendly to Medicaid and Medicare. So for rural Vermont, I will be voting yes on s 64 and given the heartfelt and articulate debate on both sides, I request when the vote is taken, it be taken by role.

[Speaker Jill Krowinski]: The member from Tunbridge request that when the vote is taken, it be taken by roll. Is the member sustained? The member is sustained. When the vote is taken, it will be taken by roll. The question is, shall the bill be read a third time? Member from Essex.

[Unidentified Member from Essex]: Thank you, madam speaker. I have been listening to this debate. I think I would I I am compelled to speak because I would like to clear up some inaccuracies and some assumptions. So I've heard mentioned several times an analogous reference to advanced practice nurse practitioners, advanced licensed nurse practitioners, or physician assistants. In the state of Vermont, a APRN has to work under has two thousand four hundred hours of working underneath the supervision of a physician. They also spend years in training. And additionally, they do clinical rotations all under It's the exact same with a physician assistant. However, a physician assistant in the state of Vermont must maintain a collaborative agreement with a physician. That's someone in order for them to provide counsel or collaboration with throughout their entire career. I've heard mention of several people noting access problems with specific procedures that family members or themselves have had. And I'm unfortunately, as 64, would not alleviate that because none of those procedures that were noted are actually allowed in this. In fact, there is a list of procedures that are not allowed. I I have been in the legislature for six years now, and I can remember multiple occasions when we have done scope expansions for various professions. They are most often recommendations from either the Office of Professional Regulation or the Board of Medical Practice, and they are based on sound data. I believe that when this bill was put in front of us as it came over from the senate, I looked at this and I thought, in what world is it okay for the legislature, a citizen legislature, to be making decisions on what procedures are clinically appropriate and what are not. I can never ever remember a bill or a scope expansion where we have explicitly decided what procedures can and cannot be done. I cannot pronounce half the procedures on this list. We did a bill. Many people may remember the former, member from Barrytown. We just did a bill this past year. We reported it out of this committee or this body last year, and then the, senate sent it back over to us, on the expansion of doctoral level psychologists in order to prescribe. We spent a lot of time on that bill, and it was based on a report from the Office of Professional Regulation and the parameters that a doctoral level psychologist needed in order to prescribe. A doctoral level psychologist has obviously a four year bachelor's degree. They have a three year master's degree. They then have a doctoral level program, which is another two years. They work for thousands of hours under the supervision of another doctoral level psychologist. That is what it takes to become a doctorate of psychology. We made, in addition, because it was recommended, that in order to prescribe a very small subset, only pharmaceuticals relating to mental health conditions, they then have to attend and become licensed in pharmacology, which is a two to four year program. That was in addition to their doctoral level. And then in addition to that, they needed to have fourteen months of clinical rotations, essentially a residency. This bill in front of you, thirty two hours. It's basically a weekend course. Thirty two hours, not on live human beings. Thirty two hours on plastic eyeballs. And then each procedure on this list, they have to have basically supervision to see if they're competent. Two times. An ophthalmologist spends between four and six years in residency in which they are performing thousands of surgeries. This bill is nowhere equivalent to what we have required in all other scope expansions. There are two boards that should be making this decision. It is their charge. And those two boards sat in front of your committee on health care and said, we can't agree. You, you, a citizen legislature, you are the referee. I said this in committee. We just did a bill on the corporate practice of medicine. And I asked the question, how is this not the political practice of medicine? And the response was, it is. I don't play politics with people's lives.

[Speaker Jill Krowinski]: Member from Milton.

[Unidentified Member from Milton]: Madam speaker, I rise in support of this bill. While I recognize the concern about the amount of training, we must consider that advancements in technology made many of these procedures simpler and safer. We all know Vermonters are dealing with extremely high health costs. I believe this bill will help provide better accessibility and controlled costs. And for that reason, I will be voting yes.

[Speaker Jill Krowinski]: The question is, shall the bill be read a third time? Are you ready for the question? Member from Morristown.

[Representative David Yacovone (Morristown)]: Thank you, madam speaker. I find myself ravaged by indecision. In our committee yesterday, I voted no. I was the lone vote. But as I listened to the discussion this morning, I surely see clearly all sides. Once every six weeks, I go to Burlington and have a needle put my eye. Trust me, when someone puts a needle in your eye, they have your full attention. I've been doing this for twelve years now. My story though is not so much that, but when I first went there, sent by my optometrist, got in there quickly, the ophthalmologist said there's something more here than meets the eye. Found that I had a rare genetic disorder that causes blood vessels to break and that altered to a degree his treatment. My ophthalmologists who see me now bring up the bill appropriately so they don't twist my arm or anything, Say, Dave, there's more to it than just an injection. Now from where I sit, once every six weeks, I am focused on the injection. I I wonder about their hand skills, how deep will they go with the needle, are they moving it around. Don't want them to put it in the same hole they put it in six weeks ago, though generally it's healed. From visit to visit, sometimes it hurts, sometimes it doesn't. But my whole day is is not a good day because I'm stressed. Like I have been on throughout this discussion, it brings back my routine visits. Yet, I I so I I would never go to anyone that doesn't do this routinely, and I appreciate my my surgeon. You know, he went eight years postgraduate work, four of them in surgery as a residence, the difference in training between what we're being asked to do on this scope of change and what the ophthalmologists receive is just no no comparison at all. But I so I that's my choice. I would go and my poor wife who has to drive me in the roads and all those kinds of things in the winter, but we do it. Ultimately, I'll be blind. But if we can put that off as long as we can, that's a good thing. Alright? But I greatly value that people should have the choice. I worry that a couple years from now, somebody in rural Vermont that doesn't have much access with their optometrist, they're not gonna know that he had a preceptor eight times or whatever, only twice were they overseen given the injection. They're probably not gonna know any of that. They're not gonna have anyone, I don't imagine, who can spot a rare genetic disorder and alter the course of treatment. I guess what I'm trying to say as a layperson is I can't imagine how they're going to get the same quality, but it'll be local, and there is some value to that. There's a good thing when your name starts with the letter y because you get to vote last often, and I will be carefully considering what to do as I wait my turn. Thank you.

[Speaker Jill Krowinski]: The question is, shall the bill be read a third time? Are you ready for the question? Member from Winooski.

[Representative Daisy Berbeco (Winooski)]: Madam speaker, I rise in support of s 64 and, because I recognize that everything hasn't been said until everyone has said it. I've heard a lot of incredibly compelling perspectives and information about this bill, which was in my committee health care, where it was voted out ten one zero. Our committee heard from many expert witnesses. We heard from optometrists who were trained in Vermont, went to school outside Vermont and wanted to return back here, but didn't because they can't practice at the top of their license here. There are a couple pieces of information I just wanna share or correct, and that is one, I think someone referred to there being 16 states that do this. There are actually 12 which have allowed optometrists to perform the exact procedures which are named in s 64, 12 states not 16. And the 16 number is probably because they have either fewer procedures or more. I'm not sure. And another piece of data that may be helpful to members is that there was a paper published in 2024 by L. R. Which found that one out of 146,403 laser procedures that were performed by optometrists across those 12 states, there were two negative outcomes, and that's an error rate of point zero zero one over several decades. So although I've heard a lot of incredible experiences, personal experiences, which often undermine all of our votes. And many of us have been contacted by constituents over this bill more than any other in our time serving here. I know I certainly have received hundreds of emails on this bill. However, we're here to govern, and I think I have struggled with this bill deeply because I have a responsibility to protect Vermonters, but I also have a responsibility to honor the expertise and procedures that allow us to function as a government. I've read the OPR reports, And as with other decisions that are made in my committee and in this body, I follow the advice of the licensing body for these professions and for this, it's OPR. They found that these procedures can be made by optometrists with some recommended additional steps which were the eight hours and two procedures or something that someone noted in more detail than I can recall. To me, that means more. The the recommendation of OPR and the 200 and something page report that they wrote as a follow-up, which we asked them to do, it says to me that there is clearly a demand to explore this issue further, which they did very comprehensively. I do not think it is good governance to pick pieces of the OPR report such as the lack of conclusive finding that this will expand access and yet ignore the piece of the report which recommends that optometrists be allowed to perform these procedures given the additional pieces that OPR recommended such as all adverse procedures be reported to OPR within thirty days and additional training be done by optometrists every two years. In my opinion, in my review, the time that this bill was in house health care, OPR did excellent work as they always have done with everything that I've worked on with them. So I'll be voting yes. I am also voting yes because right now, not in 2023 when that OPR report was written, but currently today, there are 115 active licensed optometrists in Vermont, and 56 of them practice in counties where there's no ophthalmologist. There are 29 active ophthalmologists in Vermont. 20 of them are in Chittenden County. So in Bennington, Windsor, Lemoyle, Rutland, Winsom, Wyndham, Orleans, there are no ophthalmologists. And the Northeast Kingdom only has one, and it's in Saint Johnsbury. So I'm hearing loud and clear that there is a hope that this will expand access. I think for me, I don't need conclusive evidence that this is gonna expand access in order to vote yes. I I think that should not be a determining factor. Again, the error rate of point zero zero one for these procedures, about a 150,000 of them performed by optometrists across the 12 states where these exact procedures have been being conducted for decades is probably the biggest reason why I'll be supporting this. And that same paper published in 2024, this is recent data, also illustrated that ophthalmologists for those same procedures actually had a marginally higher rate of error. So neither profession is perfect, which is why we have bodies like OPR to guide us and monitor the ongoing the ongoing expertise and and quality of our licensed providers in Vermont. Please vote yes with me.

[Speaker Jill Krowinski]: Member from Berkshire. Thank

[Representative Lisa Hango (Berkshire)]: you, madam speaker. I wanna talk for a minute about rural access. Like the member from Winooski, I don't need quantifiable data data to know that there's an access issue in Vermont. Most of you who know me know that I really hate to stand here and talk about myself and my personal experiences, but I have to. September Labor Day of twenty '23, being someone who has had numerous eye issues over the years, I recognized that something was really wrong, Called my local optometrist ophthalmologist's offices. There was no advice on what I should do. The offices were closed and there was no advice to do anything. I knew there was a problem. I went to my local emergency department. The doctor there took one look at me and said, I'm sorry, I know nothing about eyes. I cannot help you. And I said, what does that mean? So after some conversation, I encouraged this doctor to help me find a path to figuring out what was wrong and getting treatment for it. We finally did after this doctor took time and had some associates call around to Chittenden County to find out if anybody was open that could see me. No one was open, but there was an ophthalmologist who agreed to see me. We went to their office, which was completely closed, but she was there for me. I'm sorry, you need to be at UVM Medical Center immediately or you will lose the vision in your eye. So again, another round of phone calls. By this time it's 05:00 in the evening on Labor Day. So we went to UVM Medical Center and there was a doctor waiting for me, an ophthalmologist, in a darkened office in a wing of the building that wasn't being used that day because it wasn't really open. And he performed laser surgery which helped me prevent from losing the vision in my eye. So please don't tell me that there is no access issue in counties like Franklin County, where there are only a couple of ophthalmologists who help out neighboring counties and see folks in Franklin County or Essex County where there is no one. There is an access issue. And I thank the body for letting me indulge myself and tell you the story, but I only do that because I wasn't as lucky as the member from Derby who could call up his optometrist and say, hey. I have a problem. I need to come see you. Thank you. I will be voting yes.

[Speaker Jill Krowinski]: The question is shall the bill be read a third time? Are you ready for the question? Member from Norwich.

[Representative Rebecca Holcombe (Norwich)]: Thank you, madam speaker. May I interrogate the presenter of the bill?

[Speaker Jill Krowinski]: The member from Barrytown is interrogated.

[Representative Rebecca Holcombe (Norwich)]: Thank you very much. I'm curious if the health care committee took any testimony on the impact of this on the availability of ophthalmologists in the state.

[Representative Gina Galfetti (Barre Town)]: Thank you for the question. It became apparent that there were not many ophthalmologists in the state. OPR in their report also stated how many ophthalmologists there were in the state.

[Representative Rebecca Holcombe (Norwich)]: Thank you. My question is in we have huge challenges of availability and access on all kinds of procedures and then across all sectors in our rural communities. But I wondered because one of the challenges that we've seen in some of our hospital practices is when we dilute the practice, they aren't able to maintain scale to maintain the practice. And I wondered if in the health care committee you had looked at or explored whether expanding scope of practice would also erode the availability of ophthalmologists in some of our regions.

[Representative Gina Galfetti (Barre Town)]: No, that was never discussed.

[Representative Rebecca Holcombe (Norwich)]: Did you also look at potential impact of on availability of ophthalmologists who we do need for some procedures if people can perform many of the practices that they might do with a much lower level of training and get basically paid to do the same work but with a much lower entry crossed into the profession?

[Representative Gina Galfetti (Barre Town)]: Thank you for the question, member. Actually, it came out that ophthalmologists, a number of them were in favor of this pill because it would some of the minor procedures that they currently do, laser surgery for example, would be then be able to be done by optometrists which would allow the ophthalmologist to then concentrate on the more intricate procedures and such as surgery and that kind of stuff. So, yes, it was discussed but it was that it would actually free up some time from the ophthalmologist and hopefully it would cut down on the wait of three to six months, to get an appointment in to see an ophthalmologist.

[Representative Martha Feltus (Lyndon)]: Can you please

[Representative Rebecca Holcombe (Norwich)]: tell me who which ophthalmologist testified that expanding the the who who provided that testimony?

[Representative Gina Galfetti (Barre Town)]: I don't have specific names and I don't believe whether we do

[Representative John O'Brien (Tunbridge)]: Point of

[Unidentified Member from Burlington]: inquiry a point of order, madam speaker.

[Speaker Jill Krowinski]: Member from Burlington, what is your point of order?

[Unidentified Member from Burlington]: I don't believe we use names on the floor. Thank

[Speaker Jill Krowinski]: Guest member from Burlington, I find your point of order well taken. We don't use names on the floor. You may continue.

[Representative Rebecca Holcombe (Norwich)]: I guess no further questions. I will go and review the transcripts in the healthcare committee.

[Speaker Jill Krowinski]: So the question is shall the bill be read a third time? Are you ready for the question? Member from Fairfield.

[Unidentified Member from Fairfield]: Thank you, Madam Speaker. I certainly wasn't planning on speaking about this today. I would say it's been an eye opening debate but I don't want to make puns. Being from rural Vermont, I have noticed a few things and I've looked at this bill probably more than I thought I ever would and you know, on average, we have basically the average number of ophthalmologists in the state of Vermont as as per capita as anywhere else But then you look at rural Vermont. And instead of the the the per capita of five per 100,000, there's one per 100,000. So that's one issue if you live in rural Vermont and and this is nothing against Chittenden County, I like going there, but that's where everybody is. That's where all of the per capita ophthalmologists are. The rest of us don't have that. The other thing is if you do research, it will tell you, and I'm not a medical person, so I'm not going to attest to this with my life, but a lot of research says that there is no difference in like malpractice, etcetera, between the two. So I understand the concerns and I will tell you that there are two parts of my body that I am paranoid about a medical person touching. One is my neck and the other in my eyes. And I still would not have a problem going to an optometrist for this procedure. And yes, I do have blurry vision. I can barely see the speaker and I can't read up close. I can see the member from Milton. Hi. But I don't I this this bill doesn't harm anyone. It gives us in rural Vermont an opportunity to have providers that we don't have to travel forever to see. It doesn't hurt ophthalmologists. It helps optometrists. We've heard many stories today through emails and probably our own personal experiences of the hardships people are having bringing these professionals into our state. So anyway, I could ramble. I'm sorry. I wasn't prepared to speak but I do support this bill and thank you.

[Speaker Jill Krowinski]: Are you ready for the question? Member from Charlotte.

[Representative Chea Waters Evans (Charlotte)]: Madam Speaker, we heard a lot of testimony in my committee about this. And it has been I didn't anticipate getting to watch an eye surgery on YouTube during committee time, so that was super fun. But what I'm saying is this. We heard testimony that there are barely any reports of adverse outcomes from from these expanded scope surgeries. We also heard testimony that people don't report those adverse outcomes for a variety of reasons, like, you know, relationships between ophthalmologists and optometrists. And I love my dentist very much, but I don't want him doing a root canal. And it's because there are different there are different procedures that people can do who are health care professionals. And so, I guess it my struggle with this, because I'm voting no on this now, today, I voted no on it in committee, and the reason isn't because I don't believe that there that there is a problem with health care access in rural communities. And it's not that I don't believe that everybody in Vermont needs access to good health care, particularly their eyes. But it's we were hearing testimony from an optometrist, not a Vermont optometrist. It was someone from Oklahoma, I think. And he was talking about about the issue at large, and he used the phrase political opposition. And that really gave me pause because this should not be a political issue at all. This, for me, is about making sure that we are doing our job to to give Vermonters all the information they need, all the support they need, and all of the confidence they need in the decisions that we are making for them. And I really admire and respect and appreciate the work that the office of professional regulation does, and I would like to support everything they do. But in this case, it's not that I don't think it's important that we allow this at some point. I just think it is I think that we need more time to make this decision. And I think if it's been going on for eight years, I think we are going to be okay if it goes on for two more. I think that we just need to really figure this out. Because if this is that confusing, then I just don't think we are in a place where we can support it as it is.

[Speaker Jill Krowinski]: Are you ready for the question? Member from Cavendish.

[Representative VL Coffin IV (Cavendish)]: Yeah. I wasn't planning to again, myself. Well, not planning to speak, but I'm gonna run my mouth here for a moment. Yes. This debate's been going on eight years. I've been here for almost two. This bill takes effect in 2028. That is the two more years. Optometrists will need to update their training. They will need to. But this will encourage optometry students that are getting this training now in school that's fresh to possibly come to Vermont. Will this expand practice? Will this increase optometrists immediately? No. Effective date, 07/21/2028. Okay. Will this encourage them to stay? Yes. When I go to the VA 3 times a year for my eye exams, and yeah, do three times a year because my eyes are not so good. I can see little people waving at me on a map. I don't need a GPS. Alright? These things are thick. But when I talk to those young interns and ask them, are they going to stay in Vermont? Are they going to be here? And I have yet to have one tell me yes. No. I'm going somewhere. They're going to let me do what I'm being taught to in college, get taught to in school. We can't attract people. We can't encourage people to improve their practices, to improve their skills if they're not gonna be allowed to do it. This is a move for the future. Not tomorrow, the future. I encourage the body to vote yes.

[Speaker Jill Krowinski]: Are you ready for the question? If so, will the clerk please call the roll?

[House Clerk/First Assistant Clerk (roll call)]: Arsenault of Williston.

[Speaker Jill Krowinski]: Go. Two minutes. Will the house please come to order? Will the house please come to order and members kindly take their seats? I would like to remind members that we are in the middle of a roll call vote. Members and guests are prohibited from using computers, phones or any type of electronic device. Please refrain from the passing of notes in conversation during a roll call. When the clerk calls your name, please answer in a loud and clear voice so the clerk can accurately record your votes. The question is, shall the bill be read a third time? Will the clerk please continue to call the roll?

[House Clerk/First Assistant Clerk (roll call)]: Austin of Colchester. Bailey of Hyde Park. Yes. Bartholomew of Heartland. Bartley of Fairfax.

[Representative Daisy Berbeco (Winooski)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Rebecca of Winooski. Yes. Birong of Regents. Yes. Bishop of Colchester. Black of Essex, Bloomley of Burlington, Bos-Lun of Westminster, Bosch of Clarendon, Put In a Very city, Yes. Boyden of Cambridge, Brady of Williston. Yes. Branagan of Georgia. Yes. Burgum of Saint Albans Town. Yes. Brown of Richmond. No. Burditt at West Rutland. Burkhardt of

[Speaker Jill Krowinski]: Burkhardt

[House Clerk/First Assistant Clerk (roll call)]: of South South Burlington. Burlington. No. Burrows of West Windsor. No. Burditt Cabot. Aye. Campbell of Saint Johnsbury. Yes. Canfield for Haven. Carris Duncan of Whitingham. Yes. Casey Montpelier. No. Casey Hubbardton. Yes. Chapin East Montpelier. No. Charlton of Chester. Christie of Hartford? Gina of Burlington? Coffin and Cavendish?

[Representative Edward "Teddy" Waszazak (Barre City)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Cole of Hartford? Yes. Conlon of Cornwall? Cooper Pownall?

[Representative Gina Galfetti (Barre Town)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Corcoran of Bennington? Critchlow of Colchester? Yes. Demar of Venusburg? Yes. Dickinson of St. Albans Town? Yes. Dobrovich of Williamstown? Aye. Dodge of Essex? Dolan of Essex Junction. No. Dolgin of St. Johnsbury.

[Representative Ashley Bartley (Fairfax)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Donahue of Northfield. Duke of Burlington. Durfee of Shaftsbury. Eastes of Guildford, Emmons of Springfield, Feltus of Linden, Galfetti of Barrytown, Garifano of Essex, Goldman of Rockingham, Goodnight, Bruderboro, Ghostland, Northfield. Yes. Granting of Jericho. Yes. Greer, Bennington. Yes. Greg Burkhardt. Yes. Hango Brixheer. Harpill of Glover. Yes. Harvey of Castleton.

[Representative Mike Mrowicki (Putney)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Hedrick of Burlington. No. Higley of Lowell. Yes. Holcomb of Norwich. Cooper Randolph. Houghton of Essex Junction.

[Representative Carolyn Branagan (Georgia)]: No.

[House Clerk/First Assistant Clerk (roll call)]: Howard of Rutland City. Holland of Rutland Town. Hartford. Yes. Hunter Manchester. Yes. James of Manchester. No. Kacenska Burke?

[Representative John O'Brien (Tunbridge)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Kieser, Rutland City? Yes. Kimball Woodstock? Yes. Krapner, Burlington?

[Representative Matthew Birong (Vergennes)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Hornizer, Brattleboro? Krasno, South Burlington? Labor Morgan. Yes. I'm sorry. Lally Shelburn. Yes. Alona South Burlington.

[Representative Mike Mrowicki (Putney)]: No.

[House Clerk/First Assistant Clerk (roll call)]: Lomono Morristown.

[Unidentified Member from Essex]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Lerush of Franklin. Yes. Lipsky of Stow.

[Representative Mike Mrowicki (Putney)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Logan of Burlington. Yes. Long and Uffin. No. Long and Melton. Yes. Leaders of Lincoln. Bruno of St. Albans City. Yes. Maguire of Rutland City. Malay Pittsburgh. Yes. Mark out of Coventry.

[Representative Michael Marcotte (Coventry)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Maslana Thetford. Yes. McKenna Montpelier. McCoy Pultney? Yes. McGillard Report? Nicholas of Milton?

[Representative Edward "Teddy" Waszazak (Barre City)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Mollieb Callis? Yes. Minnie of South Burlington? No. Morgan Ela Milton? Yes. Morgan Emma Milton?

[Speaker Jill Krowinski]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Morris of Springfield?

[Representative Gina Galfetti (Barre Town)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Morris of Bennington? Yes. Moro Weston? Yes. Roeke, Putney? Yes. Nelson, a Derby? Yes. Nielsen, Brandon? Nigro Bennington. Yes. North of Ferrisburg. Yes. Mollie S. Walker. Yes. Neutrovich. O'Brien at Tunbridge. Yes. O'Brien at Burlington. Oliver Sheldon? Yes. Olson of Starksboro? Yes. Page in Newport City?

[Unidentified Member from Fairfield]: No.

[House Clerk/First Assistant Clerk (roll call)]: Parsons of Newberry? Cozzo of Colchester?

[Representative Lisa Hango (Berkshire)]: No.

[House Clerk/First Assistant Clerk (roll call)]: Pinsonault Dorset? Poucher Hansburg?

[Representative Kate Nugent (South Burlington)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Powers of Waterford? Yes. Bridget Yes. Bridget Burditt? Yes. Quinby of Linden?

[Representative Erin Brady (Williston)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Richardson of Burlington?

[Unidentified Member from Essex]: No.

[House Clerk/First Assistant Clerk (roll call)]: Is that what's a Randolph? Shy of Middlebury? No. Scully of Burlington? Sheldon of Middlebury? No. Sebilia of Dover? Yes. Susie of Barrytown? Yes. Southworth Of Walden? Square Of Underhill. Yes. Steady Of Milton.

[Representative Daisy Berbeco (Winooski)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Stevens Waterbury.

[Representative Mike Mrowicki (Putney)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Stone of Burlington. Sweeney of Shelburne.

[Representative Mike Mrowicki (Putney)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Tyler V. Corcoran.

[Representative R. Scott Campbell (St. Johnsbury)]: Yes.

[House Clerk/First Assistant Clerk (roll call)]: Taylor Mendon. Taylor Mendon. Yes. That a yes? Yes. Conlon. Yes. Torrey Moore Town. Walker Swanton. Yes. Wasses at Deberry City. Waters Evans or Charlotte? No. Wells Of Brownington? Yes. White O'Hatesfield? No. White O'Bethel? Yes. Winter Of Ludlow? Wood Of Waterbury? No. Yakavoni, Morristown? Bartholomew of Heartland, Bosno, Westminster, Burditt, a West Rutland, Christie Hartford, Gina Burlington, Conlon of Cornwall, Donahue of Northfield, Duke of Burlington, Cooper Randolph, Howard of Rutland City, Corcoranizer of Brattleboro, Maguire of Rutland City, Nielsen of Brandon, Parsons of Newberry, Scully of Burlington, Stone of Burlington, Torrey of Moretown, and Winter of Ludlow.

[Speaker Jill Krowinski]: For purpose of explanation, member from Berkshire.

[Representative Lisa Hango (Berkshire)]: Madam speaker, I voted yes for rural access and the opportunity for availability when my constituents need urgent eye care.

[Speaker Jill Krowinski]: Member from St. Johnsbury.

[Representative R. Scott Campbell (St. Johnsbury)]: Madam speaker, may I explain my vote?

[Speaker Jill Krowinski]: You may.

[Representative R. Scott Campbell (St. Johnsbury)]: I vote yes. Is allowing this expansion of practice scope for optometrists safe and appropriate? I don't know. Most of us citizens in this legislature don't know. This decision should have been made collaboratively by the agencies agencies of jurisdiction, the office of professional regulation, and the board of medical practice, not by us. But I am choosing to follow the recommendations of four committees that took extensive testimony, and all support the bill.

[Speaker Jill Krowinski]: Member from Essex.

[Unidentified Member from Essex]: May I explain my vote?

[Speaker Jill Krowinski]: You may.

[Unidentified Member from Essex]: I'm voting no because this bill is nothing but a political fight, and I refuse to make political decisions that affect the health of Vermonters. If you wanna support rural Vermonters, then support ongoing hospital transformation efforts that include shared services instead of providing sub care subpar care to your rural constituents.

[Speaker Jill Krowinski]: Member from Barrytown.

[Representative Gina Galfetti (Barre Town)]: Madam speaker, may I explain my vote?

[Speaker Jill Krowinski]: You may.

[Representative Gina Galfetti (Barre Town)]: The process this bill had to endure while deals were made to get this rural access issue to the floor makes me sick. The member from Stowe paid a heavy toll for being kept from those conversations. I hope the passage of this bill signals a change to this horse trading policy.

[Speaker Jill Krowinski]: Member from Essex Junction.

[Representative Lori Houghton (Essex Junction)]: Madam speaker, may I explain my vote?

[Speaker Jill Krowinski]: You may.

[Representative Lori Houghton (Essex Junction)]: I appreciate the work of all the committees, staff and office of professional regulation and the years of work on this policy. As a member of your healthcare committee, I've worked hard for ten years to grow rural health health care access and its workforce. Yet I felt compelled to vote no because members and staff should be able to deliberate in an environment grounded in transparency, professionalism, and respectful engagement from all stakeholders.

[Speaker Jill Krowinski]: Members, please listen to the results of your vote. Those voting yes, 93. Those voting no, 38. The ayes have it and third reading is ordered. Member from Pulte, can you please offer us a motion to suspend our rules to play senate bill 64 in all remaining stages of passage.

[Representative Patricia McCoy (Poultney)]: Madam speaker, I make a motion to suspend rules in order to place x 64 in all remaining stages of passage.

[Speaker Jill Krowinski]: The member from Pulte moves that we suspend our rules to place senate bill 64 in all remaining stages of passage. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. Aye. The ayes appear to have it. The ayes do have it. And you have suspended rules to place senate bill 64 in all remaining stages of passage. Please listen to the third reading of the bill.

[House Reading Clerk (staff)]: S 64, an act relating to amendments to the scope of practice for optometrists.

[Speaker Jill Krowinski]: The question is shall the bill pass in concurrence with proposal of amendment? Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay.

[Representative Mollie S. Burke (Brattleboro)]: Say nay.

[Speaker Jill Krowinski]: The ayes appear to have it. The ayes do have it, and you have passed the bill in concurrence proposal of amendment. Member from Pultely, can you please offer us a motion to suspend rules to message our action on senate bill 64 to the senate forthwith?

[Representative Patricia McCoy (Poultney)]: Madam speaker, I make a motion to suspend rules in order to message our actions on s 64 to the senate forthwith.

[Speaker Jill Krowinski]: The member from Pultely moves that we suspend our rules to message our action on senate bill 64 to the senate forthwith. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. The ayes appear to have it. The ayes do have it, and you have suspended rules to message our action on senate bill 64 to the senate forthwith member from. On our notice calendar is the senate proposal of amendment on house bill nine forty two which is an act relating to miscellaneous agricultural subjects. Can you please offer us a motion to suspend rules to take up house bill nine forty two off the notice calendar for immediate consideration?

[Representative Patricia McCoy (Poultney)]: Madam speaker, I make a motion to suspend rules in order to take up off the notice calendar for immediate consideration h nine four two.

[Speaker Jill Krowinski]: The member from Pulte moves that we suspend our rules to take up house bill nine forty two off the notice calendar for immediate consideration. Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed please say nay. The ayes appear to have it. The ayes do have it and you have suspended rules to take up House Bill nine forty two for immediate consideration. House Bill nine forty two is an act relating to miscellaneous agricultural subjects. The bill passed the senate in concurrence with the proposal of amendment that is printed in today's calendar. Member from Cabot.

[Unidentified Member from Cabot]: Thank you, Madam Speaker. I'll be as brief as I can. I'm gonna skip to the amendments made by the Senate since we already went over the other portions of the bill previously. If you do have any questions about those, please feel free to ask me. The Senate proposal of amendment, the first and second instances of amendment amend section three six VSA chapter 37, sections six eighty one and six eighty six. And this is found on page Well, the It's found on page thirty nine forty seven of the house calendar. These amendments amend the retail pricing standards section of the bill. The first instance of amendment would add a definition of convenience store. The second instance of amendment would then exempt convenience stores from the unit pricing requirements of that section. Convenience stores would still need to follow the requirements for accurately listing the total selling price of an item but they would be exempted from having to do unit pricing and we heard testimony on that previously in our own committee and we saw that as being an issue that was that the Senate did a good job of addressing. The third instance of amendment adding section four equine farming and use value appraisal program study. This section directs the commissioner of taxes to study and provide recommendations for including equine farming in the use value appraisal program. The report will be due on or before 12/15/2026 and be sent to the house committees on agriculture, Food Resiliency and Forestry and on Ways and Means and the Senate Committees on Agricultural Agriculture and on Finance. It's just a study. It's not gonna change anything right now to address the issue of allowing facilities, barns, etcetera used by equine farms to potentially be included in the use value of the use value appraisal program. The fourth instance of amendment adding section five and amending 10 VSA three twenty five ms regards the Rural Economic Development Initiative. The Rural Economic Development Initiative or R. D. E. Helps rural communities and working lands businesses access funding for community and business development. Currently R. D. E. Assistance is limited to small towns of people of 5,000 or less. This section would permit R. D. E. Support projects called community development initiatives that assist businesses and municipalities throughout the state. R. E. D. E. Projects projects in areas of agriculture, historic preservation, outdoor recreation, and other critical economic development needs. The fifth instance of amendment adds six adds section six and amends six VSA four six four three e. This amends s 60, an act relating to establishing the farm and forestry operations security special fund to provide payments for farm and forestry operation losses due to weather conditions. This section clarifies that it is the secretary of agriculture, Food and Markets in consultation with the review board that makes the determination on awards for this program. It's just a small technical change that the governor requested upon signing with the understanding that we would come back and make a small amendment. It really has no impact on the act itself. It just brings technical correction. The sixth instance of amendment adds section seven amending effective dates. The act shall take effect on 07/01/2026.

[Representative R. Scott Campbell (St. Johnsbury)]: Yeah. What else do we have?

[Unidentified Member from Cabot]: Oh, straw poll. Oh, my apologies. We took a straw poll in our committee, and it was unanimous, eight zero in favor of the amendments from the senate.

[Speaker Jill Krowinski]: And now for ways and means, member from Thutberg.

[Representative James Masland (Thetford)]: Thank you, madam speaker. Ways and means this morning took a very close look at the senate recommendations, excuse me, Senate Committee on Finance, recommendations on H942. We did not have possession of the bill but we did take a very close look with the assistance of a member from Legis Council and a member from JFO. I'm going to be reading mostly from the fiscal report which is available on the Ways and Means website and also House overview page. The bill does not have a direct fiscal impact at this point in time. The bill would charge the Department of Taxes with studying and providing recommendations for including equine farming in current use. If these recommendations were followed, they would likely broaden the scope of farming under current use, which would include a number of properties that could enroll. As such, that has a potential impact in the future of the increased properties in current use would cause potentially a decrease in the available money in the general fund because, excuse me, in the education fund because as we know, current use funds have an impact on the education fund. The reduction in current use due to additional properties would mean the statewide homestead yield and non residential property tax rates would need to be increased in the future to cover the difference. Section four of the senate recommendation would charge the department of taxes with studying and provided recommendations for including equine farming in current use. This report would be due to the house committee on Agriculture, Food Resiliency and Forestry and your Committee on Ways and Means and the Senate Committees on Agriculture and on Finance December 15 current year. The report would also include analysis of potential impact of allowing agricultural land and farm buildings that are currently used in equine farming to enroll in current use. And for this report, equine farming would include would require four or more equines to be owned by the border or the or on the farm. So madam speaker, on a straw poll in ways and means, we voted for for favorable eight one two and we urge the birdie to consider that as you vote on the bill before us. Thank you, madam speaker.

[Speaker Jill Krowinski]: So the question is, shall the house concur in the senate proposal of amendment? Member from Georgia.

[Representative Carolyn Branagan (Georgia)]: Thank you madam speaker. Madam speaker, I intend to vote yes on this bill as does most of our committee. It's important to always get as much information as we can. But I want to point out something to the members. You've already heard part of the fiscal report. May I read one sentence which will be a repeat of what's already been read? I wanna I wanna read one sentence out loud to the members here.

[Speaker Jill Krowinski]: You may.

[Representative Carolyn Branagan (Georgia)]: Thank you. This is from the joint fiscal office report which we received this morning. All else equal, a reduction in Ed fund revenue due to additional properties enrolling would mean the statewide homestead yield and homestead property tax rates would need to be increased to cover the difference. Madam Speaker, we have heard many many times from Vermonters that taxes are too high. They can't afford any more money coming, to be paid into Montpelier. We've heard that over and over again. The thing with current use and with CHIP districts and with the CHIP districts is that money is diverted from the Ed fund before it even gets there for other uses. Things that have have never had a chance to be voted on by the Vermont public there. They are voted on here in the legislature. I want the study to be done because that will give us additional information, us as legislators, a different add to the information we already have regarding how this Ed fund money is used. But I can tell you so far, current use this past year's scooped up $56,000,000 from the Ed Fund for use last year in 2025. TIF districts took $9,300,000 away from the Ed Fund, never hit the Ed Fund coffers. Chip Chip districts, we voted on a year ago, will start to have an impact on on the Ed Fund next January. That's when a report will also, on these figures appear to the e board. So I I want to, be sure that we get this information. I am as I said, plan to vote yes on this bill, madam speaker, and and I hope that other members will as well. But when the report comes in next December, you know what? I'll still be in office because I I get to serve until the first week in January. So I will receive a copy as a member of the ways and means of this report and you'll be hearing from me.

[Speaker Jill Krowinski]: So the question is, shall the house concur in the senate proposal of amendment member from South Burlington?

[Representative Erin Brady (Williston)]: Madam speaker, I wanna make an apology. As the clerk, I think I had a scribbly handwriting. The straw poll vote in our committee was actually six one two. We had two members, not present this morning when we straw

[Representative Richard Nelson (Derby)]: polled. So

[Speaker Jill Krowinski]: the question is, shall the house concur in the senate proposal of amendment? Are you ready for the question? Member from panel.

[Representative Jed Lipsky (Stowe)]: Madam speaker, may I interrogate

[Representative David "Dave" Bosch (Clarendon)]: the presenter of the bill?

[Speaker Jill Krowinski]: The member from cabinet is interrogated.

[Representative Jed Lipsky (Stowe)]: Thank you. Madam speaker, my question pertains to section five, the community development initiatives. The amended version refers to community development initiatives, means priority projects located throughout the state. And my question to the member is whether those priority projects have some criteria with them that has been established, referencing perhaps the priority projects of the ACCD or if this is just general language.

[Unidentified Member from Cabot]: Madam speaker, I didn't catch the very end of of the question.

[Representative Jed Lipsky (Stowe)]: Thank you, member. Madam speaker, my question pertain to whether this is just general language, the term priority projects, or if it refers to something specific.

[Unidentified Member from Cabot]: Madam speaker, I can speak to on that question is that it this is administered by the Vermont Housing and Conservation Board. And with regard to what a priority project means, I'm I'm not I'm unaware of what that might mean.

[Representative Jed Lipsky (Stowe)]: Alright. I thank the member.

[Speaker Jill Krowinski]: The question is, shall the house concur in the senate proposal of amendment? Are you ready for the question? Member from Thutford.

[Representative James Masland (Thetford)]: Yes, madam speaker. I just like the members to know that scribbly notes in their corrections are always appreciated. Thank you.

[Speaker Jill Krowinski]: Are you ready for the question? Member from Shaftsbury.

[Representative David Durfee (Shaftsbury)]: Madam speaker, I just wanted to point out that the the language in regarding priority projects, this is this is existing language and statute. These are existing programs. The Housing and Conservation Board just made a small change to the language so that instead of saying that it seeks to assist, it would include they felt that was important for reasons of inclusivity and making sure that they were able to deal with projects that might not otherwise be allowed under the existing language. And I I think it doesn't it won't change practice at all. And and I urge the body to support the amendment.

[Speaker Jill Krowinski]: The question is, shall the house concur in the senate proposal of amendment? Are you ready for the question? If so, all those in favor, please say aye. Aye. All those opposed, please say nay. Aye. The ayes appear to have it. The ayes do have it and you have concurred in the senate proposal of amendment. Members at this time we are going to recess. We have received some bills over from the senate so please keep an eye on your email for bill updates or if your committee needs to meet. So with that, the house will stand in recess until the fall of the gavel at