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[Sen. Virginia "Ginny" Lyons (Chair)]: You're left. Alright. Good morning. It's Friday the thirteenth, which is a good news and a bad news because tomorrow's Valentine's Day. It makes it the good news. And this is Senate Health and Welfare. We're gonna take up Katie. We'll go right to h 05:45. Oh, I lost all my committee tabs. Yeah. Okay. No. That's all. Okay. Good
[Katie (Office of Legislative Counsel)]: morning. Good morning. Katie with the office of legislative council. Let me share our latest draft of, oops, any sharing permission.
[Sen. Virginia "Ginny" Lyons (Chair)]: Fine tuning this for us, which is great.
[Katie (Office of Legislative Counsel)]: We go. Five forty five. This is draft 2.1. This is the same version that you have last looked at. If you remember, we had looked at instances of amendment. The committee asked for it to be part of a strike all. So now the amendments from OPR that you looked at as instances are integrated into this draft. How would you like to proceed? Would you like me to
[Sen. Virginia "Ginny" Lyons (Chair)]: Let's go through the draft. And see where it is, and then I think once that happens, we'll be able to sign the bill on the bill.
[Katie (Office of Legislative Counsel)]: So if you remember, the first half of the bill takes effect on passage and is effective through 07/01/2031. You have section 18 BSA eleven thirty. This is amending existing law that sets up the Department of Health's Immunization Program. The really biggest change in this section is changing the definition of immunization to be recommended immunization, which means immunizations that are recommended by the Commissioner of Health, instead of, like, the CDC recommendations. This section also allows the Department of Health to purchase immunizations outside of CDC with a different vendor, and you have some language that updates how appointments are made for the Immunization Funding Advisory Committee, those changes oh, there they are. These changes stay in effect after the 07/01/2031 date, with regard to the appointment of this advisory council. Okay. I'm gonna skip ahead. Section two is the recommended immunization section. This is a new section that will sunset on 07/01/2031. In subsection A, you lay out the parameters that the commissioner can make recommendations on, and the consultation from the, sorry, been getting a lot of email pop ups. Subsection B is giving some guidance about who the commissioner has to consult with prior to making recommendations. So we know the commissioner has to consult with the Vermont Immunization Advisory Council, and the commissioner also has to consider recommendations from various professional organizations, including the CDC. Subsection C is the liability language with regard to civil and administrative liability for healthcare professionals acting within the commissioner's recommendations. Subsection D allows a standing order for immunizations that are recommended by the commissioner. Subsection E has to do with displaying information related to recommended immunizations on the department's website, and also in Subdivision E2, requiring the department to note when there are recommended immunizations that differed for some reason from the recommendations of the Immunization Advisory Council. Section three, this is the Vermont Immunization Advisory Council. This updates the membership of the council. And as we have mentioned before, these updates would exist beyond the 07/01/2031 date. This would be an ongoing change. In subsection C, this draft updates the language regarding the responsibilities of the council to include advice on recommended immunizations. It also specifies that the Secretary of Education or the Secretary's designee and the representative of public schools, those two individuals are not voting on the recommended immunizations. And then we get to section four. Section four and five are health insurance sections. Currently coverage is linked to CDC recommendations, so this language instead links to the commissioner's recommendations with regard to coverage for immunizations. So that's section four and five. That brings us to sections six and seven. Six pertains to pharmacists, seven pertains to pharmacy techs. The authority to prescribe, order, and administer immunizations is currently tied to the CDC, so the change here is to instead be tied to recommendations of the commissioner for that authority. Same thing for patients five or older receiving a flu or COVID immunizations. Section seven, this was one of your instances of amendment coming from OPR. There's some reorganization going, but the change was the authority for pharmacy techs to administer immunizations, which is subdivision two. So pharmacy technician shall only administer immunizations when a licensed pharmacist who is trained to immunize is present and able to assist with the immunization as needed pursuant to valid prescription by a practitioner, or a standing order made by the Commissioner of Health, or a protocol approved by the Commissioner of Health under subdivision twenty twenty three (two) that is the previous section, so it's referring back to the pharmacist authority, to patients who are 18 years of age or older, and to patients that are five years of age or older seeking the fluid immunization vaccines or subsequent formulations. And just as a reminder, this would also be ongoing law. So, this would not revert back as of 07/01/2031. Okay. So that brings us to the halfway point of the bill. What happens at that point is that language starts to go back in place to sort of return to the status quo. So in section eight, we're returning to the definition of immunization, again with this additional language being retained that it includes other immunizing agents, but the link is to CDC and no longer to the commissioner's recommended immunizations. These ellipses, we've already talked about this, but when you see the ellipses were retaining existing law. So this is the Department of Health's immunization program. Most of the changes are using the definition of immunization instead of recommended immunization. This is all going back to current status quo. This is what I was looking for. Immunization Funding Advisory Committee, we already said that, but that the appointments are going to be the same moving forward. So that's what these ellipses mean at the top of page 18, that language will not change as of 07/01/2031. Okay, section nine is the Vermont Immunization Advisory Council, and we have the same thing happening here with these ellipses, that because we're showing ellipses and not subsection B, we're retaining the changes to the membership of that committee that were made in section three of the bill. But the duties do revert back, meaning that this committee would no longer give advice to the Commission on Unrecommended Immunizations, We would no longer need this language about the Secretary of Education and a representative of public schools being able to give advice. Okay. Sections ten and eleven are the two insurance sections, and again, those go back to the way they are now, so retaining the link to the CBC instead of recommended immunizations. Section 12 is pharmacists. So this goes back to the way it currently is in existing law with the link to the CDC instead of recommended immunizations. And now, one of your instances of amendment was this section 13 that had been reverting pharmacy text to the status quo language, but OPR asked that the language in section seven be retained as is on an ongoing basis. So that is why this section is deleted, because you no longer need it to revert back to the way it is now. Section 14. This is a repeal on 07/01/2031 of section two of the bill, which has all of the language about the scope of the commissioner's recommendations and who the commissioner has to consult with. And then we have our effective dates, That the effective date section, sections one through seven, and section 14, that's repeal, take effect on passage. Sections eight through 13 take effect on 07/01/2031.
[Sen. Virginia "Ginny" Lyons (Chair)]: Thank you. You make it sound so clear. So simple. Okay, too many questions for Katie on this one? Know, I think we've been through it a lot, so my suggestion, I'm open to suggestion, I think we could vote on this first thing Tuesday morning? Would that be more appropriate? I don't
[Sen. Ann Cummings]: know if this is the proper time of discussion, there is just one thing I still would like to see in the bill from the testimony that we heard is the risk sheet, if I can call it that, is a federal sheet, and it covers immunizations that are on the CDC list. And so we may now have some that are not, and so how do people get informed? Should there be a requirement that a state provide a similar sheet for those vaccines that are not on the federal sheet that you would get from the pharmacist or your doctor or what have you, just so people are aware that it's coming.
[Sen. Virginia "Ginny" Lyons (Chair)]: So I'm gonna turn your question to the Department of Health. Sure. There, oh, you're there. Lauren Lehman, thank you. This is gonna be a question that people continue to ask. I think we did answer it previously, but it would be helpful to take care of again.
[Laurie Lehman (General Counsel, Vermont Department of Health)]: Laurie Lehman, General Counsel, Department of Health. So since our last conversation, did go back and look at the vaccine information statements, there are, even for those vaccines that are not on the federal schedule right now, but are given pretty widely, or might not be given routinely, like, big days or somebody who's traveling. There's a vaccine information statement, and in those they don't necessarily point to recovered, again, reliability statements, but they do give, you know, here are the common repercussions, here's how to report an adverse, here are the common side effects, here are, here's a list of where to report any adverse events, here's how to, you know, who to contact, and when they should contact. The wording is covered. It is covered. It's not, you know, it doesn't say this is not gonna provide this. Right.
[Sen. Ann Cummings]: I was more concerned too about whether or not it's not on the CDC list, but I thought maybe I misinterpreted the the testimony, but it sounded like the federal sheet that's handed out just covers those that are on the federal list too. So that's why I wanted to make sure that it covered everything.
[Laurie Lehman (General Counsel, Vermont Department of Health)]: Absolutely. And I also want to make clear that, and as we've heard testimony, both hearing, you've heard testimony and hearing from the judiciary, the vaccine information statement is not complete informed consent. So, and it's not supposed to be solely relied on as informed consent. So the healthcare provider is still supposed to go through the foreseeable side effects, etcetera, with the patient in addition to that issue.
[Sen. Ann Cummings]: Thank you.
[Sen. Virginia "Ginny" Lyons (Chair)]: Okay. Two papers on my desk. If you can, I don't know where this thing came from? Usually, people go to pass things out. There should be a Right. Identification as to where they came from because I don't know who is. One of them is a signed letter by I don't know. I I don't remember who it was. She couldn't here you are. Do you wanna say who you are? Yes. I'm sorry. Who you are?
[Katie (Office of Legislative Counsel)]: One of is just the attachment to an email I sent this morning, so I I apologize that I forgot to put my Normally, right.
[Sen. Virginia "Ginny" Lyons (Chair)]: Yeah. There should be a name
[Sen. Ann Cummings]: on the street.
[Sen. Virginia "Ginny" Lyons (Chair)]: Right. On the floor. It has to have who it's from, which gives me, I don't know if it's from the Department of Health or if it's from an advocate or a doctor, it just helps me. So, Ann Cummings West, Director of Vermont Stance.
[Katie (Office of Legislative Counsel)]: That would be great, thank you.
[Sen. Virginia "Ginny" Lyons (Chair)]: Okay. Any other questions for Lauren? Any other questions for Katie or for her? Okay.
[Laurie Lehman (General Counsel, Vermont Department of Health)]: Alright. Well, thank you so much.
[Sen. Virginia "Ginny" Lyons (Chair)]: Thanks for that information. So, now I think my suggestion was to vote on it first thing Tuesday morning. We could vote on it today. We've seen the language previously and they've had an opportunity to think about it. I'm open to either one, and I'm looking for discussion. I mean, I can make the motion if that's what folks wanna do. Sure. So who's gonna play floral?
[Sen. Ann Cummings]: Who draws the shorts for a while?
[Sen. Virginia "Ginny" Lyons (Chair)]: As I will say, I will hold the vote open for senator Morley for
[Sen. Ann Cummings]: He's on.
[Sen. Virginia "Ginny" Lyons (Chair)]: He's on? He's here. Yeah. It's 4AM, but he's on. Oh, good morning, senator Morley. You awake? He's next week. He was awake. That's awake. You're still muted, though. Yeah. He's again, you're And you're frozen. Frozen and muted. So maybe maybe oh, there you are. You're still muted. It was minus two in my driveway this morning. She was
[Sen. Ann Cummings]: You're still muted, John.
[Sen. Virginia "Ginny" Lyons (Chair)]: You're still muted.
[Katie (Office of Legislative Counsel)]: It's like
[Sen. Virginia "Ginny" Lyons (Chair)]: you may be in a business center.
[Sen. Ann Cummings]: We can have them in. You don't have a Internet. Up.
[Sen. Virginia "Ginny" Lyons (Chair)]: It's past two. No. That's not. I was trying to figure out if I could. Okay. Maybe Can
[Sen. John Morley III]: you hear me now?
[Sen. Virginia "Ginny" Lyons (Chair)]: Yes. Okay. Terrific. So we're going to vote on H545 as reviewed by Ledge Counsel, or at least we're going to entertain a motion. Senator Gulick has indicated she's going to provide a motion.
[Sen. Martine Larocque Gulick (Vice Chair)]: Yes, I'm happy to do that. I move that we vote favorably on H545, which is draft number for '21. Send it to the full Senate. One thing I should say, there is a motion on the table, but one thing I should say is that judiciary did review the liability section and five zero approved that. Any other questions, conversations, discussion?
[Sen. Virginia "Ginny" Lyons (Chair)]: Moment of mistake by motion. Go ahead. I move that the Senate hope of offer committee vote favorably on draft two. One of H five four five and send it to a full center. Thank you for consideration. Okay.
[Sen. Ann Cummings]: So, mister Clark. Alright. Take the role. Senator Benson. Yes.
[Mr. Clark (Committee Clerk)]: Senator Gulick. Senator Gulick. Yes. Yes. Senator Morley. Yes. Senator Lyons.
[Sen. Virginia "Ginny" Lyons (Chair)]: No. I'm last. You are last. Did you vote? Yeah. Ask for us. Oh, I'm sorry. Yes. The clerk did a good job. Chair fell apart. So
[Sen. Ann Cummings]: the tally is five yes, zero no, and zero abstain.
[Sen. Virginia "Ginny" Lyons (Chair)]: So thank you, senator Morley, for for your being here. I know it's a challenge where you are, and we really appreciate it.
[Sen. John Morley III]: Well, it's not a challenge after about well, 7AM is pretty nice. So I be traveling here in a couple days, and I wanna thank the committee for allowing me to participate. I participate in every meeting, and I'm trying to keep up with everything. So thank you for allowing me to do this.
[Sen. Virginia "Ginny" Lyons (Chair)]: That's great. No, it's good. So thank you for that. So we need a reporter to anyone who would like to report the bills? Okay I'll report the bill unless there's someone else who can twist my arm and take it away from them. I'm happy with the protocol. So it'll be on notice on Tuesday. It'll be up Wednesday. Okay. Thank you. And Katie will chat. Okay. Alright. So that's it for five forty five, hallelujah. I mean, it's an age bill and it's taken a bit of time, but I think it's an important bill for us to worked on. The House and the Department of Health were very interested in how you can see our board working. Alright, so we're gonna move on to the next bill, which is S-one 142, and Janet is here. It's from Senator Brennan. Yeah. Can you let Senator Harrison know that we're ready for her? Yeah. Do you know if maybe she's on? She's on transportation. She's she is. She's so we'll wait for her to come in and then we'll vote for them. I don't have Jennifer near me. Don't you? Yes. I do.