Vermont Legislature SmartTranscripts:

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: 100%, we will live.

[Sen. Brian Collamore (Chair)]: Good afternoon once again, and welcome back to the Senate Government Operations Committee meeting on Thursday, April 2. I'd to welcome back Lauren Kibbert and Jen Kolink, both of whom can take seats at the foot of the table. And we'll take another further look at H five eighty eight. Yes, sir. This is the so called OTR bill. Funny when you say that out on the street, nobody knows what you're talking about. In this building, knows about OTR. What's up? So welcome back. Thank you. Where did we leave this? I'm trying to recall.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Well, for the record, I'm Lauren Ibert. I'm the deputy secretary of state, and we want everyone to know about I know you.

[Sen. Alison Clarkson (Member)]: 100%. 100%. Well, the more professions you regulate, the more people of a benefit.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: And I'm Jane Cohen. I'm the director of OTAR. How lucky am I to be in that role, the state organization, I think, in state government? I know you have some suggested tweaks to

[Sen. Brian Collamore (Chair)]: We what came also had a request from someone representing pharmacists.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Yeah. And but that person couldn't

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: be Because we missed some we still have some sections to talk to you about Oh, okay. That Jen is gonna go over starting in section 14. We have a Yep. About

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Right.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Nursing, pharmacists, psychologists, and midwife. There's quite a few.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Okay. So I'll go quick so that we can get to some suggested revisions too because those

[Sen. Alison Clarkson (Member)]: are important. I'll just get the bill. Yes, dear.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: So you'll see in section 14, we are removing the active practice requirement for APRNs, those are Advanced Practice Registered Nurses. When they renew their license right now, they have to demonstrate that they've been actively in practice for a certain number of hours in the previous two years. We're one of the only states that has that requirement, and really professions have moved away from an active practice requirement to more of having continuing education classes, like for lawyers and pharmacists and a lot of other professions, like, you just have to take CEs to maintain That's correct. To maintain your competency. So it's a barrier, and we actually had a petition by someone who was previously or who was an APRN who hasn't met met that active practice requirement and who was petitioning us to do do just what we're doing. When we looked into it and did the research, we determined that it's fine to do that. The other thing is APRN and I'm sorry.

[Sen. Alison Clarkson (Member)]: Just wanted to I'll

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: let you finish it. APRNs do have to, they specialize, kind of the way physicians specialize. And so those specializations require substantial Continuing it. Continuing it. That's right. So for for the reason of the specialization, that was those national certifications, and because it hasn't been demonstrated to ensure patient safety, and in our research, that was also something we looked at. We posed the question to the board of nursing, do you support getting rid of this requirement? And they absolutely support it and so do we.

[Sen. Brian Collamore (Chair)]: Senator Balsky.

[Sen. Tanya Vyhovsky (Vice Chair)]: It's actually my question was about patient outcomes. When I think about clinical practice, know, I think practicing law is maybe different than putting your hands on or in some instances in someone's body. Yep. And so I was just curious about the the outcomes. And it sounds like the research shows that instincts that don't require this outcome are That's not statistically right.

[Sen. Brian Collamore (Chair)]: That's good.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Okay, great. The next section, 14a, is about pharmacists and clinical pharmacy. Those statutes are in title 26. This is about prescribing and testing. This expands pharmacists prescribing authority in the practice of clinical pharmacy to include state protocol approved by the commissioner of health to test and prescribe drugs for the treatment of specific conditions. Those conditions are COVID-nineteen, influenza, and streptococcal pharyngitis. This expansion, first of all, is well within the pharmacists' practice. This revision came about from the Rural Health Transformation Program When that grant application was made, Test to Treat, which is what this is known as in the pharmacy world, was part of that effort. These tests that pharmacists would be performing are CLIA waived. So in other words, are tests that are known that are kind of cleared by the FDA and known to be very reliable and low risk. They're simple. They're accurate. So being able to get people into their pharmacist, which they have more touch points than they would with their primary care provider, helps them get in more quickly and helps get those treatments to them more quickly. For some of these conditions, and I don't know if you'll have the Commissioner of the Department of Health, but he testified

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: on

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: the House side about how critical it is, especially for strep and flu, to get people treated as immediately as possible because it reduces poor outcomes. I know that, Jill. COVID. All of them is risky. So for people to have to wait for an appointment with their primary care provider for a week

[Sen. Alison Clarkson (Member)]: or two, you're kind of losing a window. The

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: next one is psychologists. So you may have heard that OPR has undertaken some mental health licensure reform efforts. We published the study last year, or maybe it was the beginning of this year no, a year ago. Sorry. And that study was we were asked to do that by the legislature to help us determine in what ways could be streamlined mental health licensure because it's it's a complicated process. We have a lot of different mental health professions, psychologists being one of them. The different requirements, there are different supervision rules, so we've undertaken that work. And so that's kind of the landscape in which this change is being made. So you're gonna see legislative reform next year from us on all of the mental health professions, including psychology. But in the meantime, psychology is one of those professions where if you go and you get a psychology degree from an approved a higher learning institution, and you're getting out your master's degree or your doctoral degree, and then you come to Vermont and you try to get license, if you're missing certain coursework, you know, the opportunity to supplement that coursework after you've attained your degree is extremely limited. So I think you can only, some instances, only take an additional six credits. So here you've been in school getting your doctorate degree and spending years and years on your education, and then you you come to Vermont and you find out, oh, I need, nine additional credits in this particular area that's dictated in rule, you're going to have to start over. There's no supplementation pathway. Obviously, we have a shortage of mental health providers, and we've also received a lot of feedback from people who have applied, have not been able to get a license from us. A lot of feedback that we should have greater supplementation pathways. And we also had at least one petition and maybe another, but I am recalling one specific petition where somebody was asking us to immediately engage in rulemaking so that we could loosen that restriction to still allow competent practitioners, but who may need some greater supplementation. Essentially, this allows us to consult with the Board of Psychologists and then create some greater flexibility through policies just for a short time period until we can get to this mental health licensure reform as we're making stuff be finished here. So just a really important effort that we're that we're hoping to So there'd

[Sen. Brian Collamore (Chair)]: be go forward with.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: And I'm assuming this is unique to psychology because I certainly know so why wouldn't we do

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: it for all of the mental health professions if it's not a unique problem to psychology? It's psychology is more of a one of the more stringent

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Okay. And that was sort of the question that I was

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Yep. It is one of the more stringent ones, and that's the profession where we've received actual petitions, like, to to take action immediately on this, but it is it is a problem in other professions. It's I just don't think those other professions are assured.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Well, and I I just may add, that was a major finding of our mental health study, and one of the things that we are going to substantially change in the mental health reform is that inflexibility of supplementation across all of our mental health professions. If you don't have a BSM course in your master's program, that is a huge problem across all of our mental health professions. And it could be that your DSM class is not called DSM. It was called something else. It create there's a lot of structure, and there's another class that creates problems. Stupidity is one of the bigger ones. True. A lot of unnecessary structure, and we're we are looking for more flexibility across all of the mental health professions and pathways to get in, but psychology is the most stringent. Okay. Yeah. That's what I was trying to understand is why only psychologists yeah. I know at the beginning of the session, asked you to look for the sort of low hanging fruit that might make immediate differences this year. So I appreciate that. I was just really curious why we wouldn't provide this to all of the medical health professions. We are already providing as a lot of flexibility on supplementation if you are applying and don't meet those qualifications. They're sort of pushing the boundary of what we can do there, quite frankly, while we're waiting for the mental health reform. But and that is really because for our other mental health professions outside of social work and psychology, the landscape of education is much more it's less standardized, is the way that I would say it. Like social work, that's a very defined if you graduated from ASWB school, you have taken exactly what you need to take. It's like guaranteed. A little less so with psychology and even less so with family practitioners or the clinical mental health. My other question, and this is due to actually having a couple people reach out to me about the inflexibility around the five year. So I've had a few people reach out to me who have disabilities about trying to get licensed and are looking for some type of waiver, disability waiver to the five year requirement, and my understanding is under current law that is impossible. The five year requirement is get reimbursed by Diva? No. So there's a requirement that you complete your hours towards licensing

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: with providers. We do waive that requirement. So if somebody has a disability, they can we have an application on our website that requests a waiver or an accommodation because of that. And actually, I just signed one of those yesterday.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: So I've heard from three different people that they have been told by OPR that there is no such thing as illegal, and they will just have to figure it out.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Okay. I'm I'm happy to talk to those. Okay. So please give them my my name, and we'll get that straightened out and see what we can do.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Okay? There is something with billing and five years that is not in veteran control where you can get reimbursed while being supervised for a period of time, and I believe it's also five years, but that's outside of OPRs. And that's the insurance. The insurance providers, of which I think the only one we have any real controls in Medicaid, yes. So,

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: and in our waiver process for folks with ADA, who need ADA accommodations, we do require medical, we do require information from a physician. I don't know if that's a barrier, but definitely have those folks reach out to me and we'll try to clear that out. Okay.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: I was going to ask that we change that, but it sounds like we don't need to change it. Just need to Yeah.

[Sen. Brian Collamore (Chair)]: Did the house take any testimony from the board of examiners or the psychological association?

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Not from the psychological association.

[Sen. Brian Collamore (Chair)]: Are they okay with this temporary licensure? The board?

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Yes. Yes. And we this this provision actually, you know, our our staff attorney who works most closely with the board of psychological examiners kind of helped us kind of craft this, because we needed to make sure that we were collaborating with the board in the creating these policies. So that's what we wanted to make sure of. And so, yes, it does. We don't see any controversy with that. Okay. And then the last thing I think we need to cover is midwives. And you'll see in section 16 Yeah. This eliminates the midwife advisory committee. That's a committee that's kind of been default for some time, and it's it was an advisory committee to report to the Commissioner of Health and to the Office of Professional Regulation. It was created like when midwives were first regulated, and so I think it kind of was born out of some, in a way, concern about midwives independently practicing. So we're eliminating this midwife advisor and committee. We still have advisors in the midwife profession. So in other words, we still have midwives that we connect with and provide a subject matter expertise regarding the regulation, regarding discipline. So that's not going away. It's just this is an extra committee that's somewhat duplicative and hasn't really been working for

[Sen. Alison Clarkson (Member)]: a long We're doing our reduction boards and commissions. Thank you for your help.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Oh, okay. You're welcome. Great. Then there's one other requirement that we're kind of changing a little bit. Right now, when APRNs renew their licenses, they have to, every two years Sorry, midwives. Thank you. Thank you, Lauren. They have to report to us a substantial amount of data on every single birth that they attend. And so just about almost every facet of of that birth situation. It's an onerous requirement for midwives, and that data that we collect was, I think, intended for the Department of Health. I don't think it's being utilized. We'll say it that way. We're hoping to This change removes the requirement and puts it as the director may require, so we're going to do some rule making around it, and then we're connecting with the Department of Health to see what do they actually need for us to collect from midwives. That enables us to do that work, if at some point we can eliminate that.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: There's just two things that I'll add to that. Midwives do report all births to the Department of Health throughout the creation of a birth certificate, and they also report to us, separate from this data, the adverse outcomes, which includes transport to a hospital, injury to a mother, or a baby, or death. Brian? So

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: that is it. I think we've covered everything else that

[Sen. Brian Collamore (Chair)]: we We did do the speech language pathology. Oh yeah. We did the

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Massage. He did.

[Sen. Alison Clarkson (Member)]: Yeah. We've massaged the Massage.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Well, I don't know that we've massaged it, but We haven't. Well, need some help.

[Sen. Alison Clarkson (Member)]: Yeah. And yeah. Just on the massage while we're on it, and we have them here. Can we just put our little and the water on it? Because as you know, I mean, it's no surprise to you that they're pushing hard to be licensed and not registered. And what we're doing here is registering statutes. K. And we've already registered our massage therapist. I would just love to get an indication from you about how much more work it is for your office to have a license to have massage therapists be licensed, which is what they're urging us to do in this field as you do.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Yes. There's level of work. It will be more work because we'd have to review qualifications and immediately go into rulemaking in a more urgent way. We're gonna have to do rulemaking anyway around establishments, but

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: it would be it would

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: be an accelerated track, I think. So hours of staff time, more. Enforcement cases, possibly more complicated because it would be a standard of care, whether they met the standard of care as opposed to just the more black and white of was there sexual misconduct or human trafficking, which is where we are now. But I'm more concerned about the ripple effects for people who are not going to be qualified. You probably remember the discussion in 02/1920, the amount of people who said, please do not create a licensure path because I would be boxed out. So, of the profession, you know, the Reiki, they haven't gone to the same massage schools that the massage therapists that you've heard from do. And so, if you were to move in that direction, I would really think that you would need to hear from more than just the massage therapist association, because they absolutely do want licensure. They always have. Right. Oh, I'm And the Office of Professional Regulation, following chapter 57, and looking at the whole landscape, not just their needs, found that there wasn't evidence of harm that required licensure, and that if we require licensure, it would be an incredible burden to a very diverse group of body workers and touch professionals that exist in this state and would create a it could cause some people to not be able to be practicing.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: And the other thing I'll oh,

[Sen. Brian Collamore (Chair)]: Jennifer, go ahead.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: I'm wondering what would be to stop this. Because I I actually think massage therapists putting their hands on people, and and I actually did a little bit of research, can absolutely do harm. I I But I wonder what would be to stop us from having a massage therapy license and registration for the other touch professionals. Yeah. I mean, we really considered that and decided against it. This is something that we've studied four times. And we, you know, there are there's really not at least the last time that we substantially studied it, we did not find data driven evidence of harm from massage. That being said, there are, you know, stories out there in the world, when you look at malpractice or cases from other states or those types of things, we didn't find it. And that was in, we studied that

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: in eighteen, nineteen, twenty. And we also haven't gotten, you know, we, believe me, in professions where we're regulating, but we don't require qualifications, we still hear about substandard work, and that contractors is a perfect example. So, like, we get so many complaints about quality of work that we can't, you know, we can't really pursue. We don't hear that in scholars. We just don't hear that. So, I understand, like Lauren's saying, there may be anecdotal stories about it, but in terms of data, we haven't seen it and we haven't gotten complaints ourselves. The other thing I would just mention is that in the sunrise process, we go through a lengthy time period where we're giving notice to the public of, like, come and if you've got concerns about this concept or that concept, please let me share with us. Well, our OPR bill only involves massage establishment. So in other words, the profession may not be They're not at the ready to, you know, especially for people who haven't gone through a national certified process in massage, they may not be following this because it's only for establishment registration. So, that would be another concern.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Yeah. I would be concerned about making a change right now at this time in the legislative session and without us being able to really figure out what all the ramifications are. We have talked in the past about whether a certification would be more appropriate than a license because that is mandatory qualifications that are voluntary. But again, I would want us to if that was the direction of this committee, I would want us to be charged or thinking about whether that is a good thing and us coming back with a recommendation to you with language if we thought that it was. Just because we have really studied this every way to Sunday and not found the evidence, and I really believe that this body I mean, you don't you can disagree with OPR, obviously, but there is a process for a reason, and I would hope that it continues to mean something. Otherwise, it it will be undermining and and honestly, like, a little demoralizing for the office as well. We put a ton of work into those reports and and we do that assuming that we'll be heard heard and taken on board.

[Sen. Alison Clarkson (Member)]: No. But I I think we needed to have this conversation because of this we're getting bombarded. Yes. Yeah. Yeah. To Lawrence's point,

[Sen. Brian Collamore (Chair)]: the purpose of the Sunrise report is to do exactly what they just described. And if the last one was done in '20. It was.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: And then there was an update in 2023. There was an update. That said that we need to right size this regulation based on our data.

[Sen. Alison Clarkson (Member)]: And we've done this, but that's the total for. Yes.

[Sen. Brian Collamore (Chair)]: For us to just sort of unilaterally decide, let's ignore the Sunrise Report and the work that OPR continues to do, I I know. But I can't support that.

[Sen. Alison Clarkson (Member)]: We have to have this conversation.

[Sen. Brian Collamore (Chair)]: Yep. I know. I'm always just thinking we're gonna get lobbied hard. I understand that.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: And we're open to the conversation as well. I just would ask that if there is the contemplation of licensure or certification, that that be done in a really measured way and that this committee not hear only from the massage therapist association. Like, we would probably we could give I don't know how we would do it, but this is a it's a very diverse community. So when we

[Sen. Alison Clarkson (Member)]: Oh, with all the other touch.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: With all the other touch professionals, and and it was very emotional and very difficult. I've yeah. Yeah. Was here. And so just to do that due diligence. You were here.

[Sen. Brian Collamore (Chair)]: Yeah. No. I've I've been here a while. No. No. I know. Can

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: fully appreciate at this point in legislative session in the OPR bill would not be the measured way to do it, but I I do I I remain on it just feels strange to me that almost every other state has come to a different conclusion. Yeah. And so I would like more to of a conversation, but I appreciate that in the second half of the session, at the end of a biennium, in an OPR bill may not be the place to do that.

[Sen. Brian Collamore (Chair)]: Actually, starting tomorrow, we're two thirds of the way through the session, not just half.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Right. Wow.

[Sen. Brian Collamore (Chair)]: It's late in the game to be monkeying with something, I

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Oh, you have information I don't about when we're getting out of here?

[Sen. Brian Collamore (Chair)]: We're budgeted for eighteen weeks.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: That's all I and

[Sen. Brian Collamore (Chair)]: this will complete week 12 because the pages will be bid fondue tomorrow. Right. And we'll budget it through May 8. Yeah.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: I don't believe we will

[Sen. Alison Clarkson (Member)]: be leaving on May 8. I don't disagree. But to that point, I think I would just you know, what time it was in.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: And I respect that. And I think, you know, the community deserves that attention from you, quite frankly. I just Next year? Yes. That's why we have another year. We do have some additional revisions that we are seeking that some of which were too late on the house side or have come to light on the house side. I won't go through each one, but I think the most important ones are accountants. We want to there's language relating to good character in the accountant statute. We have made a really concerted effort to take out any reference to good character in reasons to deny a license because it's incredibly subjective. And so we've been doing that every time a statute is opened. But the accountancy language was added on the house side, mid house process, and we failed to realize that we should get rid of that good character. So we'd like to do that. Yep. That's in section eight. The dentist, I'll just point I'm skipping over some, but dentists, we really would like to make sure that whoever is providing the supervision is a Vermont licensed dentist, not just a licensed dentist, we forgot a word, as can happen. Pharmacy, which is probably the most the biggest health care transformation in the OPR bill and came I kid you not, like, the last week on the outside, is it's really it's because of the rural health grant, but also the changing federal rules around COVID vaccination and test to treat, which have been shifting since COVID began, really. But we would like to harmonize the pharmacy technicians who currently are doing COVID tests and and then the pharmacist prescribes the Paxlovid. Okay. We would like to allow pharmacist technicians to also test for flu, which is the exact same test. I mean, they're they're combined tests generally and for strep. And we've done some work since the house side. There was discussion about this on the house side, but we weren't we weren't ready to just say yes because we it was happening so fast and we hadn't reached out and understood, and we wanted to talk to the commissioner of health. And and now we're ready to add that.

[Sen. Brian Collamore (Chair)]: So just in maybe we're gonna ask the same question. Test but not prescribed?

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: That's correct. By pharmacy technician. Okay. Yeah.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: And that was one of my questions. Okay. My other question was a tangentially related question, and that is that I've been approached to add in an additional pest to treat HIV. Yes. Yeah. We haven't seen that language.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Actually, have. So, I just want to say, I have seen that language, and we've watched the testimony at Senate Health and Welfare. So, they're already looking at a bill to attach that to, which is H611. We have some concerns and some asks about that, but as a concept, yes, we support that HIV prophylaxis. It's a good measure to include. The bill as it's currently written is primarily around insurance coverage, and there's just one provision at the end that says, OPR and the commissioner, or the board of pharmacy and the commissioner of health should figure out how to do this for pharmacists, how to incorporate this into pharmacy scope of practice. So we have ideas about how to do that, and And we can that

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: with the standing orders or the statewide protocols, as you probably remember from pharmacy chapter. So we would wanna do it in one of those two pathways. Yeah. And and I obviously also support it, and I have heard rumbling that it was there was conversation happening in health and welfare. Yeah. And as I look at it, like, it's an OPR issue. Yeah. And so I would wanna make sure that we do our due diligence and have that come through here as well.

[Sen. Brian Collamore (Chair)]: Have you heard about any of that? Yep. So we've taken some testimony on

[Sen. Alison Clarkson (Member)]: it. Yeah.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Okay. So there are some changes that we can see in the pharmacy statutes. The H-six 11, those changes are in Title 18. So we know that there would be need to be a couple of changes in title 26 in the pharmacy statutes. Very simple to be able to implement that, and then we have some suggestions for the title 18 statutes.

[Sen. Brian Collamore (Chair)]: Interesting. We just started looking at

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: this. Yeah. I think

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: be correct. What I wanted to flag is that they're sort of these two pieces are moving in tandem, and we should be aware of that in both places. Yes. And and we should probably ask to testify in health and welfare and give them the world's language, and we'll give you the world's language as well. Okay. The other I recognize that you probably are ready for us to be done, but the other really important thing is it in the spirit of collaboration, we would like to use the OPR bill to request a fix for the board of medical practice, which is that the way that the board of medical practice has their FBI background checks is written in a way that the FBI does not like. The way that OPR has our authorization for FBI background checks, the FBI does like. But because we're both part of the same physician compact, us with the DOs, them with the allopathic, we can't be a home state for physicians. All of our if if we have a physician who's in a compact, they have to have another home state. And this is causing conflict because our physicians, of course, want our state to be a home state. And but the holdup is the board of medical practices, FBI background check language. So we've been in conjunction with them advocating on behalf of our DOs because they wanna be in a home state. And when we realized that the issue was the medical practice boards, FBI language, they didn't have a good vehicle. They hadn't put that on their legislative agenda for this year. And we said, hey. We'll do it. We'll do it if if it's okay. So we would like to do

[Sen. Alison Clarkson (Member)]: that

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: so

[Sen. Alison Clarkson (Member)]: that we can In this bill. In this bill. So I'll ask the obvious question. Have you got language, and can you send it to We do. We do. When Who's doing this?

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: We we have language for all of these revisions, and I think I had it. We were we were out of remission.

[Sen. Brian Collamore (Chair)]: Tanya Vyhovsky?

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: I have no problem with that. I think it makes good sense. It's kind of wild to me that, like because most doctors join compacts. Yeah. None of any. Well, they're part of the compact, but not they we can't be a a home state. Right. Which means they're not paying their licenser licensure fees to the state,

[Sen. Alison Clarkson (Member)]: which is we need that.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Yeah. Like, I I I think but is the board of medical practice under the umbrella of OPR? No. They're under the Department of Health. Right.

[Sen. Alison Clarkson (Member)]: Are why is the committee doing this? They are the few that haven't migrated.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: This was just they don't have a bill. The the board of medical practice doesn't have an

[Sen. Alison Clarkson (Member)]: active bill

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: moving through the legislature. They they, of course, care about bills that are happening. They would.

[Sen. Brian Collamore (Chair)]: I haven't heard of anything.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: They we we reached out to them to ask what is the barrier, and this is

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: what we were told, and

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: we would really like this barrier to be removed for And the only way to get this removed for DOs is to make the change for the medical practice board. And so Let's do it. We think this is a great a great collaboration. There have been lots of opportunities for us to collaborate with the board of medical practice. We always look for them because there's opportunities that not opportunities. Unfortunately, we don't always get one for the medical practice. So when we do, let's work collaboratively together. And we we have done so quite a bit of routine care. I have no problem with it. I just don't know that, sure, mainly, this is a vehicle either given that they're not under your umbrella. Well, it it has a direct impact on our Exactly. Osteopathic physician, so it's just how I would say that it is a germane item to be added.

[Sen. Brian Collamore (Chair)]: Exactly. Let me suggest this. Let's put it in our bill. I'll speak with Senator Lyons and see if it looks like there's a possible path on health and welfare. I'll let her carry the ball, use the sports analogy.

[Sen. Alison Clarkson (Member)]: You're our secret weapon.

[Sen. Brian Collamore (Chair)]: If not, then we'll just include it in ours and show step aside kind of thing. Yeah. Does that sound reasonable?

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: This is a I mean, if I could just say, it's a really good thing for Vermont. We really should do it. I think it's just been an oversight that if we can fix it, that would

[Sen. Brian Collamore (Chair)]: be really great.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: So I understand the Germainness, and I don't want to undermine or say that that's not important.

[Sen. Alison Clarkson (Member)]: Also with Germain. I don't I don't see that as sounding as ratchet. Alright. Thank

[Sen. Brian Collamore (Chair)]: you both. It's always good to see you.

[Jennifer (Jen) Cohen (Director, Office of Professional Regulation)]: Thank you for that.

[Sen. Brian Collamore (Chair)]: We'll get to this again next week, and I don't know when we're gonna vote it out, but hopefully fairly soon.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: Okay, we'll vote whenever you need us.

[Sen. Brian Collamore (Chair)]: I think we need to get testimonies from the health commissioner on the pharmacist's request to test and prescribe, and then we probably need to do a little bit more work on the psychology or psychologist who's saying that. But other than that, it seemed pretty simple.

[Lauren Hibbert (Deputy Secretary of State, formerly OPR Director)]: I agree. Thank you.

[Sen. Brian Collamore (Chair)]: Thank you. Good to see you. Bye. Is Becca probably not gonna be back? I know she sent the note, but I can't remember. So I guess her What? Well, anyway, why don't we take I hate to do this because I know it won't be five minutes, but a five minute break, and we'll be back in five minutes to take up the final bill of the day.