Vermont Legislature SmartTranscripts:

[Lt. Gov. David Zuckerman (President of the Senate)]: Will senate please come to order? We'll observe a moment of silence in lieu of a devotional this morning. Thank you. Are there any announcements? Senator from Chittenden.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Thank you, mister president. I would move that the senate suspended rules in order to move h two eleven, the data broker bill to the committee on finance via rule 31 pending entry on the notice count.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Ginny And Central has moved that h two eleven be moved to finance per rule 31 pending entry to the notice calendar. Are you ready for the question? If so, all in favor, say aye. Aye. All opposed, nay. The ayes have it. The motion carries. We have a committee of conference report on 07:10, and we are assigning a committee of conference. The conferees are senator Watson, senator Hardy, and senator Beck. Orders of the day. We have on the calendar for action, h nine fifty seven, introduced on 04/15/2026. It was referred to the committee on government operations, which reports it is considered the bill and recommends that it ought to pass in concurrence. Listen to the second reading of the bill. H

[John H. Bloomer Jr. (Secretary of the Senate)]: nine fifty seven, an act relating to approval of amendments to the charter of the town of Williston.

[Lt. Gov. David Zuckerman (President of the Senate)]: Recognize the senator from Windsor, senator Clarkson, for the report of the committee on government operations.

[Senator Alison Clarkson (Windsor)]: Thank you very much, mister president. The Williston charter change is one we have seen many times before. They are simply asking to, remove, their listers from being elected positions to being appointed, and the new appointors would be called as assessors. You see this in September and the first section is of the charter amendment is fairly boilerplate in and you'll see the they strike out blister and and they then adopt an assessor in section 15. They well, that's actually whatever little sub things are called. There are appointed non administrative officials and and that section they add the assessors. The total votes in well, Wilson supported this more than two to one. The total votes cast were 2,496. The yes votes were 1,560, and the no votes were seven twenty seven. There they this was voted at their town meeting in March. They already have an assessor's office set up in anticipation of this change, which is great. So it's up and running, and Williston is growing very rapidly as all of you in that neck of the woods know. And we have one senator who resides in this town and she has confirmed this. And that Williston is excited to have this charter change made. And they embrace the assessors enthusiastically as this is just as their growth is increasingly a challenge for their for the list or office. So, we heard from only two witnesses, we heard from the the sponsor of the bill and the reporter the sponsor of the bill, representative Burkhart, and we heard from our own fabulous legislative counsel and senate government operations asks for your approval.

[Lt. Gov. David Zuckerman (President of the Senate)]: The question is shall the bill be read a third time? Are you ready for the question? If so, all in favor say aye. Aye. All opposed nay. The ayes have it. You've ordered third reading of h nine fifty seven.

[Senator Terry Williams (Caledonia)]: One done.

[Lt. Gov. David Zuckerman (President of the Senate)]: Have s one ninety. It was passed by the house with proposal of amendment. The question is, shall the senate concur in the house proposal of amendment? Senator from Chittenden.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Thank you, mister president. First, I will say that by a majority of the committee and a straw poll, we will concur with a proposal as it came back from the house. And mister president, I've heard some disturbing comments about this bill wandering around the state house, and so I'm gonna take some time to present the bill as it has come back to us and the underlying policies that are here that are going to do some some very important things for all of us in this state. First of all, we're going to be seeing a reduction in in premiums for folks, in in health care. One of the things that we've heard over and over and over again is the increased cost of education, property taxes. And then we hear, well, it's the health care premiums that are doing it. Well, this bill, mister president, as we passed it and now as it's being returned from the other body, The other body has added in language that will reduce health care costs for our school districts. That's exceptional. The other important thing, mister president, is we know that the federal government has not been a friend of health care. And the subsidies for folks who are on what are known as qualified health plans or the plans that exist for individuals and small businesses, those who can least afford to pay for health care. This bill is going to also reduce their premiums. So we have a I guess it's a bifactor. Well, there will be a trifecta with this one as well. So, mister president, what this bill is going to do is to help lower the premium cost in '27 for folks who are on our qualified health plans, our small businesses, and our individuals. And this bill is going to lower premiums for folks who are educators or have health care through our school systems. That's a win win for us. So, mister president, last year at this time we passed act 68. Act 68 was a reinforcement and a referendum to continue work at the Green Mountain Care Board on what's known as re as reference based pricing. Act 68 through its its work also with the agency of human services has resulted in savings through our hospital expenditures of $300,000,000. Our hospitals are working very hard in transformation and saving money through, their administrative, changes. We also know that the work that we've done in act 68, act one sixty seven, and others have allowed for hospitals to become financially sustainable. And that's a continuing part of the work that we have in this bill. We we passed this bill a very strong vote. And I would like I'd like to say, mister president, that this is a next step for improving our system of care, our hospitals, of improving our system of care through cost reduction and making health care more affordable for Vermonters. The Green Mountain Care Board will be establishing reference based pricing for hospitals, and they'll be doing it in a way that is for individual hospitals. It won't be all hospitals have the same level, and that's exactly what passed our Senate. But now there's consideration for whether it's a critical access hospital, whether it's a larger hospital or an academic medical center. Each one will be considered separately. Consideration will be given for payments for specific medical procedures and services. This will be transparent. It will be transparent for hospitals, transparent for insurers, most importantly transparent for us as patients. The hospital fiscal year begins in 2027, October 1. That's five months from now, and we're on a very important timeline because we're in a crisis. We're in a health care crisis, a cost crisis. We have we have seen the loss of over 2,000 people dropping their insurance either completely or moving to a lower level plan out for that has caused them to have more out of pocket expenses and higher, higher costs. So as I said before, this is a product of what we've seen at the federal level. And what we can do here is is not to raise prices, but what we can do here is to ensure that people have access to the care that they need at an affordable price. So just to reiterate, this bill gives the authority for the Green Mountain Care Board to start implementing reference based pricing for hospitals in fiscal year twenty twenty seven. We know that in our prior legislations, we've asked the Green Mountain Care Board to complete comprehensive rulemaking in 2028. This bill, for reference based pricing for our hospitals. This bill allows the board to go forward based on data that they have and data from other states that have done reference based pricing for individual categories of folks like our, school folks or folks who are in the QHP program. Secondly, this bill will reduce costs for those who most need it. That's our individuals and small businesses where they currently may have high out of pocket and high co pays. Our quali qualified health plans now with the work that will go on with this bill will allow for a reduction in the premiums for those folks. They're the ones who need it the most. This will also lower premiums, and it will lower and reduce property taxes because we're focusing on our educators and staff in schools. So the bill will allow the Green Mountain Care Board to commence with reference based pricing in 2027 as was intended in act 68. The Green Mountain Care Board has been working diligently to finalize rulemaking, but due to timing, on putting out a request for proposal and bringing in a consultant, they they won't have time to complete the rules by October. The consultant's been hired, and they're currently working on rulemaking that will be finalized in early twenty twelve '27. But the bill allows them to proceed with commencement in a limited scope without rule just for 2027. And they'll be using, as I said before, data from other states, data from this state, and the board certainly has the the analysis to do this work comprehensively. The bill will now allow, reference based pricing in the qualified qualified health plans in '27. QHP is divided between the individual market, that's individuals who have no option for employer sponsored insurance. They're mainly self employed folks. And then the small group market, and those are small businesses who offer health insurance to their employees but are not able to self insure. Well, these are not the richest businesses in our state. The expiration of enhanced premium tax credits at the end of twenty twenty five has pushed Vermont's marketplace enrollees into impossible choices. Vermont Department of, Vermont Health Access, enrollment tells the story. Vermont lost over 60,000,000 per year in federal subsidies beginning in January 26. Over 5,000 Vermonters have disenrolled entirely from the marketplace by April 26, five times the rate seen in 2025. Of those that remained, we saw a number of Vermonters moving to bronze plans, which have higher out of pocket and co pays. We've seen 60% of new bronze enrollees came from gold plans. These are not new to market shoppers choosing bronze. These are Vermonters trading down coverage they previously had chosen. When Vermonters trade gold for bronze, they don't just pay lower premiums. They face higher deductibles, out of pocket costs when they when they actually need care. We can't call that more affordable. There's also been no relief for the small group plans, and they have never received subsidies and have borne the greatest burden of every rising cost, often forcing them to provide high deductible plans to Vermonters who work for them. We know that one of the significant cross drivers in education funding is the increase in health care costs for our educators. This bill expands reference based pricing to the Vermont Education Health Insurance, and this will reduce spending and stabilize increasing health care costs for PHEV. This will help our education fund and contribute to lowering the tax burden all of Vermonters pay for education. This bill will also help hospitals. The financial pressures Vermont hospitals face are real. Diagnosis matters. University of Vermont's losses, as described by, the CEO, stem primarily from reduced utilization, not from insufficient commercial rates. The utilization process gets worse, problem gets worse, not better, if we allow the QHP market to keep shrinking. When Vermonters can't afford coverage or they downgrade to high deductible bronze plans, they skip care. That means fewer paying patients, more bad debt, more charity care, the exact conditions that further strains hospital finances. This is what is hurting all Vermont hospitals, not this our largest academic medical center. Some hospitals may warrant a unique approach, and that's why in Act 68, we asked the Green Mountain Care Board to consider community need when establishing reference based pricing. The goal of reference based pricing is not just to rein in spending, but to make sure we're putting our money where it matters most. I hope I've made my point, mister president, that this bill is important to all of us in making health care more affordable and moving ahead with the principles that we have established previously. You know, I remember handing out this piece of paper to you all when we looked at s one ninety earlier in the session, and it did talk about what reference based pricing is. It's a standard that we use for specific services or care within hospitals. Reference based pricing is used in across the country. I can list you some of the states that currently use it and the savings that they have found from the use of reference based pricing for their groups of, public employees or for their groups of QHP, and their savings are real. It's in the 40 to $100,000,000 amount. So if anyone would like to know what reference based pricing is, I refer you to the work that we did earlier in the session on that. This bill doesn't define it again because we've done that already in this room. If you want to know the states that have reference based pricing, I'm happy to refer that to you, in a report that came to us in 2024. If you would like to know where we began thinking about this, I'll refer you to our legislation in 2022, 2023, 2024, 2025. We have had a consistent ladder toward affordability in health care in this room. We've had a consistent process to ensure that our hospitals maintain their financial sustainability within our communities. Now, mister president, I I will, go through the bill with you. You have it in the calendar on page forty five fifty four. And what I'll do is to remind you of what is in the bill and then what the house has done as it came back to us and some of the improvements that, I think there there are improvements in the bill. We've I don't want to say that all the time because I think we do good work in here. But it's always important to know that we work in partnership with folks in the other body. So in section one of the bill, the house has added language in B that the board shall utilize reference based pricing to reduce hospital prices incrementally until they equal the national median prices by hospital type in the calendar year 2030. So the median now across the country is somewhere, between 250300% of Medicare. So this will mean that the the Green Mountain Care Board will be looking at individual hospitals until 2030 and looking at how to gradually improve that pricing so that excuse me, mister president. So to gradually increase that reference base or make it go toward the median level so that we can ensure that we have the affordability that we need in the state. The the house did not change the language in the rest of that section. There was a date set in C of section one that they moved the date out to 01/01/2028 for contracts entered into or amended for hospitals and health insurers to begin expressing the percentage of Medicare or another benchmark. So what we know now is that insurers and providers, including our hospitals, enter into contracts and they establish reference based pricing, benchmarks. This will give time for that, benchmarks, to be established by the board and then for insurers and hospitals to negotiate below that bench benchmark. So if the benchmark is set at 300% of Medicare, insurers and hospitals can negotiate for for prices below that. The House made some minor changes. Actually, it's quite a major change, mister president. In section two of the bill with as the bill left the senate, we had qualified health plans for reference based pricing. The, houses added the the educators into that, the high into that, which will, allow for savings for our, school districts in health care. The in that same section two, the Green Mountain Care Board has been given flexibility so that they may establish percentages for individual hospitals for qualified health plans and for the Vermont Health Education initiative. And then. If you look at E1 in that section, what we had passed out of the Senate was a 250% percentage of Medicare for, to be established for hospitals across the board, and this takes that number out. And as I said before, it'll be, it'll be a decision between the Green Mountain Care Board and individual hospitals for their individual, service reimbursement rates. The the house kept language that we had, regarding reimbursement rates on what's on a on high reimbursement Medicare, reference based pricing. So we had the number 500%. Hospitals should evaluate those prices that are above 500%. Some charges are as high as a thousand or 1500% of Medicare. So having those prices come down, and will help, help all of us as we try to pay for those services at the same time. It's in the hospital's hands to evaluate what those services are and how they can best determine where they can reduce those effectively without hurting their bottom line. And they'll be working with the Green Mountain Care Board. Then then there's a section that will that was taken out. We had a large report included in our bill in section three. That whole report is taken out. We asked the treasurer to evaluate a public, insurance program that would have included the high and the SEA. We've take that has all come out. We learned in the house, learned that it would cost the treasurer some money to do that. We didn't have that appropriated. Then we have. The section on a report on the provider tax and how the provider tax might be utilized effectively in the reduction of costs And that is, was included in our bill as came back to us in as it is. Then Section 4A is a new section that the House Health Care added and that allows for, Department of Vermont Health Access in consultation with Department of Financial Regulation, to look at what's known as a 13, 32 waiver. And then then there is the rest of it, provider bargaining groups. That's where the Green Mountain Care Board doesn't negotiate with provider groups, we had in our bill that they would not need to do that. And so that was left in. Then there was a section on appeals for the Green Mountain Care Board. Should a decision be made contrary to the hospital's wishes, The hospital has the authority and the right to appeal that to the Supreme Court from the Board. Then the interactive transparent dashboard, for health system performance, so looking at quality data analysis that is left in at the board level. Then and the other study that we took out, that's the study that we took out on From the treasurer's office that they have taken out. Then. Section nine. Is a is a section on some cost. That is to Medicare beneficiaries when they seek, hospital care. And so is it we discovered in the process of looking at some of the health information that both hospitals and patients were being disenfranchised were being harmed by having extra costs through this Medicare program. Honorable for September 1, there is a working group working on how to ameliorate that and how to provide support for hospitals and for patients. So we'll get a report back from that working group that exists at the Green Mountain Care Board. And that's really it, Mr. President. So overall, the bill, the most important thing that the bill does is to address the affordability issue for us within our system of care by reducing, premiums for qualified health plans and reducing premiums for folks who are in the world of education. You know, in the beginning of the session, our committee had a long conversation. We have a new committee. We have new committee members, and I don't envy the load of information that were placed on them. And they've done a remarkable job in, understanding and working, with us on this, information. But for each one of us on the committee, finding cost savings is important, and finding a way to improve our system of care is important. And we've continued that work, and we will continue to do that work. So, mister president, I'm I'm not gonna prolong your agony, but I will say that I do ask that you support this bill and allow for us to concur with the house proposal on s one ninety. Thank you, mister president.

[Lt. Gov. David Zuckerman (President of the Senate)]: The question is, shall the senate concur in the house proposal of amendment? Senator from Chittenden.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Mister president, I am delighted to have you vote. Thank you.

[Lt. Gov. David Zuckerman (President of the Senate)]: Delighted to have a few more senators join us as well. Senator from Essex.

[Senator Russ Ingalls (Essex)]: Thank you, mister president. We've been on a downward spiral as far as cost on health care in Vermont for a long time, twenty, twenty one years. When you look at New Hampshire's and versus Vermont and Maine's and New England's, 19.8% of our premiums, 19.8% of our payroll goes to paying our premiums on healthcare. A bronze plan in New Hampshire is somewhere around the $400 market and Vermont, it's $1,100 We just we're one of the highest health care costs in the nation and our state. And and I, you know, I just have a real hard time moving forward on something. Could I, inquire of the report of the bill, please, mister president?

[Lt. Gov. David Zuckerman (President of the Senate)]: The reporter's interrogated.

[Senator Russ Ingalls (Essex)]: Mister president, can the reporter point us to wearing this bill or monitors our guaranteed savings?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Mister President, the guaranteed savings will come out of the work that the Green Mountain Care Board will do on reference based pricing. The 2027 work, should that go forward effectively. You never know what bumps in the road there are. But if you look at our qualified health plans and sort of balance what's happened in other states, we'll see a 40 to $70,000,000 savings ballpark. If you look at. Maybe I should look at a report specifically for you so I can tell you exactly what the estimate is. Is. So only for for VHI, the education, will look be looking at maybe, $36,000,000 savings, so there will be savings. So that's where the savings are, and it's not something you put your finger on. It's something that is an outcome. Excuse me, from the work of our regulators at the Greenland Care Board.

[Senator Russ Ingalls (Essex)]: Did we have a JFO note on it to break it down to how much it's gonna save Vermonters? I I I we're talking about savings. And if it's obvious that we're gonna have that, it should have been an obvious number that we could point to. Hear where the reporter has generalized to where some savings could be. But going through the committee process of of what we're talking about bills, we had a good example yesterday with the chair of finance, could move forward on a bill, which I believe rightfully so, actually should have been able to move forward on the bill because we didn't have the, the knowledge about what it was gonna cost the state of Vermont. Is there a JFO note on s one ninety that's going to specifically tell us how much money are we gonna save?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: So, mister president, as you know, joint fiscal, does notes on any appropriation that would be included within the bill. There's no appropriation within this bill. What there is is a regulatory direction that will, save money for Vermonters. If you look at what has happened in other states when they have put reference based pricing in place, as I indicated earlier, when you put reference based pricing in for state employees or school employees as Oregon, North Carolina, Montana, Washington, Nevada, Colorado, what have those states have done, we will see savings relative to our little population in our hospitals. We'll see savings between 40 and $80,000,000. That's nothing to sneeze at.

[Senator Russ Ingalls (Essex)]: I thank you for reporting. Mister president, I just think before we go and transform once again, a large part of our health care and the way that it runs, and we really just can't point to any dollar amount other than just a great idea as you move forward with something. I just can't support something that that is going to vastly change how we are paying through all these systems and we can't point to, actual dollar amount within a million dollars of what, of what we could possibly be saving. I can I I gotta be a no on this? Thank you, mister president.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? Senator from Chittenden.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Mister president, I heard dollar amounts. I I don't know. My colleague keeps saying we can't point to a dollar amount. The tariff health and where welfare gave a range of savings that would be produced by this pill. I just want to go back to the driving need for this and that is our education system as well as our municipalities and other systems are suffering from exploding health care costs. We tasked many years ago our health and welfare committee with finding ways to reduce those premiums. They have done that. Reference based pricing is one way to reduce those prices. By saying we can't point to an exact number the way we could with an appropriation or lack of appropriation doesn't mean there isn't very good reason and evidence to suggest that we will save in the tens of millions of dollars that will find its way into the property tax reductions that we're seeking. So with that said, mister president, I just find it contradictory to say I'm gonna vote against this bill because you can't point to a specific number. We were given a range of savings that we will see. I trust the health and welfare committees work on this, and I will be not just a yes but an enthusiastic yes because this goes to the heart of the issue, which is not just the property tax, but one of the biggest drivers of the property tax, that is health care premiums. I heard very loud and clear from the chair of health and welfare, those will come down. That's the direction I'm seeking, so I am a yes on this bill.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? Senator from Franklin.

[Unidentified Senator (diarization mixed Franklin and Rutland recognitions)]: Thank you, mister president. I too am all about affordability for our constituents in and throughout the state of Vermont. I guess I just need a little clarity if

[Lt. Gov. David Zuckerman (President of the Senate)]: I could interrogate the presenters.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Presenters

[Lt. Gov. David Zuckerman (President of the Senate)]: interrogated. Mr. President,

[Unidentified Senator (diarization mixed Franklin and Rutland recognitions)]: what happens if the Green Mountain Care Board ultimately chooses not to implement the meaningful reductions? Because the bill repeatedly says the board may act. Is it possible that Vermonters absorb implementation cost and system disruptions while seeing little or no measurable affordable

[Senator Virginia 'Ginny' Lyons (Chittenden)]: benefit? Thank you, mister president. That's a very good The reason the word may was put in there is given the timing of this so that any decisions on changes to reference based pricing across the board will be a lot of work with all of the 14 hospitals that we have in the state, and then putting that information out by October 1 when when the work is done. So so there's flexibility there for the board in addition, to everything else. Understood. Okay. Act 68 said, begin reference based pricing in 2027. We're approaching 2027. This is the time to do it. Understood. We also have an underlying statute that the board shall write rules by 2028 and shall begin reference based pricing across the board for everyone 2028. This is a one year interim event that allows for us to look critically at reducing costs for people on quality health plans, small businesses, individuals who can lease the Ford insurance, and then also our educators to help lower our property taxes. So, you know, so maybe you wanna do nothing. What good will that be? Thank you, mister president.

[Unidentified Senator (diarization mixed Franklin and Rutland recognitions)]: I thank you, senator. Mister president, I can't say that I'm enthusiastically a yes or a no on this particular issue. However, I can say at this point, I'm I'm somewhat skeptical. But thank you, mister president.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Washington.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Thank you, mister president.

[Senator Ann Cummings (Washington)]: Those of us that spend our mornings in health and welfare, I think, can get into the weeds. The balance the reason May is in there a lot is because we only have one hospital out of 14 in this state that is just over the line into the black financially. All of our other hospitals are in tenuous financial shape. If we do reference based pricing, which says you can charge x percent above generally the Medicare price, That is going to reduce what they can charge. That reduces their revenue. If we reduce their revenue too quickly, they will go under. So health insurance may be cheaper for people who live in the kingdom, but they may need to drive to Burlington to get that health care if our rural hospitals start to go under. That's the balance that we're we're striking. And so we're trying to move it down, but very

[Senator Virginia 'Ginny' Lyons (Chittenden)]: small rural hospitals are

[Senator Ann Cummings (Washington)]: financially shaky nationwide, and they're closing. And so we're trying to to just find that balance for folks, and that's why there's no guarantee because if it looks like a hospital's going under, the board will have to back off.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? Senator from Addison.

[Senator Ruth Hardy (Addison)]: Thank you, mister president. As senators know, I spend a lot of time looking at, education policy and school budgets and education funding mechanisms. We have a committee right now that's working on our yield bill that's trying to figure out how much we ratchet down the amount that school districts are allowed to spend. And this is a serious issue, and it's one that is really going to have a big impact on the education system in Vermont. One of the biggest cost drivers for school districts is health insurance. And what this bill would do is start to address that more in a more targeted fashion. I want to remind senators that last year we passed a reference based pricing bill. It was a bipartisan bill. It was something we all agreed on. One of the members of the other body in my district, he and I love to stand up. We're from opposite parties. We love to stand up and

[John H. Bloomer Jr. (Secretary of the Senate)]: be like, we agreed on this thing.

[Senator Ruth Hardy (Addison)]: We both agree on reference based pricing because it is an effective mechanism that has been used in other states to bring down health care costs. And what this bill does is target it as an initial step to do it where it's needed most. As several senators have noted, it would start with health care costs in our education system and health care costs for our small businesses. Those are entities that need the relief now, And there are guardrails and ways to get out if necessary, as the senator from Washington just said, but this is an important first step to lowering costs in our health care system and in our education system. And it's really important that we pass it now, and I hope the whole chamber will support it. We all want an affordable state. Now is the time to vote for it. Thank you, mister president.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? Senator from Rutland.

[Senator Russ Ingalls (Essex)]: Thank you, mister president.

[Unidentified Senator (diarization mixed Franklin and Rutland recognitions)]: May I inquire that you report of the bill Reporters interrogated. Earlier, I believe mister president's reporter said a majority of the committee voted to support this. I'm wondering if the exact vote could be

[Senator Virginia 'Ginny' Lyons (Chittenden)]: sure. Mister president, it's a straw poll. It was three to two. The two who voted against it were two new members who felt they didn't have sufficient member, info one at least didn't have sufficient information on reference based pricing, and that's understandable given where we are. But I do think that with the testimony that we've taken from experts across the country and in the state and in New Hampshire, that we have a lot of data and from the and also experts who have worked with the Green Mountain Care Board from other states. We have a lot of data that supports the work that underlies this bill and will help move the the work forward.

[Senator Russ Ingalls (Essex)]: I thank the reporter. Mister president,

[Unidentified Senator (diarization mixed Franklin and Rutland recognitions)]: I ask when we take a vote, would it be by roll call?

[Lt. Gov. David Zuckerman (President of the Senate)]: The senator requested that when the vote is taken, it be by roll. Are you ready for the question? Senator from Caledonia.

[Senator Terry Williams (Caledonia)]: Thank you, mister president. May I inquire of the reporter of

[Senator Nader Hashim (Windham)]: the bill?

[Lt. Gov. David Zuckerman (President of the Senate)]: The reporters interrogated.

[Senator Terry Williams (Caledonia)]: Hi. Thank you, mister president. I and I apologize for some of these questions. I've I've never, served on a health care committee, these might seem pretty basic, but I'm just trying to get some information here. Can the senator please let me know which of the hospitals in Vermont are not critical access care hospitals?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Well we have some prospective payment system hospitals such as Rutland, the slightly larger hospital, Southwest Hospital. I don't have them all on the tip of my tongue right now, mister president, but there are four or five of them, and I'm glad to get those all for third reason.

[Senator Terry Williams (Caledonia)]: Okay. I I know where Rutland is. Is Southwest? Is that Princeview Bennington?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Yeah.

[Senator Terry Williams (Caledonia)]: Okay. Thank you, senator. So my next question, I'm looking at and I'm looking at section two on page 4,556 of the bill, two sub a, and the the term Medicare adjusted base rate and my understanding, please let me know if I'm incorrect here, is that the Medicare adjusted base rate is what the reference based pricing price is that's the base for reference based pricing?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Yes.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Okay.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: I'm Just the base. So we have the base, and then we have the adjusted base as a percentage of Medicare.

[Senator Terry Williams (Caledonia)]: Okay. Thank you. I understand that now. And then at the end of that section, it talks about to establish baseline payment levels which include adjustment for geographic factors such as wages. So if there's a an adjustment for the wages in a certain geographic area, can that adjustment only be up or could it be down how does how does that work?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: So that is a consideration to be made by the board when they are looking at hospital, reimbursement, rates.

[Senator Terry Williams (Caledonia)]: But, just to put a fine point on the question could the could the board adjust down from the Medicare adjusted base rate or only up?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: They would probably be only going up from the base. Okay.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Yeah. Thank you.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: But if it's a reference based price that's been established by the board then there would be flexibility within that would become the high point.

[Senator Terry Williams (Caledonia)]: Okay. Thank you. And then moving down to in the same section sub b there the same page that sort of

[Senator Virginia 'Ginny' Lyons (Chittenden)]: What page are you on?

[Senator Terry Williams (Caledonia)]: I'm on page forty five fifty six of

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: the bill

[Senator Terry Williams (Caledonia)]: of the calendar sorry. In section two I'm in the same area here on sub b, it says that the Medicare adjusted base rate shall be applied to a critical access hospital assuming that well if it were not designated a critical access hospital and some my question is is there normally in the when I guess this would be the Fed when they establish a Medicare adjusted base rate do they do critical access care hospitals normally receive a different Medicare adjusted base base rate?

[Senator Virginia 'Ginny' Lyons (Chittenden)]: They will receive a different reference based pricing. So this allows for critical access hospitals to be considered within their category, and it will allow for adjustments to be made based on geographic location, on economics. So it's a it's a it's a lot of work, and then you start moving into the types of services and so on.

[Senator Terry Williams (Caledonia)]: Okay. But but this language, and I assume this is this is underlined, so this is a part of the House proposal. It says, you know, last clause using the Medicare payment methodology that would apply if the hospital were not designated as a critical access hospital. That to me means that whatever adjustments the Feds might make for that critical access hospital that this language would preclude that adjusted base rate to account for the fact that they are a critical access hospital.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: So, yeah, that's a confusing phrase, but it does allow for critical access hospitals to be considered separately and with their own individual, needs and location.

[Senator Terry Williams (Caledonia)]: Okay. I think the senator, I guess, I I know this is only second reading. We have a third reading and

[Unidentified Senator (diarization mixed Franklin and Rutland recognitions)]: Yeah.

[Lt. Gov. David Zuckerman (President of the Senate)]: So let me correct everyone. The question is, shall the senate concur in the house proposal of amendment? You still have the floor, senator.

[Senator Terry Williams (Caledonia)]: Thank

[Lt. Gov. David Zuckerman (President of the Senate)]: you. But I I wanna it's been stated a couple times. We have time before third reading. We don't. The question is, shall the senate concur in the house proposal of amendment?

[Senator Terry Williams (Caledonia)]: Okay. Thank you for clarifying that. And that is really, I guess my real hang up with this bill. I appreciate that some numbers have been thrown out that are believed savings. I appreciate the pro tem putting a point on that, but this to me, this language looks like that Medicare adjusted base rate can be increased based on geographic factors such as wages and I don't know exactly where those areas of the state would be. Probably University of Vermont Medical Center. I don't I don't know what the data says about wages around the state, but it looks like that the UVM Medical Center wouldn't receive an increased base rate. I understand that that makes that makes perfect sense to me. I think the the wages in Burlington are higher than the wages at St. John's Buried and BRH, and that makes sense to me. But what does not make sense to me is that it seems like the feds, they do provide a different Medicare adjusted base rate for critical access hospitals, which I think generally speaking are in rural parts of the state, generally speaking. But this language precludes the Green Mountain Care Board from applying that adjustment for morality for those critical access hospitals and I think while I don't I am open to the idea that maybe this language could be better or refined or whatnot, but I think that's what this language says is that if a critical access hospital, if they deserve an extra base increase because of where they are, population density, reality, that this clause sub b blocks the Green Mountain Care Board from adjusting that base rate to meet that. And that's a real problem for me, especially as we I think that's in some ways been the overriding theme of maybe this biennium, if not this session, is that how is this all gonna impact rural Vermont versus urban Vermont? And I think that this as is drafted right now, it's really, it's okay for the areas of the state that have increased wages. They're going to be adjusted for that. And again, I don't disagree that that's an appropriate thing to do, but it precludes the areas of the state that might have a different base rate because of their morality, because of their population density. And so for me, that's a nonstop. And I'm going to vote no unless maybe we want to take a recess and somebody wants to clear put some clarifying language in here to make that okay for me. But right now, I am not okay with this bill as it's this proposed amendment and I'll be voting no.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Chittenden.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Thank you, mister president. I know it takes a lot of, reading and understanding and being on health and welfare or Green Mountain Care Board or working with this language to appreciate it. But number two on page forty five fifty six at a and b that's all one big definition. And there's a lot of work that goes into establishing the Medicare base rate. We look at services, types of services, look at, level of risk for for patients that are being served. We put all of that into we don't. Green Mountain Care Board does. This is this is a known entity for the regulatory world. What is good about is it allows for flexibility for smaller hospitals. That's what's good about it. Because without it, you're gonna put a rate in there that will cause hospitals to fail financially. So I I would say, not being versed in the language is something I completely understand, But I have to say it's been drafted very well and beautifully with a lot of input from folks, who who also understand the language. So, you know, it's interesting to me, I have to say. This bill left my committee. Everybody was happy. The administration, the hospitals, the insurers, the patients, legislators. Now what's happened? The only thing I can say, mister president, and I hesitate to say this because this is not part of my world. I like policy. This feels so political. It's unfortunate. It's sad. When you can save Vermonters money, individuals mister president. Small businesses

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Caledonia, what is your point of order?

[Senator Terry Williams (Caledonia)]: Mister president, I believe the, the senator is invoking motive.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Caledonia, you should stay. Risen senator from Chittenden, you should be seated. Senator from Caledonia, I find your point of order not well taken. The senator is still within the bounds of our rules. Senator from Chittenden, you have the floor.

[Senator Terry Williams (Caledonia)]: Thank you, mister president.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Thank you, mister president. As I was saying, it's a sad day when we can't reduce premiums for folks who are individually in the qualified health plans. It's a sad day when we can't vote for reducing premium costs for our educators and lower property taxes. I don't understand why we would vote against that, mister president. I'll be voting for this bill, and I'll be voting for many more. I will have faith in our regulators, in our hospitals, in our insurers to work together to have the outcomes that we need in this state. We are in the midst of a federal government that is not happy with health care. They are not doing things good for health care. We can't let that affect us. We need to move forward with what we can do in this room, in this building. So, mister president, I ask you to search yourselves and think about the people you represent. Do they want their premiums lower? Yes. Do they want their health care system reformed? Yes. Do they not want to be the highest cost hospitals and the highest cost insurance in the country? Yes. They would like to be lower. That will help all of us economically. That will help all of us live in this state in a more affordable way. That'll keep people here. That'll keep providers here. That'll keep health hospitals whole. That'll help small businesses. That'll help small individuals. That'll help schools. That'll help property tax loans. Well, thank you, mister president.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Chittenden.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Thank you, mister president. My second time speaking on this. I I normally don't speak twice on a bill, but I would take us back to the last election, which I've done more than once over the last two years. We heard loud and clear from our constituents that we needed to lower their property taxes. We have an ed transformation bill underway now very close to the end. A conference committee is nearing the end point for that. We have a yield bill that will buy down people's tax rates and that will also set an excess spending penalty all designed to keep the property tax low. I view this bill as very much in the same class as those bills. Bills. In other words, we should not go home without we should not go home without addressing, property tax rates as they are driven by health care premiums. So this is the premier bill from the health care committee to lower premiums and thus property tax rates. So everyone knows that we are in the end game of the session. Everyone knows that we're potentially within forty eight hours of going home. When that happens, and anyone who's been in the building for a while understands this, when that happens the minority party begins to assert a little more authority over what can be, accelerate. What can move in that faster time frame with rule suspensions and so one of the things that our colleagues across the aisle sometimes do is say, we don't want this bill to move quickly. We want it deny rule suspensions. Sometimes that kills bills, and it kills them because we're not willing to stay another day. So there are a number of bills that I wouldn't make this following statement on, but I will on this one. If we are not going to be able to get this bill because people wanna get out tomorrow, we will not get out tomorrow. We will get out when this bill makes it across the finish line because all of us said to our constituents, we are going in with a laser focus to reduce your property taxes. There's no way to do that without affecting health care premiums. We have explicit testimony from the chair of our health and welfare committee that this bill will do that. I trust her. I trust the range of numbers that have been offered to us. Those are substantial savings. Those will translate into lower lower property tax rates. So with that said Mr. President I I don't like to condition things on events that have yet to happen but I will say that my hope is to be out tomorrow by midnight. If that is not possible in order to get this bill, we will find other ways. The session can be extended in various ways, hopefully without impacting our bottom line, but we will get this bill assuming a positive vote out of the Senate to concur with the House. I will do everything in my power to make sure we go home with these reductions in price for premiums and reductions in property tax rates. Thank you, mister president.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question?

[Senator Alison Clarkson (Windsor)]: Roll

[Lt. Gov. David Zuckerman (President of the Senate)]: call has been requested and then the vote is taken. It shall be by roll. Senator from Caledonia.

[Senator Terry Williams (Caledonia)]: Just to be real brief here, I I do think it's unfortunate that some, believe that the defense of rural Vermont is political. Thank you.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Chittenden.

[John H. Bloomer Jr. (Secretary of the Senate)]: Mister president, I I will not deign to, guess what's in people's minds or impugn anybody's motives or character, but we've heard two things pretty clearly in this debate. One is I don't know what this would do. I don't understand well enough. And the other thing we've heard is that maybe there could be amendments. Maybe we could fix the language so that more people feel comfortable with what, impact it will have positively and negatively in their communities. That is the right of any Senator. And that is the right, particularly of the minority party, when they see something complex and want to be part of creating the solutions that move forward. Mr. President, a very wise former Republican minority leader in the house once said to me that if we're all doing our jobs right, then the majority steers the ship and the minority points out the rocks. There are rocks, mister president. The the senators present have a duty to listen to their constituents and get bills like this right Because inaction is no longer an option. Inaction, frankly, on healthcare has not been an option for an incredibly long time. But throwing one's hands up and saying, don't understand, but I see healthcare costs escalating for my constituents is not fulfilling one's full duty in this body or as an elected official. So Mr. President, I would say I for one would welcome a recess, a proposal of amendment that helps us meet the very critical needs to reduce our healthcare costs in the state for our constituents. But if that is not being offered, then simply saying, I don't know, is also a choice in this moment.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? The question is, shall the senate concur in the house proposal of amendment? Senator from Windham.

[Senator Wendy Harrison (Windham)]: Just very briefly, I do know that my rural district is hurting because of the cost of health care, and I do strongly believe and trust the, committee process and the all of the work that we've done to reduce health care costs. And I do know that my rural hospitals need a comprehensive system, which is what we are going to. So I am very supportive of this bill.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? Question is, shall the senate concur in the house proposal of amendment? If so, the secretary shall call the roll.

[Senator Ruth Hardy]: Senator Ruth? Yes. Senator Beck?

[Senator Scott Beck]: No. Senator Bongartz?

[Senator Seth Bongartz]: Yes. Senator Brennan? No.

[Senator Terry Williams (Caledonia)]: Senator Williams? No.

[Lt. Gov. David Zuckerman (President of the Senate)]: Those voting yes, 17. Those voting no, 13. And the senate has concurred in house proposal amendment on s one ninety. S three twenty three was passed by the house with a proposal of amendment. The question is, shall the senate concur in the house proposal of amendment? Senator from Essex.

[Senator Russ Ingalls (Essex)]: Thank you, mister president. We have received back from the house a proposal of amendments and by straw poll of the agriculture committee voted five zero zero to concur with the changes. The changes were de minimis, and we're happy to move forward with s three twenty three. I also want to sincerely with everything I have thank the Senate for their hard work as the Pro Tem has heard me say numerous times. When a bill comes through the committee that I'm chair of, it's going to be a Senate bill before it's all said and done. We couldn't have done this without the work of the Senate. We have different opinions on a lot of agriculture stuff. But we started out the year with a very hard task in front of us with a Supreme Court decision that was going to profoundly change on how farming would be in the state of Vermont. And the Senate Agriculture Committee worked really, really hard with the help from the body of the Senate to make as a senior senator Rutland has said, and I believe landmark decisions based on how farming is going to thrive and survive in the state of Vermont. So we're very happy about that. We also were first in the nation of coming with a ban on paraquat. Those decisions aren't taken lightly and we were appreciative of the flexibility of the senators who felt strongly one way or another to allow us to come with the terms that could work for all. So very thankful of that. Also want to say, this is the last bill that we have, of 2,026 coming out of the Senate. And I wanna, expressly, thank the pro tem for, four years of, being under his administrative watch of being a chair in the committees. Politically, we probably don't agree on a lot, but humanly, we agree on most. And it was an honor to serve for you, mister Pro Tem, and I wish you the best in the future as you move on. Thank you, mister president.

[Lt. Gov. David Zuckerman (President of the Senate)]: Question is, shall the senate concur in the house proposal of amendment? Are you ready for the question? If so, all in favor, aye. Aye. All opposed, nay. The ayes have it, and the senate has conferred in the house proposal of amendment on s three twenty three. We now have h nine forty four. The committee conference has submitted a report as found in today's calendar, and the question is, shall the senate accept and adopt the report of the committee conference? Senator from Lamoille.

[Senator Richard Westman (Lamoille)]: Mister president, this is a a spending bill that has about, in total programs, nine thirty six million in program spending. There's one time spending of about $6,000,000 in this proposal that comes through. So we're just shy of $1,000,000,000 in our spending in that. In the overall, let me go back to what we were trying to do. There's short term pieces in this of our financial problems. There's a long term piece that we dealt with that is around vehicle miles traveled, and then there is help for the towns, which you will find most of that language now is in the big bill, it directly related to where we are, and there is language all around it. So there are all of those pieces are included in this, and I will talk about that a little later. The shadow that is created in this in the overall is really the shadow of the relationship between the general fund, the T fund, and the education fund. That shadow is really in the shorter term problem that we have. And there is work in the miscellaneous tax bill that relates to that, that is around purchase and use, and the solution that is a partial solution in this has one year of reducing the purchase in use tax. That overall shadow really does affect everything that we did in this. In the bill itself, and I'm just going to go through the key points, in the transportation program, we utilized $1,750,000 in additional TID bond funds, And the TID funds that we used, we reorganized in this from the House pass bill, and we used the excess in that for state highway Bridget projects, and we freed up the 1.7 from the T bill, and we put that money into district leveling, and we took $50,000 and put it into Drive Electric Vermont. In the bonding areas that are in this, we require a report on projects that could be built more quickly if the General Assembly authorizes the use of transportation infrastructure bonds in FY '28 '29. So basically, we set ourselves up to get the information in '28 and '29 to be able to bond with larger projects if we, if that made sense, and we will get the information back next winter to be able to do that. So the tool that is bonding, we keep as an option. In the mileage based user fee, what is in this? We will apply mileage based user fee to electric vehicles beginning 01/01/2027. We cap what they can spend for this initial period at $178 per vehicle in this. Following a transition period, the EV owner will be able to choose whether to pay the MBA for the mileage based user fee at the end of each reporting period on a pay as you go basis or as a flat fee at the beginning of each reporting period. This requires AOT to design and submit for approval by the General Assembly a plan on proposed legislation to expand NBUF to plug in the hybrids in 2029. We asked them to develop a plan, bring it back to us, and the legislature will consider the plan that AOT develops. But nothing will go into place until the legislature takes action upon that. Part of the reason we need to do that now, and we wanted to do that now, is because we have a $3,000,000 federal grant to work on this and it will allow us to use that grant to move forward. In other areas in transportation alternatives, we increased the maximum grant awards from 300,000 to $600,000 with $1,200,000 in FY27. We eliminate the 50% set aside for environmental storm water mitigation projects, but we add a preference for salt and sand sheds in this bill. We have language about non emergency medical transports in this. There's money within the appropriations bill that the conference committee hasn't signed, we have agreed to money between both sides for 300,000 to keep the effort up that we started last year when we put 600,000 into working on the issue of getting more people to help drive in non emergency medical transports. We expand EV charger availability and information. We create requirements that the publicly funded and available EV charging stations that are installed or refurbished after 09/30/2026, must make real time status information available to third parties through an app. So basically, the infrastructure that is charging stations around the state, there'll be one place that's an up to date place to go to figure out where you can get charging and what that charging looks like. The bill prohibits common interest communities from placing unreasonable restrictions on installation of EV chargers in certain areas. So if you have a condominium development, they can't just say no, but this sets up a process for condominium developments and their governing boards to help people be able to have charging there. It basically states that the community may impose reasonable restrictions but not unreasonable restrictions. There's a bunch of miscellaneous provisions within the bill. We permit Green Mountain Transit, the public transit agency, to include voluntary member contributions and grant donations from other organizations, which they hadn't been allowed to. We extend AOT's public private partnership authority until 2029. The bill brings Vermont statutes into alignment with the National Bridge Inspection Standards. We make changes necessary to complete the sale of the Caledonia Airport, repeals obsolete language relating to log dries, which we haven't had in a century and requires a DMV to study in potential of implementing an intelligent speed assistant program in Vermont. Different from what was in the Senate, we advanced The bonding that we had proposed in the Senate bill was more aggressive than the report back that we're getting, but we will get all of the information we need to be able to move forward next winter with the language that we have in the bill. We removed a number of the payment options that are in the vehicle miles traveled, there were numerous, there were five ways to pay, we scaled this back in what is before you. There are changes in effective dates, and we got rid of some of the language that was around the law authorizing the Public Utility Commission and what their authority was because they had been in. Those are the main differences between the bill and the House and the Senate.

[Senator Ann Cummings (Washington)]: But

[Senator Richard Westman (Lamoille)]: basically, a lot of what the Senate took as initiatives, we took steps forward within this bill. What else should I tell you without going through this section by section? You did great. Had a lot of questions about the future and the future outlook within this bill. And what I would say to people that ask, should I vote for this? Should I not vote for this? And what does the future like this? And what I would say is, from our standpoint, from where we were when the bill passed out of Senate transportation originally, No, this isn't a perfect bill. We're in a difficult situation. Will this bill get the job done for the agency this year? Yes, it will. Does it take steps to put us in a better place? Yes, it does. Does it take positive steps that will get the roads plowed? Yes. Does it do everything that we're going to need to do in the future? No. It puts us in a it takes steps and moves us ahead. It doesn't do everything that we'll need to do over the long term. We had envisioned a more aggressive short term problem addressing, which dealt with purchase and use, but that is tied up in all of the issues that are between the Ed Fund, the General Fund and the Transportation Fund. It does take a step for a year. In the long term, we had envisioned in transportation that we brought to the Senate, and it moved back, moving more aggressively with vehicle miles traveled, but this does take positive steps in that direction, particularly with electric vehicles, and puts us in a better place. And finally, I would say, with the language that we have been working on in the Conference Committee on the Budget, there is going to be some relief for towns and there is $3,000,000 that is coming out of the surplus, which is mentioned in will be mentioned in both the big bill and this bill around the special fund that gets created for town highway aid that is in there. There's a lot in here that is moving in the right direction. And we unanimously on the committee of conference recognized that and we all signed, and it is a step forward. So given that, we would ask for your support of this. We'd say that as we put this together and we're rushing to push it together, there is There were some definitions that get left out. So there is in this an addendum from the conference committee report we found out the day after that we had signed that we had specific definitions that related around the charging stations and the language that's in here around the charging stations. So at this time, I would also recommend that that was language which are only definitions. That addendum is included in this report and the EUC.

[Lt. Gov. David Zuckerman (President of the Senate)]: Question is, shall the senate accept and adopt the report of the committee at conference on h nine forty four? Senator from Orange.

[John H. Bloomer Jr. (Secretary of the Senate)]: Mister president, first, I wanna thank the transportation committee for the hard work they did on this bill. I know they were dealt a very difficult hand to work with given the lack of funding in the transportation fund. But every Vermonter relies either directly or indirectly on our transportation system. And our tourist business relies very heavily on our roads and bridges. If they're starting to crumble, they're not going to come to Vermont. That's going to have a rippling effect on our economy. So if I put my civil engineering we're get

[Lt. Gov. David Zuckerman (President of the Senate)]: going

[John H. Bloomer Jr. (Secretary of the Senate)]: to a We're We We're in this body and in our sister body allocate millions of dollars every year to different projects, yet we are unable to find the monies to meet the needs of our transportation system. And that's just not acceptable. And as a result, Mr. President, I'm going to be voting no on this bill because I don't see that we have actually recognized and put into place a real plan that's gonna dig us out of this hole and put our transportation system back on a sustainable path into the future. Thank you.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? The question is senator from Windsor.

[Senator Rebecca 'Becca' White (Windsor)]: Thank you, mister president. As the vice chair of transportation and someone who for the last eight years has exclaimed from the rooftops, there's something wrong with the T Fund. And to have that fall on deaf ears until we had our latest chair for Senate Transportation. I would argue that this is the first year I've actually been impressed by a plan to get us back to a position of stable ground within our T Fund. So to vote no on this because you don't feel that it plans further ahead is a bad reason because we have held back for the last few years on addressing this issue. And what I saw in our committee was tackling it without fear, was having difficult conversations about what we would gain from raising revenue and what we would lose when we cut projects. So to not vote for this bill because you were unable to recognize the balance that we had to do as a dance in transportation, I think is again a bad reason to vote no. You should vote yes for this bill because it funds every road project in our community. It funds just about every culvert replacement in our community. It funds bike and pedestrian safety. It keeps our roads plowed and maintained. And if you want to be able to go to your constituents and say, yes, I helped with that bridge in Bethel, or yes, I helped with that bridge in Corinth, You can't say that you voted for it if you don't vote for it today. You can't take credit for the good works of the agency of transportation, which I know so many of us do with positive reflections reactions from our constituents. So I will be voting yes, and I'm grateful for the work of the Committee on Conference and especially the due diligence of our legislative staff, both council and joint fiscal, who were able to navigate an exceptionally, difficult and contentious topic with grace. Thank you.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Washington.

[Senator Ann Cummings (Washington)]: Thank you, mister president. I think we all know that the transportation fund is in financial problem trouble. It's got a significant hole. And I think we all need to find a way to dig our way out. This, with the m buff, gives us one. The only other suggestion that has been put forward is to take $50,000,000 out of the education fund. That's several cents on the property tax rate. And I think when this bill came to your committee and finance, we were just did not feel that was a fair exchange. It didn't cause the problem in the Ed fund in the transportation fund. And if we're going to vote this down because it doesn't have enough money, I think we need to find a way to raise money that doesn't involve raising taxes on every citizen in this state.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are you ready for the question? Senator from Caledonia.

[Senator Terry Williams (Caledonia)]: Thank you, mister president. I am a grudging yes on this bill. I don't know how I could tell my constituents that we're gonna pay 56 miles out of 20 700 this year. I think if if I put that out on social media, you you pick your emoji that would come back. I do appreciate that people are trying to get this thing going in the right direction, but, you know, in in my book, maybe I'm wrong. I think the three most important things we should do in this building funding wise are operation of government, public safety, and transportation. I don't know what order I put them in. We gotta get out of this creation of new programs, new positions, new everything, funding things that maybe we shouldn't be funding any longer while our bridges and our roads are crumbling. I mean, we have our priorities are way out of whack right now. We need to get to the point where we're paving 300 miles a year and and people can get through driving without bent rims busted struts tires that I mean it's bad And at 56 miles a year, it's not gonna get any better. I think everybody knows that. So I appreciate the movement. We've done it. I arguably a terrible job up until this point, but I do appreciate that, maybe some are interested in going in a different direction, a smoother direction.

[Senator Russ Ingalls (Essex)]: You. Are

[Lt. Gov. David Zuckerman (President of the Senate)]: you ready for the question? The question is, shall the senate accept and adopt the report of the committee of conference? Are you ready for the question? If so, all in favor, say aye. Aye. All opposed, nay. No. The ayes appear to have it. The ayes do have it, and we have accepted and adopted the report of the committee conference on h nine forty four. Senator from Rutland.

[Unidentified Senator (diarization mixed Franklin and Rutland recognitions)]: Thank you, mister president. May I please request a brief recess?

[Lt. Gov. David Zuckerman (President of the Senate)]: We'll take a brief recess. Will the senate please come to order? Senator from Chittenden, I understand we're moving on to s one ninety three now.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: I will, make a motion, mister president, to to bring s one ninety three up off the notice calendar for immediate action by suspension of the rules.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Chittenden Central has moved that the senate suspend its rules in order to take up s one ninety three for immediate consideration. Are you ready for the question? If so, all in favor, say aye. Aye. All opposed, nay. The ayes have it, and the motion carries. We have s one ninety three, which was passed by the house with proposal of amendment. The question is, shall the senate concur in the house proposal of amendment? I am not sure which senator speak. Senator from Windham.

[Senator Nader Hashim (Windham)]: Thank you, mister president. This strike all amendment is located on page forty six fifty seven of today's calendar. So as senators may recall in what feels like the distant past, we passed s one ninety three out of this body, and it is a bill related to establishing a forensic facility and competency restoration. I wanna emphasize a point that I have raised in the past regarding, or in this bill's discussion. So our current system is broke. It's broken to such an extent that it severely and negatively impacts everybody involved. We are one of two states without a system to address competency restoration, and as a result, individuals charged but not convicted of serious crimes who also have mental health conditions are literally just sitting in jail and going through an endless cycle of competency evaluations. At this moment, these are folks who have no way to settle their case or to or take it to trial. And on the other side, without these changes, the state will be unable to prosecute and resolve the most serious of offenses, and victims and their families will be unable to have closure or restitution. The strike all amendment to s one ninety three from the other body contains several substantive changes, and they have provided us, as I said, a strike all, and so there are changes all throughout. I'm gonna be jumping around a little bit. So I'm gonna start with section seven. Section seven is a feasibility plan for the Agency of Human Services, to be provided to the legislature by 01/15/2027 to address the location, design, planning, beds, and costs of a of establishing a permanent facility. Section 12, provides that the agency of human services, will report progress on that feasibility plan and emergency rules to the justice oversight committee at the August and November meetings. And there's another concept that has several changes or that changes throughout several sections, throughout the bill. So as passed by the senate, state's attorneys had to prove by clear and convincing evidence that a person has a qualifying condition that would create a substantial risk of bodily injury to another person. As passed by the house, the standard is now that a person has a qualifying condition and the person's release would create a substantial risk of bodily injury to another person. So what this does, it establishes that no causation is necessarily required between the qualifying condition and the risk. This change was requested by the agency of human services. Another change, under the senate version, if a person is determined as non restorable, the court could order that person recommitted to a facility if they were considered dangerous or released on supervision if they were not considered dangerous. The other body added a third option in sections two and nine in which a person could be committed to jail custody if the person's qualifying condition is an intellectual disability, and this is consistent with act two forty eight, the current law providing for Dale custody of criminal offenders found not competent because of an intellectual disability. S one ninety three provides for competency and dangerousness evaluations of persons placed at the facility at different times, every six months or when requested by the medical director. The other body added a provision that when such an evaluation is required, that individual can obtain their own independent evaluation as well and provide it to the court. This was also added in sections two and and nine. The senate version required an evaluation of a person who was adjudicated not guilty by reason of insanity within seventy two hours after being committed to a forensic facility. The other body changed that to sixty days. The effective dates also provide a significant impact on this entire bill. The other body's amendment essentially creates a three year interim period in which DOC, generally speaking, continues to be in the lead role for carrying out the responsibilities described in this bill. However, clinical services are now required to be carried out by the Agency of Human Services Medical Director rather than DOC. Section 12 provides that the Agency of Human Services in consultation with DOC, the Department of Health, the Department of Mental Health, and Dale shall adopt emergency rules to establish an interim forensic facility and competency restoration program. Those rules must be established on or before 12/31/2026. Following the establishment of those rules, the interim forensic facility and competency restoration program will be effective on 07/01/2027. The interim policies of the bill, which are sections nine through 11, will sunset on 07/01/2029 along with the emergency rules. In 2029, it is expected that a new forensic facility not operated by DOC will be online. This new facility, may or may not be co located on a correctional facility, would be operated by the AHS, DOH, DMH, and Dale, with clinical services overseen by the AHS medical director. DOC would still be permitted to provide security services on the perimeter of such a facility in the future, that's after the interim period. So when this bill went to the other chamber, there were some initial changes that were initially, particularly concerning to me, and I was pretty certain that we were going to be going to a conference committee. But over the last few weeks, the bill has returned much more closely, to the Senate. The straw poll in committee was four zero one, and we asked for the senate support to concur with the house proposal of amendment. And mister president, I also asked for a roll call.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator has requested when the vote is taken. It shall be by roll. Are you ready for the question? The question is Mister president. Shall senator from Chittenden, would you like the bell rung?

[Senator Russ Ingalls (Essex)]: The bell.

[Lt. Gov. David Zuckerman (President of the Senate)]: Question is, shall the senate concur in the house proposal of amendment? Are you ready for the question? Are you ready for the question? If so, the secretary shall call the roll.

[Senator Philip Baruth]: Senator Baruth? Yes.

[Lt. Gov. David Zuckerman (President of the Senate)]: Yes. Senator Brock. Yes. Senator Chittenden. Yes.

[Senator Thomas Chittenden]: Senator Clarkson. Yes. Senator Caledonia. Yes. Senator Cumming.

[Lt. Gov. David Zuckerman (President of the Senate)]: Yes. Senator Julie. Yes. Senator Hardy.

[Senator Richard Westman (Lamoille)]: Yes.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator Harrison.

[Senator Wendy Harrison]: Yes. Senator Hashim.

[Senator Nader Hashim (Windham)]: Yes.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator Hinsdale. Yes. Senator Lyons.

[Senator Virginia 'Ginny' Lyons (Chittenden)]: Yes.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator Bongartz? Yes. Those voting yes, 29. Those voting no, one. And the senate has concurred in the house proposal of amendment on s one ninety three. Senator from Chittenden Central.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Thank you, mister president. At this time I would ask that the Senate suspend its rules in order to message actions taken this this morning on H944 and act relating to the fiscal year 2027 transportation program H9. Sorry about that that would be H944, S193 an act relating to establishing a forensic facility for certain criminal justice involved persons and s three twenty three, an act relating to miscellaneous agricultural subjects. To the house floor for.

[Lt. Gov. David Zuckerman (President of the Senate)]: The senator from Chittenden has moved that the senate suspend its rules in order to message our actions on h nine forty four s one ninety three and s three twenty three to the house forthwith. Are you ready for the question? Senator from Windsor.

[Senator Alison Clarkson (Windsor)]: Thank you. May I inquire of the pro tem, about h nine fifty seven?

[Lt. Gov. David Zuckerman (President of the Senate)]: We have not done third reading yet, senator. Okay. Are you ready for the question? If so, all in favor, say aye. Aye. All opposed, nay. The ayes have it. The motion carries. Senator from Chittenden.

[Senator Philip Baruth (President Pro Tempore, Chittenden Central)]: Thank you, mister president, and thank the senate for their work this morning. You'll see that the calendar is rapidly dwindling down to a few items. For those who haven't been here more than this session, what to expect is that within the next thirty six hours we will continue to get things from the house as they come over we'll act on them expeditiously send them over things but it gets down to a real time exchange between us. We are rapidly reaching that point because some of the things that we did not take up this morning, we'll do in the afternoon session, and some of those we will do tomorrow morning. So with that said, mister president, I would move that pending announcements to senate standing adjournment until 2PM.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are there any announcements? Senator from Washington.

[Senator Ann Cummings (Washington)]: Thank you, mister president. I'm gonna ask senate finance to meet at 12:15. We received a bill this morning.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Windham.

[Senator Nader Hashim (Windham)]: The conference committee for s two zero eight will meet at 1PM in house of this year.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Rutland.

[Unidentified Senator (Rutland District)]: Thank you, mister president. On behalf of the chair oh, chair.

[Senator Russ Ingalls (Essex)]: It's okay.

[Unidentified Senator (Rutland District)]: On behalf of the chair of the education committee, s one three one, the CTE bill proposal amendment has been received back from the house. We would like the education committee to meet at 01:30 in the Education Committee Room. Please be very flexible because there's a couple of moving pieces we have to get together in order to hit that 01:30 mark. Thank you, miss Murphy.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are there any announcements? Senator from Windsor.

[Senator Alison Clarkson (Windsor)]: Thank you, mister president. We must be hurtling towards the end because, yes, you're right, the legislative slideshow is up and running. I encourage you all to take some time. It's fourteen minutes long, and I hope it will give you all pleasure.

[Lt. Gov. David Zuckerman (President of the Senate)]: Senator from Washington.

[Senator Anne Watson (Washington)]: Thank you, mister president. The conference committee on h seven ten, I believe, is going to aim to meet at 1PM.

[Lt. Gov. David Zuckerman (President of the Senate)]: Are there any further announcements? Seeing none, the senator from Chittenden Central has moved that the senate stand in adjournment until 2PM this afternoon. Are you ready for the question? If so, all in favor, aye. Aye. All opposed, nay. The ayes have it, and the motion carries.