Vermont Legislature SmartTranscripts:

[Rep. Matthew Birong (Chair)]: Online now with the last Hi. Are you?

[Rep. Michael Morgan (Member)]: Folks. Welcome back

[Rep. Matthew Birong (Chair)]: to government operations and military affairs. We took a short break so Rep Stone could confer with counsel. Rep Stone.

[Rep. Mary-Katherine Stone (Member)]: I have sent two separate instances of amendment to Nick. And when we are ready, let counsel, do you mind walking through them? No, I could do it

[Jennifer Carbee (Legislative Counsel)]: in the work too, you don't wanna wait. Okay.

[Rep. Mary-Katherine Stone (Member)]: Alright. Are they getting posted for people who are viewing at home or elsewhere?

[Jennifer Carbee (Legislative Counsel)]: So, again, Jen Carvey, Office of Legislative Control. But okay. Sharon, can see. Great. Thank you. This is just the Medicaid piece. So this would however, it would be structured in an actual amendment, and I know how it's being offered, striking out section six effective dates and inserting in lieu thereof three sections to be section six through eight. And it's just the same Medicaid language you have seen, requiring Vermont Medicaid to cover services within the scope of practice of an optometrist with the advanced therapeutic procedures specialty to the same extent they would be covered if delivered by a physician, directing the Vermont Health Access to seek a state plan amendment from the Centers for Medicare and Medicaid Services to take effect on 07/01/2028 to allow the Medicaid coverage. And then nothing that directive to seek the state plan amendment take effect on passage. Medicaid coverage takes effect the later of 07/01/2028 or approval of the state plan amendment if it takes longer. And then the rest of the bill would still take effect 07/03/2028.

[Rep. Matthew Birong (Chair)]: Any questions for council? So what does that mean?

[Jennifer Carbee (Legislative Counsel)]: This is as opposed to all of the representative Stone's proposals embedded in one document. This would be if you wanted to add the Medicaid piece.

[Rep. Matthew Birong (Chair)]: Yes. So

[Rep. Mary-Katherine Stone (Member)]: RepStone with the presentation of these two.

[Jennifer Carbee (Legislative Counsel)]: That's just that's one separate document.

[Rep. Mary-Katherine Stone (Member)]: Yes. There are two separate documents. Right? Yes. Okay. Yes. Okay. With these two, does that mean that everything else in the first amendment is we're scratching that and it's off the table? Or are these Which do you prefer? Are these changes to that amendment? It lives on somewhere, can vote on or not. But again, the whole point was the large Christmas tree and then that was so I could have some conversations and things could be brought up to hopefully find some threads. This is me just saying, okay, Christmas tree didn't seem like it was well liked, or not well liked, but like, you know, whatever.

[Rep. Matthew Birong (Chair)]: It was getting rushed

[Rep. Mary-Katherine Stone (Member)]: through without the appropriate testimony to even know if we liked parts of it or not, but from what I was able to hear today, I think these are the two most important parts that I really want to discuss, and that's to take consideration before passing the agenda. Okay. So we can Okay. Yep.

[Jennifer Carbee (Legislative Counsel)]: Thank you.

[Rep. Matthew Birong (Chair)]: So do we have these two proposals or all three proposals?

[Rep. Mary-Katherine Stone (Member)]: These two proposals right now. Okay.

[Jennifer Carbee (Legislative Counsel)]: Want me to put up the second one? Please. These are now posted on your web page, so I'm pulling it from there. And so this one would do the Board of Medical Practice aspects, but keep everything else in the bill as it came to this committee. So take out section two and put it back in with the additional continuing education for holders of the advanced therapeutic procedure specialty being approved by the Board of Medical Practice. And then it would take out section I kept the highlighting in from the larger amendments so that you could see what the changes are from the bill as it came to this committee. So striking out section four, the new sub chapter in its entirety, and then putting it back in with, again, these changes to put the Board of Medical Practice in and in some cases, the consultation with the Board of Optometry. It keeps, as you can see, it keeps all of the laser procedures in the bill. It doesn't amend that section that took them out of the definition of the for the scope of practice or added them to the prohibited list. It puts back the eight hours of clinical training, and the two of all of the procedures that keeps in the board not closed.

[Rep. Matthew Birong (Chair)]: And maybe my memory's filling me a bit on this piece on the board of medical practice. I I think I recall it, but if not, maybe if I'm wrong, I'm wrong,

[Unidentified participant]: Tom and Silva, saying somewhere it was

[Rep. Matthew Birong (Chair)]: inferred that they would potentially knock that down and not be in favor of doing any of that. There was talk to her about it being confusing. So I think that becomes problematic.

[Rep. Mary-Katherine Stone (Member)]: That was my asked a clarifying question this morning. The board of medical practice would do it and they said yes. So I wrote the word yes and a check mark and wrote underneath it. This could be a middle ground. That was said actually when the ED doc came in of last week, and then the person who was online today in the bottom left hand corner of the screen, that's why I asked that clarifying question at and the he said yes. Did.

[Rep. Michael Morgan (Member)]: I remember that as well. He was very clear about it. He said, we take on groups and the work gets done overnight and we're ready to go.

[Rep. Matthew Birong (Chair)]: So,

[Rep. Michael Morgan (Member)]: well, it sounded like if we couldn't get the board there within fifteen minutes, that it would get done. That was my impression. Again, at the expense of being repetitious, seven years is long enough. Let's move. In law enforcement, if we have an objective, it gets met, we clear the streets, people get back to their regular lives, and those that wanna remain and become guests of the law enforcement community are welcome to do so. But we cart them out of the scene. Done. Seven years.

[Rep. Matthew Birong (Chair)]: You're alive. I

[Rep. Michael Morgan (Member)]: strongly about it. I think it's important. I think it's important dialogue, and I've enjoyed all of this. But, you know, I'm sitting here thinking to myself, seven years. I hope we don't have a crisis situation in which we have to make a decision within a half day.

[Rep. Matthew Birong (Chair)]: I'm sure that it's coming from the heart. No, no, thank you very much, representative. Repetigo.

[Rep. Mary-Katherine Stone (Member)]: Two questions. What would happen to the optometrists who don't hold a certification for the expanded scope of practice? Who would oversee them? Would it be the board of optometry continuing to oversee them or would the board of medical practice have to also in conjunction? No, this was only, the Board of Medical Practice was added only around the advanced procedures, the rest of

[Jennifer Carbee (Legislative Counsel)]: it stays with the Board of Optometry.

[Rep. Mary-Katherine Stone (Member)]: And how could the Board of Medical Practice accurately do that without having an optometrist on the board? Would we have to add an additional member to that board? I think that would be a question for the Board of Medical Practice. I think they do oversee ophthalmologists who perform these procedures. So I'm not sure if it would require an additional appointment. I just asked that because when I asked the makeup of the board, there was specifically mentioned there's one podiatrist and one physician assistant because those are very different from medical doctors or DOs. Their scope of practice is different.

[Jennifer Carbee (Legislative Counsel)]: Board of Medical Practice also regulates anesthesiologist assistance and radiology assistance.

[Rep. Matthew Birong (Chair)]: You put

[Rep. Mary-Katherine Stone (Member)]: the words out of my mouth. I was just saying that the board is diverse, but it doesn't necessarily have a tit for tat on there, don't believe. They oversee anesthesiologist's assistants, but they didn't name that as someone who was on the their board. We don't know if you don't

[Rep. Matthew Birong (Chair)]: have optometrist or something?

[Rep. Mary-Katherine Stone (Member)]: You wouldn't have to have one. I don't think it's in their roles that they have to have an optometrist if they're seeing an optometrist, just like they don't have an AA when they're overseeing AA. So I don't think that that point would be But they're not currently overseeing optometrists. No. That's my concern. If they were under your They are overseeing people who perform the procedures that these optometrists with medical practice are wanting to do. They're indeed. Anyway, we differ on that, but I would be more comfortable if the board had a specific optometrist on it. But that's neither here nor there because that's not part of

[Jennifer Carbee (Legislative Counsel)]: the amendment process. The current makeup of the Board of Medical Practice's makeup is specified in statute. So you could to include at least one, nine must be 17 members, nine must be licensed physicians, one must be a physician assistant and one of podiatrists and six are persons not associated with the medical field. We could certainly look to amend if that was school.

[Rep. Matthew Birong (Chair)]: So what I need to do right now is being conscious of time, we have counsel here for the animal welfare bill. Representative Boyden needs to go down to appropriations. We're going hit pause button on this conversation until we'll pick at this back up. So five. We'll return to this conversation. But right now, we're shifting to animal welfare. Our boy asked about animal preparations for Kansas. It's a floating target this time of year.

[Jennifer Carbee (Legislative Counsel)]: You just stop on the diapers.

[Rep. Matthew Birong (Chair)]: Yeah. We're tapping the brakes on this until later. Dear counsel. Lead your kids. You've jumped. Shift over break here. Eight forty one Council, how are you?

[Hillary Chittenden (Legislative Counsel)]: Doing well. How are you? So for the record, Hillary Chittenden, Office of Legislative Counsel. You had Eric in here last on H-eight 41, but I took over the bill on the Senate side. Need to walk the committee through the changes made by the Senate. Is it all right if I share my screen? So since there are only a few main changes, I won't give an overview. I'll just dive right into the language. The first change will be starting on page four, running on to page five of this master showing the changes to the bill that the Senate made. This section is talking about the authority of the Division of Animal Welfare to adopt rules. What was previously subdivision one was general rulemaking authority. Subdivision two specifically required the Division of Animal Welfare to adopt rules to implement a certified rabies vaccinator program. And there was a bunch of language about that. The Senate Gov Ops Committee took testimony from the Secretary of State's office that indicated this program was already happening elsewhere. So they removed that language from the bill. So it no longer mentions a certified rabies vaccinator program or the Division of Animal Welfare adopting rules to implement it, but it leads the general rulemaking authority. I'll keep moving, but feel free to stop me with questions. This next change is made in a couple of places. On the Senate side, they added pet dealers, which is the language used in the statute. So it's just kind of a fixed conformity. And similarly, removing any other person and one or more domestic pets was just to clarify that regardless of whether they are importing, animal shelters, rescue organizations, and pet dealers are required to register with the Division of Animal Welfare. This next change is on page seven and then running on to page eight, probably easier to see on page eight. The bill, as passed by the House, had a limit on the number of breeding dogs a person could own. A person could not own more than 35 breeding dogs. I believe the goal was to try to address what are known as puppy mills. There was discussion on the Senate Gob Upside about whether 35 was the right number, whether a lower number made sense, or whether there was some other way to address this concern about puppy mills that would make more sense. They heard some testimony from, I believe, North Country Hounds and a couple other individuals who owned a large number of dogs, but none I think no one testified that they had more than 35 breeding dogs. But the discussion on Senate side was without certainty about whether 35 was the right number, they wanted to hear and think more about what the right number was or what the right way to address this concern was. So they removed the 35 limit. And I'll scroll down to the end. This will be, I think, the last change. Instead, the bill already required a report back by the director of animal welfare. And so the language that the Senate side added to the report and don't worry, I'll go back to what I just scrolled over. But the language that the Senate side added to the report was including specifically a proposal for the development of an oversight structure for dog and cat breeders and sellers and people owning large numbers of these animals. So essentially, it's saying we're going to take out that 35 limit, but we want to hear more about the right way to handle this issue, whether it's a 35 limit, whether it's lower. Director of animal welfare, please include that when you report back to us in December of this year, I believe. All right, there are two more changes, so I'll scroll back up. We've gone past them. This section, Section nine of the bill, is requiring, or current law, requires shelter and rescue organizations to gather information about the animals that they are taking in. The bill originally required them to report the information to the Director of Animal Welfare. The suggestion from the Director of Animal Welfare was that there was not capacity at the Division of Animal Welfare yet to take in that information and do meaningful things with it. So requiring adding that burden to shelters or rescue organizations to report it didn't make sense if the division wasn't ready to handle and do something with it. So on the suggestion of Lisa, that was removed.

[Jennifer Carbee (Legislative Counsel)]: Then the

[Rep. Matthew Birong (Chair)]: That's all I'm sorry, I have it here.

[Rep. Mary-Katherine Stone (Member)]: Where was that data coming from? Collected by rescue organizations. Okay, thank you. Yes.

[Hillary Chittenden (Legislative Counsel)]: And then the final change?

[Rep. Mary-Katherine Stone (Member)]: I'm a little confused, because don't we now have a director of animal welfare? We

[Hillary Chittenden (Legislative Counsel)]: do. So the director stays, but right now it's just the director. Her testimony was that there isn't currently capacity for her unit to really do meaningful things with the information yet. I think it's a new division as of two years ago, I think, and they're still building it out. So this might be appropriate in the future, but for now, the discussion was, let's not burden the orgs with reporting if we can't do anything with the reporting yet. All right, and the last change, this is in what was previously Section 14 of the bill as passed by the House. The bill as passed by the House had an advertising section that was requiring any advertisements of domestic pets for adoption or sale in Vermont to include certain information. And there were some questions from Senate go ops about whether this was the right information to require and whether this was the right way to do this. After discussion with the director of animal welfare, she suggested removing it from this version of the bill. The bill, as introduced, had kind of a broader licensing approach, and so requiring this information in advertisements could have been enforced with a broader licensing approach. It made a little bit more sense in that context, and so the director suggested for now not including it and waiting until it was addressed as part of a broader licensing regime, or there was other discussion of enforcement. So don't just stick the requirement out there, there isn't going to be any enforcement in the bill, and wait to kind of do that together. And there were also some questions about requiring that ads posted on the internet include certain information trigger some other legal questions about the right way to do that requirement. And so handling that in future means we could crack that a little bit more elegantly to avoid any possible legal questions. So I think that brings us to the end, capitalize animal welfare on the report section, a few other tweets like that. But that sums up the changes made on the Senate side to H-eight 41.

[Rep. Matthew Birong (Chair)]: Thank you, counsel. Any questions while we're reviewing this? Over to rep Waters Evans as this has been her project for Fears Vail. So the table is yours.

[Rep. Chea Waters Evans (Ranking Member)]: I spoke to some folks just informally over at Exotic Ops and talked to the director of animal welfare. And it seems like everyone was in agreement that these are reasonable changes. She feels fine about them. She's always the priority because she knows her stuff. And it seems generally fine to me. I would recommend that we concur.

[Rep. Matthew Birong (Chair)]: Okay. Any other commentary from the table? Any other questions for counsel?

[Rep. Chea Waters Evans (Ranking Member)]: What happened to the working cats? The working cats?

[Rep. Matthew Birong (Chair)]: That's a valid question. Yes.

[Rep. Chea Waters Evans (Ranking Member)]: Was it?

[Rep. Matthew Birong (Chair)]: God, I forgot about that. Please, let's dive back into

[Rep. Chea Waters Evans (Ranking Member)]: this. I

[Rep. Matthew Birong (Chair)]: will tell

[Rep. Chea Waters Evans (Ranking Member)]: you, when you start talking about

[Rep. Matthew Birong (Chair)]: Oh, she's got a

[Rep. Chea Waters Evans (Ranking Member)]: snarky When you reply to your people to register their cats, and then some of the cats have jobs, and then all of a sudden you're like, Do they need a social security number? It just strikes

[Rep. Matthew Birong (Chair)]: the same. Are they called FICA?

[Jennifer Carbee (Legislative Counsel)]: FICUS, I think.

[Rep. Chea Waters Evans (Ranking Member)]: FICUS. That what they mean?

[Rep. Matthew Birong (Chair)]: FICUS. Yes.

[Hillary Chittenden (Legislative Counsel)]: FICUS. They need more fun. Cute. FICUS. FICUS. We need

[Rep. Chea Waters Evans (Ranking Member)]: need more information, but thank you for asking about the working cats. They are not unionized. That is a bill that go through housing in general, I believe. You would like to see that further. Maybe go see Rex has now because animal welfare and new cancer are an oath. So, working cats are out of this bill, but everything else seems great to me. Thank you for asking Rex. No, no more questions on the cats. You're being serious. I don't know. Cats caused some consternation, so they're gone. I don't want to make anyone license their cat. Okay. I'm not asking anyone to license their cats working or unemployed.

[Rep. Matthew Birong (Chair)]: That's another conversation for human services.

[Hillary Chittenden (Legislative Counsel)]: Amazing how cross cutting animal welfare is. Yeah, it

[Rep. Chea Waters Evans (Ranking Member)]: really is. It touches all aspects of government.

[Rep. Matthew Birong (Chair)]: We could probably hit 11 committees, if you really want.

[Hillary Chittenden (Legislative Counsel)]: We're nice here.

[Rep. Chea Waters Evans (Ranking Member)]: Thanks. Lovely. On

[Rep. Matthew Birong (Chair)]: that note, given the mess amount of work the committee has done on this and Gratwaters Evans' comfort with the changes, I am comfortable calling for a favorable draft hold to concur with the Senate proposal of amendment as presented.

[Rep. Mary-Katherine Stone (Member)]: Well, I'm gonna read the office floor name.

[Rep. Matthew Birong (Chair)]: That's for the floor. Yep, that's for the floor. If you want to reinsert that in there, we would have to review said language, possibly

[Rep. Mary-Katherine Stone (Member)]: Because they're working cats. All

[Rep. Matthew Birong (Chair)]: right, folks. You guys take a break for a little bit before forty five? No, I'm getting to that favorable Can you pause? Sorry. No, we're doing thumbs so we can get to a pause in the action. Nine-zero-two. Yes. Okay. Alright. 902. I will let the office know because this is gonna be up for action later today. We are on break until 02:45, and we will return to our S 60 for conversation.