Vermont Legislature SmartTranscripts:

[Speaker 0]: Senate will come to order. We'll have a moment of silence in lieu of a devotional. Thank you. Good afternoon.

[Speaker 1]: Good afternoon. Afternoon. Are

[Speaker 0]: there any announcements? Seeing none, we have a house bill for reference. H nine fifty two introduced by the committee on corrections and institutions, an act relating to capital construction and state bonding budget adjustment. Please listen to the first reading of the bill.

[Speaker 2]: Evening. H nine fifty two, an act relating to capital construction and state bonding budget adjustment.

[Speaker 0]: Now you've heard the first reading of the bill. It is referred to the committee on institutions. That brings us to the orders of the day. We have up for third reading h two thirty seven, an act relating to prescribing by doctoral level psychologists. Are there any amendments to be offered prior to third reading? Senator from Franklin.

[Speaker 1]: Thank you, mister president. Being handed out today is a proposed amendment, to this particular bill that's offered. The amendment goes to the issue of the age cut off in the underlying bill and the age cut off of the underlying bill essentially does not allow psychologists to provide treatment as the bill was designed to do for anyone who is over the age of 80. There are issues I believe that are significant with this cut off in particular because there are more than one federal law that prohibits it. Essentially, that says that you cannot make medical determinations on the basis of age even though Medicare does by the 65 year old cut off. But it says that a provider can't do that, and the this particular bill does that. What the amendment does is it simply says that for people who fall into that category, there is a way to do that, and if if doing the cutoff is based upon examination, is based upon medical facts, is based on certain co morbidities, based on certain prescriptions that that person takes, then it is appropriate to use age as one of the factors to make a decision. But it can't be used exclusively anymore than you can say that a physician cannot treat a person because of their race, because of their sexual orientation, or because any one of the other protected categories. And age is protected category in that in that situation. And so what this does is it simply says that at least as far as the person over 80 is concerned, that instead of an absolute blank requirement, it says that prescriptive authority excludes the authority to, in 17b prescribe or discontinue prescription drugs for patients who are says are less than 18 at or pregnant and less than 18 basis is courses that you will only got authorized that they can't make those independent decisions or who is pregnant because that again is a medical condition that is relevant to the diagnosis. It then though goes on to say that there's a new sentence added. It says the written collaborative agreement, which is between, the psychiatrist and the psychologist, shall contain a protocol for the completion of a clinical risk assessment of each new patient prior to treatment that specifically includes a review of prescription drug interactions and physiological considerations. What that does is it allows for a diagnostic reason to be used for treating elderly patients or patients of advanced age because very often those people are affected by the kind of treatment. They may be affected by a drug that's prescribed. They may have a condition that is much more likely to be true in an older person than a younger person that requires that. This doesn't specify what kind of review, what kind of interaction, what kind of clinical review is required. That's left to the two prescribers to do or to the extent that there's Professional Regulation, if it chooses to intervene, but it doesn't require them, it doesn't make them. But this is designed to provide a degree of protection to all of the people involved so that you don't do something that is patently against federal law, at least based on the research that I've done. There are a number of other states that allow, prescribers, to be, psychologists. Generally speaking, they also involve a psychiatrist or other medical provider providing some degree of oversight or involvement in various state by state basis. But at least of the research that I've done, and I can't say that I've looked at every section of every law that affects this, I could not find a single case that did a specific age cutoff as this legislation proposes to do. Thank you, mister president.

[Speaker 0]: Thank you, senator. Question is senator senior senator from Chittenden Southeast.

[Speaker 3]: Thank you, mister president. We know that this bill has been, sitting on the calendar for a while. It also has been in as the senator from Chittenden Center Central reported yesterday, it has been in senate health and welfare since last year, May, I think. And your Senate Health and Welfare Committee did consider many issues related to the permission that's been given to psychologists to, prescribe for their patients. And as part of that discussion, we are concerned about elderly patients who are are some of the most vulnerable to increased numbers of drugs. Elderly patients are known to have polypharmacy, which means they take more than one drug. And many of those drugs may be related to psychotropic drugs. And we know that as folks get older, there are physiological changes with reduced liver and kidney function. There are changes to brain vulnerability. In other words, drugs cross the blood brain barrier in a more expeditious manner. So those things need to be taken into consideration whenever anyone is treating an elderly patient. So Mr. President, in many ways what we have in the bill as passed by your health and welfare committee is more protection and more care for elderly patients as they do become more vulnerable as they get older. So and I I don't wanna prolong the conversation regarding the medical foundation for this, but just knowing that if someone has two medications, they are, at a at an adverse drug reaction risk of increased increase of thirteen percent. If they have five medications, which is not unusual for someone who's elderly, to have a fifty eight percent, adverse drug reaction or risk. So there there is data that supports, providing greater care for people as they get older and having consideration for the prescribing authority that is given to the psychologists in the bill. So, Mr. President, that that is on that that particular section of the bill and the other section of the of the proposed amendment. The second proposal of amendment really dives into what, the professional relationship would be with practicing psychiatrists and practicing, psychologists. And we did hear from the Office of Professional Regulation that these protocols are established on a regular basis and to have it in statute is extremely unusual. So we would, on a majority vote by or straw vote on the part of your committee on health and welfare, we ask that you not, support this proposal of amendment. Thank you, mister president.

[Speaker 0]: Thank you, senator. Question is, shall the bill be amended as proposed by senators Brock and Chittenden? Are you ready for that question? All those in favor signify by saying aye. Aye. All those opposed, nay.

[Speaker 1]: Nay.

[Speaker 0]: The nays appear to have it. The nays do have it. And you have not sorry?

[Speaker 1]: Division? Yeah.

[Speaker 0]: Division has been requested. All those in favor, stand. All those please be seated. I thought that was implied, but All those opposed, please stay. Please be seated. Please listen to the results of your vote. Those in favor, 11. Those opposed, 15. And you have not amended the bill. Are there any other amendments prior to third reading? If not, the question is please listen to the third reading of the bill.

[Speaker 2]: H two thirty seven, an act relating to prescribing by doctoral level psychologists.

[Speaker 0]: You've heard the third reading of the bill. The question now is shall the bill pass in concurrence? Are you ready for that question? If so, all those in favor signify by saying aye. Aye. All those opposed nay. Nay. The ayes appear to have it. The ayes do have it and you have passed H two thirty seven. We now have up for third reading h seven thirty three. Are there any amendments to be offered prior to third reading? Seeing none, please listen to the third reading of the bill.

[Speaker 2]: H seven thirty three, an act relating to designating a franchise relationship.

[Speaker 0]: Question now is shall the bill pass in concurrence? Are you ready for that question? If so, all those in favor signify by saying aye. Aye. All those opposed, nay. No. The ayes appear to have it. The ayes do have it, and you have passed h seven thirty three. That completes the orders of the day. I would look to the senior senator from Chittenden Southeast for a motion.

[Speaker 3]: Thank you, mister president. I move pending announcements that the senate stand adjournment until 11:30 on Friday, April 10. Thank you, mister president.

[Speaker 0]: Are there any further announcements? Senator from Windsor.

[Speaker 4]: Thank you to all of those who stopped by the climate solutions caucus today for lunch. The demonstration of how our electric grid works on in a hands on way is still available until 2PM. So if you'd like to see it, you can still go see if an LED or a condescent bulb, for example, takes more energy until two in Room 10.

[Speaker 0]: Any further announcements? Senator from Washington.

[Speaker 1]: Thank you. Senator appropriations will meet at 01:30.

[Speaker 0]: Senator from

[Speaker 1]: Senate government operations will meet at two.

[Speaker 0]: Senate secretary reminds me that we have a decorum session until two. So with that said, chair of appropriations, would you like to amend your announcement?

[Speaker 1]: My dear, I'd like to amend my announcement. We will meet after the session of the call.

[Speaker 0]: Thank you. Are there any other announcements? Ah, senator from Washington.

[Speaker 3]: Thank you, mister president. Senate finance will meet at two.

[Speaker 0]: Any further announcements? Senator from Windsor.

[Speaker 5]: Thank you, mister president. We had a terrific final farmers' night, and it occurs to me that even though and I would also like to express deep appreciation for the one senator who did join us at the Braver Angels workshop, which was, I think, very useful as we work to reduce the divides and improve our conversations with people we disagree with. And, you know, it it just was terrific. I would like, however, to ask all of you, even if you don't necessarily come to Farmers Night on a regular basis, if you have performers in your neck of the woods who you think we ought to be including in Farmers Night next year, we'll begin that process in June after session, and I'd appreciate hearing from you. So thank you very much.

[Speaker 0]: Any further announcements? Seeing none, I will ask only that senators remain seated once we gavel out, and we'll move into the decorum session that was just mentioned. With that said, senior senator from Chittenden Southeast has moved that the senate stand in adjournment until 11:30AM, Friday, 04/10/2026. Are you ready for that question? If so, all those in favor signify by saying aye. Aye. All those opposed, nay. The ayes have it, and we stand in adjournment until 11:30AM, Friday, April 10.