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[Rep. Robin Scheu (Chair)]: Good morning, this is the House of Corporations Committee. Excuse me. It is Wednesday, 01/21/2026. It's 11:45 or so, and we are going to have a run through of age five forty five, which passed out of the Human Services Committee yesterday on a vote of ten ten. And so we've asked Katie Nguyen from legislative council to run through the bill with us. We are being asked to take a straw poll. We're not going to have possession of this because there doesn't actually really appear to be any money, but there maybe could have been at some point possibly if you squinted. So that's why we're just doing a straw poll and a run through, and it'll be going to the floor on notice today on the floor of the thirteenth Friday. So H545, Katie, it's all yours.
[Katie McLean (Office of Legislative Counsel)]: Okay, thank you. Katie McLean, Office of Legislative Counsel. I have the committee report of Human Services pulled up on the screen. I guess we should just take a step back and we'll do a high level because I'm sure you're not wanting to go through all of this language. So currently, a lot of the language in Vermont statute around recommended immunization schedules is tied to the CDC. What this bill does is uncouples that relationship between recommended immunizations and the CDC, and instead has the Vermont Commissioner of Health making the recommendations on the schedule for the state of Vermont. These are not required immunizations. This is the recommended schedule for children and adults. And the way the commissioner does this is through consultation with an existing Vermont based immunization group, and Human Services has updated some of the membership of that committee. It also directs the commissioner to consult with or review existing schedules and recommendations from different professional groups, including the CDC. So CDC, American Pediatric Association, American Family Medicine practitioners, there's a list that the commissioner has to review prior to issuing recommendations for Vermont. What's noteworthy is that this change is in effect until 2031. And then I don't want to say revert entirely, but we go back to the structure that's in place now whereby Vermont statute is coupled with the CDC recommendations again. So a lot This bill, I think, looks longer than It looks intimidating at '24 pages, but half the bill is sort of going back to language that is currently in effect now. So this does is right now it allows the Department of Health to purchase immunizations from the CDC. This would still allow that to happen, but would also allow immunizations to be purchased at other vendors at the lowest cost. If at some point the CDC is not offering immunizations that the CDC doesn't recommend, but the Department of Health does, for example. It allows right now reimbursement for healthcare is tied to the CDC recommendations. The consumer doesn't pay for the immunization. It's covered by insurers. So this would ensure that the recommended immunizations as determined by the commissioner of health would still be free of charge to the consumer. Similarly, authorizations for pharmacists are tied to the CDC recommendations. And this would allow pharmacists to provide the same and pharmacy technicians to provide the same immunizations or have the same authority. But instead of with regard to the CDC recommendations, it would be the Commissioner of Health's recommendations. So that's high level, but those are sort of the major things that this bill does.
[Rep. Robin Scheu (Chair)]: Any questions so far? Wayne, do have a question? Well,
[Rep. Wayne Laroche]: I see what's going on. I don't know if that I approve. But going to the other sources for vaccines, is there any risks there if we're not getting the vaccine quality? Or is that all tied together? Does it all come out of the same pod?
[Katie McLean (Office of Legislative Counsel)]: Meaning if the Department of Health were to purchase immunizations from another vendor besides the CDC, That question did come up in Human Services. The Commissioner of Health, I remember, responded to it. I'm not a medical person, but the Commissioner said that they're very specific with the recommendations in terms of specific type serial numbers that they would be purchasing to ensure that it's not just any flu immunization, but this specific.
[Rep. Robin Scheu (Chair)]: There's also an advisory council. Did you mention that?
[Katie McLean (Office of Legislative Counsel)]: I did. There are actually two. They're both existing. There's one that looks at funding for immunizations. That's an existing statute, and it is a way of calculating the per member, per month payments that the health insurers pay into the Department of Health's existing immunization program. So these calculations are ongoing now. So there really were no changes to that group other than sort of organizational and grammatical. There's a lot of cross out to the group, but the membership itself is mostly the same, maybe some changes to how the appointments are happening. Second group is the group that is helping the commissioner develop recommendations. That is also an existing group. However, there are many more changes to the membership of that committee now that it would be taking on this new role of recommending this schedule to the commissioner. And that's where this is the part that often comes to us because there's a council and there'd
[Rep. Robin Scheu (Chair)]: be per diems, but there's no per diems in this. It's all part of everybody's job, so there's no cost from a
[Rep. Wayne Laroche]: general fund to have this happen. To that question, will this be putting additional burdens on staff so that we incur additional costs within the agency?
[Katie McLean (Office of Legislative Counsel)]: For the health department? I think you'd have to ask the health department. I'm sorry, I can't answer that. I do know that it is the health department that's proposing the change though.
[Rep. Wayne Laroche]: This health department's asking for this? Yes.
[Rep. Martha "Marty" Feltus (Vice Chair)]: I would just point out that I have had some constituents bring to my attention page seven, where there is an immunity towards civil and administrative liability for immunization caused adverse events to the person that administers the concession. Some folks object to that. Thank you. I can talk
[Katie McLean (Office of Legislative Counsel)]: a little bit about that. So this is language, it was referred to House Judiciary and they looked at this particular paragraph. Excuse me. I can walk you through this. A health care professional who prescribes, dispenses, or administers I'm at the bottom of page of no, bottom of page six.
[Rep. Robin Scheu (Chair)]: Okay.
[Rep. Wayne Laroche]: Thank you. It's on page seven.
[Katie McLean (Office of Legislative Counsel)]: A healthcare professional who prescribes, dispenses, or administers an immunization in accordance with the recommendations issued pursuant to subsection A of this section shall be immune from civil and administrative liability for immunization caused adverse events unless the healthcare's professional actions regarding prescribing, dispensing or administering an immunization constituted gross negligence, recklessness or intentional misconduct. So in other words, if a healthcare professional is working within their scope of practice and they're following the recommended immunization schedule set forth by the commissioner, and there is an adverse reaction as a result of an immunization that was given appropriately through the recommended schedule, this provides immunity to that healthcare professional. If that healthcare professional, on the other hand, if the act of administering the immunization prescribing or dispensing constituted gross negligence, recklessness or intentional misconduct, this immunity would not cover those actions and behaviors.
[Rep. Robin Scheu (Chair)]: Is that kind of what we have now?
[Katie McLean (Office of Legislative Counsel)]: So this language was pulled in part from the opioid antagonist statute. There's similar language that a person who is providing an opioid antagonist in good faith and following the appropriate procedures has this type of immunity. So the language was based on that.
[Rep. Robin Scheu (Chair)]: And most medical practitioners have some sort of community, unless except for gross negligence. Mean, sort of in general, the rehab. They have probably insurance. They have malpractic patients, but nothing's going to get paid up if you were grossly negligent
[Katie McLean (Office of Legislative Counsel)]: Oh, I see what you're saying, like a good Samaritan kind of provision.
[Rep. Robin Scheu (Chair)]: Well, yeah, or you won't be covered if you were actually grossly negligent, correct? You're not, regardless.
[Rep. Martha "Marty" Feltus (Vice Chair)]: But if the operation didn't go as you expected, then typically you can't send the doctor. Right,
[Rep. Robin Scheu (Chair)]: like they cut off a long leg or something like that. Mean that's pretty, yes, exactly what you're trying.
[Rep. Wayne Laroche]: Go ahead, Dave? Marty, I had heard from some folks who had some concerns on this provision, and I read it and I couldn't understand why. Is there a backstory here I'm not understanding? Do you know?
[Rep. Martha "Marty" Feltus (Vice Chair)]: I don't know the backstory. I think the information from the people I gathered that their concern was
[Rep. Wayne Laroche]: the
[Rep. Martha "Marty" Feltus (Vice Chair)]: practitioners ought to know that a certain immunization may indeed have a lot of potential problems and therefore they should not be frightened, they should not be using this immunization. And so, they want them to be aware their argument. I see.
[Rep. Wayne Laroche]: Focus, did you address informed consent?
[Katie McLean (Office of Legislative Counsel)]: For immunization?
[Rep. Wayne Laroche]: Is it in this bill at all? Or did
[Rep. Robin Scheu (Chair)]: you speak
[Katie McLean (Office of Legislative Counsel)]: No, not particularly. This bill itself doesn't require any immunizations. It's just setting out the recommendations.
[Rep. Wayne Laroche]: Of what can be used. Yeah.
[Rep. Robin Scheu (Chair)]: Right. How decisions are gonna be made about what is recommended. So they're not, nothing's required.
[Rep. Wayne Laroche]: Hence there's no informed consent, I guess.
[Rep. Robin Scheu (Chair)]: But you know, when I go and get my COVID shot or my flu shot, I have to sign about six different things that talk about the different drug interactions and all those things happen now. And that doesn't change, because this is really only about where we're going to get guidance on vaccinations from in addition to the CDC. Thank you. Yeah, Lynn and Wayne and
[Rep. Eileen "Lynn" Dickinson]: I Can have to you talk about, and hear about the low cost or no co pays and all that? Is there You talked about insurances. Are insurances required to pay this even though it's not part of the CDC anymore?
[Katie McLean (Office of Legislative Counsel)]: That's what this bill does. Instead of coupling it to CDC recommendations for payment, it couples it with the Commissioner of Health's recommendations. Yes.
[Rep. Eileen "Lynn" Dickinson]: For the patient, no matter what.
[Katie McLean (Office of Legislative Counsel)]: Yes. Because of this change, because of the bill, it wouldn't happen otherwise. If you maintain the status quo as the laws right and the CDC had a narrower scope of recommended immunizations, then there would be no requirement on the health insurer to pay any immunizations outside of that Yes, correct. Do
[Rep. Wayne Laroche]: we have any, besides the practitioners' liability, Do we have any other risk for liability coming out from their only recommendations but from not following CDC recommendations. I've dealt with the CDC and recommendations over the years and usually are citing those recommendations for justifying actions that I'm taking.
[Katie McLean (Office of Legislative Counsel)]: I'm not totally following the question.
[Rep. Wayne Laroche]: I'm asking if we're incurring any greater risk for the state or for anybody than deviating from CDC recommendations.
[Katie McLean (Office of Legislative Counsel)]: I think the changes at the CDC are still sort of a little bit of a moving target. For example, in federal law, there's a vaccine adverse event compensation program. Right now, it's still covering all of the immunizations that were recommended prior to the most recent change by the CDC. I don't know if at some point that federal program might be narrowed to only cover what the CDC is recommending. But I think that potential is out there.
[Rep. Robin Scheu (Chair)]: Yeah. So do we have enough information to do a straw poll? Good on that? I don't think we need to take a roll call. If you're in favor, would you just raise your hand? Anybody opposed? I don't think so. Great, so this is eleven-zero. Katie, thank you very much. Lynn, I think this might be yours. Is this yours? Yes. Okay. So you can just say there was no money and we had a straw poll of 11 zeros. That's all you need to say. Very short. That's on today. Well, I'm not sure what's happening. I think it may be unnoticed today and then it'll be Yeah. So tomorrow. Right so we'll let you thank you Katie I know where everybody's rushing today this is just one of those days I'm rushing to a meeting