2018 Legislative Wrap Up-Part 2

Mitigating Systemic Racism in State Government
The phrase “systemic racism” is used to talk about all of the policies and practices entrenched in established institutions that harm certain racial groups and help others. “Systemic” distinguishes between individual racism or overt discrimination and refers to the way racism operates in major parts of US society: the economy, criminal justice, housing, education, and more. There are a number of racial disparities in Vermont state systems that are troubling:

  • Vermont African American state employees have a voluntary separation rate that is two times that of White employees (14.9% vs. 6.5%) and even more troubling, employees of color are three times more likely than White employees to be terminated (3.1% vs. 1%).
  • Vermont leads the nation in the rate of incarcerated African Americans with one out of 14 African Americans adult males incarcerated.
  • Recent data from traffic stops shows that after being stopped African American drivers are four times more likely to be searched than white drivers even though white drivers are more likely to be found with illicit drugs.

As was stated in the 2017 Act 54 study of racial disparities in state systems,

If the State of Vermont is truly committed to addressing the racial disparities that exist in [state government], it must undertake a system-wide analysis of the ways in which state government actively or passively contributes to these disparities, collect data to determine our baseline, and set goals for reducing those disparities….

That is what S. 5 proposes to do. It accomplishes this task by creating a position of Executive Director of Racial Equity and establishing a Racial Equity Advisory Panel. Their duties include the statewide collection of race-based data to determine the nature and scope of racial discrimination in state government, overseeing a comprehensive review of systemic racism in all branches of government, developing a model fairness and diversity policy, developing performance targets and measures to evaluate efforts to mitigate systemic racism, and developing and conducting trainings for state agencies regarding the scope of systemic racism. The panel also will report back to Legislature annually on achieving performance targets and the collaboration of the Administration in working with the executive director.

Vermont Seeks Federal Approval to Import Drugs from Canada
S.175 is an act relating to the wholesale importation of prescription drugs into Vermont. This bill shall have the Agency of Human Services, in consultation with interested stakeholders and appropriate federal officials, design a wholesale prescription drug importation program, including requirements of safety and cost. The program would designate a state agency to become, or contract with, a licensed drug wholesaler to import prescription drugs at a significant cost savings to Vermonters. The state shall submit the proposed design for the program to the Legislature by Jan. 1, 2019.

The bill would direct the state to seek the appropriate federal waivers. And, it asks the state Attorney General to identify the potential, and to monitor, for anticompetitive behavior in industries that would be affected by a wholesale drug importation program.

Breast imaging without cost sharing
H.639 covers mammograms and 3D mammograms without cost sharing, and when there is dense breast tissue, it will cover the follow-up ultrasound with no cost sharing as well.

Health Insurance Individual Mandate
A working group composed of various state departments and called by the Green Mountain Care Board will determine such things as a financial penalty, enforcement, exemptions, and types of insurance considered minimum. A penalty will be enacted by the General Assembly during the 2019 legislative session, which will be effective in January 2020. This will provide notice of the penalty to all Vermont residents prior to the open enrollment period for coverage for the 2020 plan year.

Reducing Co-payments for Chiropractic and Physical Therapy for Treatment of Chronic Pain
S.1 reduces co-payments for chiropractic and physical therapy in 2019. The bill provides greater access to both kinds of care at reasonable costs for Vermonters with Qualified Health Plans through the Vermont Insurance Exchange. With Silver, Silver Reflective and Bronze plans, copayments will be equal to a copayment for primary care under the plans.

Pain management representatives from both the University of Vermont and Dartmouth-

Hitchcock Medical Centers testified that research demonstrates other therapies, including chiropractic and physical therapy, are more appropriate in managing chronic pain. This bill moves us forward in our efforts to reduce opioid use by providing access to more effective treatments for chronic pain, and to comply with state statute that requires chiropractic copayments be reasonable.

S.1 requires the Department of Health Access to convene a working group to develop recommendations related to insurance coverage for non-opioid approaches, including nonpharmacological approaches, to treating and managing pain. Specifically, the group will investigate whether health insurance plans should cover certain non-opioid approaches, an appropriate level of cost sharing that should apply to non-opioid treatments, and the proper proportional relationship between the amount of the copayment and the amount of the total charge or reimbursement for these services.


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