Vermont Council of

Developmental and Mental Health Services

Legislative Update for May 8, 2008

Legislature Passes S.114

The Committee of Conference met and recommended that the Senate accede to the House proposal of amendment and that the title of the bill be amended to read: An act relating to enhancing regulation for progress toward mental health parity.  The conferees were Senator Racine, Senator White, Senator Mullin, Representative Fisher, Representative French and Representative Morrissey.  Both the Senate and the House agreed to this and now the bill is ready for the Governor’s signature.

Budget Bill Passes with June Graduate Funding Questioned

The 2.5% COLA for designated agencies was included in the budget.  However, the funding for June Graduates ended up at 45 new waiver slots using the 2009 caseload reserve, which is one time funding for all waiver slots above the 9 slots originally included in the Governor’s budget request.  The Council provided the budget conferees with information on the long term nature of the developmental services used by June Graduates.  However, the Committee still had questions about the program and included the following language in the budget bill.

   (e)  The commissioner of the department of disabilities, aging, and independent living shall work with the commissioner of the department of education to track the number of anticipated June graduates over a four year period.  The intent is that through this tracking system the administration and the general assembly will have information needed to anticipate annual funding requirements well in advance of the time funding needs to be made available.  Additionally, the commissioners shall work to find ways to improve the transition of the June graduates from high school to the June grad program. In the submission of the developmental services program budget for fiscal year 2010, the department shall include a summary of the June Grad program that provides information on the number of individual served, the scope, length, annual cost of services provided, and information on if and how individuals in the June graduate program transition from this program to self sufficiency or alternate support programs.

The budget also contains significant language on substance abuse services:

Sec. 5.212.  Health - alcohol and drug abuse programs (Sec. 2.217, #3420060000)

(a)  For the purpose of meeting the need for outpatient substance abuse services when the preferred provider system has a waiting list of five days or more or there is a lack of qualified clinicians to provide services in a region of the state, a state-qualified alcohol and drug abuse counselor may apply to the department of health, division of alcohol and drug abuse programs, for time-limited authorization to participate as a Medicaid provider to deliver clinical and case coordination services, as authorized. 

(b)   (1)  In accordance with federal law, the division of alcohol and drug abuse programs may use the following interim criteria to determine whether to enroll a state-supported Medicaid and uninsured population substance abuse program in the division’s network of designated providers, as described in the state plan: 

(A)  The program is able to provide the quality, quantity, and levels of care required under the division’s standards, licensure standards, and accreditation standards established by the commission of accreditation of rehabilitation facilities, the joint commission on accreditation of health care organizations, or the commission on accreditation for family services. 

(B)  Any program that is currently being funded in the existing network shall continue to be a designated program until further standards are developed, provided the standards identified in this subdivision (b)(1) are satisfied. 

(C)  All programs shall continue to fulfill grant or contract agreements. 

(2)  The provisions of subdivision (1) of this subsection shall not preclude the division’s “request for bids” process. 

(c)  Of the interdepartmental transfer in this section, $150,000 shall be used to support the gambling addiction program. 

(d)  Of this appropriation, $35,000 shall be used to support the drug court program in Chittenden County, $25,000 shall be used to support the drug court program in Rutland County, and $25,000 shall be used for court coordination in Bennington County.

(e)  The department of health shall be advised by an executive council of Vermont’s recovery center network on an ongoing basis to prioritize service and funding needs for recovery centers, to assist with the review of recovery center funding proposals, and to provide recommendations for disbursement of funds to the recovery centers and their support needs.  This executive council will consist of a board member of each recovery center.  The executive council will hire a network coordinator with the appropriation in subsection (f) of this section.  The network coordinator will work for the executive council and provide technical assistance and training to recovery centers.  The executive council, working with the department of health, will have oversight of the recovery centers.

(f)  Of this appropriation, $45,000 shall be granted to the Vermont recovery center network.  $458,000 of the appropriation is the allocated share of the DETER program for recovery centers and shall be granted to the recovery centers in operation as of June 30, 2008. 

     (g)  It is the intent of the general assembly that maple leaf farm and serenity house will undergo the rate setting process prior to establishing the fiscal year 2010 budget for the division of alcohol and drug abuse programs.

Deputy Commissioner Barbara Cimaglio will be sharing more specific information on the substance abuse services budget with the Council which we will forward upon receipt.

This language was inserted at the request of representative Donahue to maintain the principles of the original Futures plan in the current implementation.  She has a particular concern about the geographic distribution of the residential recovery facilities.

Sec. 5.212.1.  Mental health – Vermont state hospital  (Sec. 2.220, #3150080000)

(a)             The community recovery residential program developed under this section shall be consistent with the goals identified in the existing “futures plan.”

Capitol Bill Specifies Dale Building for Consideration in Futures Planning

The Capitol Bill directs the Administration to review both the Dale building and the current state hospital when planning the secure residential facility as part of the Futures plan.

Foster Care Payments and Unemployment

H.664 was signed into law by the Governor on April 24^th.  It clarifies that foster care payments not required to be included in gross income per federal Internal Revenue Service statutes are not wages for purposes of unemployment insurance.

Agency of Human Services Housekeeping Bill

The Agency of Human Services Housekeeping Bill, H.545, was passed by both houses of the legislature. Included in this bill was the elimination of the Deputy Commissioner of Operations and the Deputy Commissioner of Disability and Aging Services in DAIL.

Electronic Access to Criminal Conviction Records

Both the Senate and House passed S. 246 following conference committee concurrence on the bill.  The bill allows electronic access to Vermont District Court convictions via a secure internet site or an alternative method approved by the Vermont Criminal Information Center (VCIC). Access to the conviction records is allowed for anyone who has a user’s agreement and a secure online account with VCIC. There is a charge to access records, but the fee is waived for a number of situations, including for individuals or organizations that provide services for children, the elderly or persons with disabilities.

Guardianship

The conference committee was able to reach agreement on H.617 and it was passed by both houses of the legislature. The Senate changes which allowed employees but not owners of certain settings such as nursing homes and developmental homes to be a guardian was accepted with the addition of a requirement for the court to look at any conflicts that might arise if the guardian was an employee of one of the specified settings.

The final version of the legislation removed restrictions on a guardian to placement of a person under guardianship in a locked inpatient setting unless the person assented to the hospitalization. The bill retained the use of Title 18 processes for placement of a person under guardianship into a state school or hospital. The bill also reiterates that Title 18 processes are the exclusive mechanism to secure approval for administration of non-emergency involuntary medications. 

The bill requires probate court review before withholding or withdrawing life-sustaining treatment, other than antibiotics, unless it would be impracticable because a decision is needed before court approval can be obtained. In such cases, the guardian must notify the court by telephone of the need for a decision and notify the court of any decision that is made.

Probate court review is also required before consenting to a do-not-resuscitate order unless a clinician certifies that the person is likely to experience cardiopulmonary arrest before court approval can be obtained. In this case, the guardian is also required to notify the court, to obtain the clinician’s certification prior to giving consent to a do-not-resuscitate order and to file the clinician’s certification with the court.

The final version of the bill also reinstates the guardianship task force that had been removed in the Senate version of the bill.

The Justice Reinvestment Bill is Finalized

The Justice Reinvestment bill, formerly titled: an act relating to increasing substance abuse treatment, vocational training, and transitional housing for offenders in order to reduce recidivism, increase public safety, and reduce corrections costs was passed by the Legislature.  The House conceded to the Senate’s plan to move forward with the reorganization of facilities this coming fiscal year.  The Senate agreed to move forward on many of the House’s proposals for how to invest the savings. The language on public inebriates will be challenging to bring into action.  A taskforce will work on this issue.  See the language from key sections of the bill below.

Sec. 8.  28 V.S.A. § 723(c) is added to read:

(c)  Prior to release under this section, the department shall screen and, if appropriate, assess each felony drug and property offender for substance abuse treatment needs using an assessment tool designed to assess the suitability of a broad range of treatment services, and it shall use the results of this assessment in preparing a reentry plan.  The department shall attempt to identify all necessary services in the reentry plan and work with the offender to make connections to necessary services prior to release so that the offender can begin receiving services immediately upon release. 

§ 708.  TREATMENT AND SERVICES

(d)  A person judged by a law enforcement officer to be incapacitated, and who has not been charged with a crime, may be lodged in protective custody in a lockup or community correctional center secure facility not operated by the department of corrections for up to 24 hours or until judged by the person in charge of the facility to be no longer incapacitated, if and only if:

(1)  The person refuses to be transported to an appropriate facility for treatment, or if once there, refuses treatment or leaves the facility before he or she is considered by the responsible staff of that facility to be no longer incapacitated; or

(2)  No approved substance abuse treatment program with detoxification capabilities and no staff physician or other medical professional at the nearest licensed general hospital can be found who will accept the person for treatment.

(e)  No person shall be lodged in a lockup or community correctional center secure facility under subsection (d) of this section without first being evaluated by a substance abuse crisis team, a designated substance abuse counselor, a clinical staff person of an approved substance abuse treatment program with detoxification capabilities or a professional medical staff person at a licensed general hospital emergency room and found to be indeed incapacitated.

(f)  No lockup or community correctional center shall  A lockup not operated by the department of corrections shall not refuse to admit an incapacitated person in protective custody whose admission is requested by a law enforcement officer, in compliance with the conditions of this section.

(g)  Notwithstanding subsection (d) of this section, a person under 18 years of age who is judged by a law enforcement officer to be incapacitated and who has not been charged with a crime shall not be held at a lockup or community correctional center.  If needed treatment is not readily available the person shall be released to his or her parent or guardian.  If the person has no parent or guardian in the area, arrangements shall be made to house him or her according to the provisions of chapter 55 of this title.  The official in charge of an adult jail or lockup shall notify the director of the office of drug and alcohol abuse of any person under the age of 18 brought to an adult jail or lockup pursuant to this chapter.

(h)  If an incapacitated person in protective custody is lodged in a lockup or community correctional center secure facility, his or her family or next of kin shall be notified as promptly as possible.  If the person is an adult and requests that there be no notification, his or her request shall be respected.

(i)  A taking into protective custody under this section is not an arrest.

(j)  Law enforcement officers or , persons responsible for supervision in a lockup or community correctional center or secure facility, members of a substance abuse crisis team or , and designated substance abuse counselors who act under the authority of this section are acting in the course of their official duty and are not criminally or civilly liable therefor, unless for gross negligence or willful or wanton injury.

Sec. 12.  33 V.S.A. § 708a is added to read:

§ 708a.  INCARCERATION FOR INEBRIATION PROHIBITED

A person who has not been charged with a crime shall not be incarcerated in a facility operated by the department of corrections on account of the person’s inebriation.

Sec. 15.  BUDGETARY SAVINGS; ALLOCATIONS IN FISCAL YEAR 2009 AND FISCAL YEAR 2010

(a)  It is the intent of the general assembly to achieve savings in the department of corrections budget which will be reinvested in substance abuse screening, assessment, and treatment and reentry support to result in reduced recidivism.

(b)  In fiscal year 2009, from within the amounts appropriated to the department of corrections from the general fund, the department shall spend $600,000 as follows:

(1)  The amount of $100,000.00 shall be to increase the capacity of the department of corrections’ intensive substance abuse program (ISAP) to provide services to those offenders with drug abuse disorders who are on preapproved furlough status under 28 V.S.A. § 808(a)(7).

(2)  The amount of $200,000.00 shall be to fund the establishment of a screening and assessment pilot program at a location approved by the court administrator to:

(A)  conduct a voluntary and confidential screening and assessment, when screening indicates that an assessment is appropriate, for substance abuse and mental health treatment needs at the time of arraignment of individuals charged with felony property, drug, or fraud offenses;

(B)  conduct a mandatory screening and assessment, when screening indicates that an assessment is appropriate, for substance abuse and mental health treatment needs following adjudication and prior to sentencing of individuals found guilty of felony property, drug, or fraud offenses;

(C)  provide the results of any screening and assessment conducted under this section to the judge following adjudication and prior to sentencing so that the judge can use the information to determine the level of treatment to be provided while the individual is in the custody of the commissioner of corrections; and

(D)  enable the commissioner to gather data regarding the prevalence of co-occurring substance abuse and mental health disorders.   

(3)  The amount of $88,000.00 shall be to assess offenders for substance abuse treatment needs prior to release.

(4)  The amount of $150,000.00 shall be used to fund substance abuse programs and vocational training in the Windsor work camp facility.

(5)  the amount of $62,000.00 shall be for entering into contracts with several community‑based substance abuse treatment providers in different geographic regions of the state to provide the substance abuse treatment services to persons on conditional reentry status pursuant to subchapter 1A of chapter 11 of 28 V.S.A. or furlough pursuant to 28 V.S.A. § 808.

Sec. 17.  PUBLIC INEBRIATES TASK FORCE

(a)  A public inebriates task force is established.  The task force shall consist of the following members:

(1)  Two members employed by the office of alcohol and drug abuse programs appointed by the commissioner of the department of health.

(2)  Two substance abuse treatment providers appointed by the substance abuse treatment providers association.

(3)  One member appointed by the department of public safety.

(4)  One member appointed by the Vermont police association.

(5)  One member appointed by the Vermont League of Cities and Towns.

(6)  Two members appointed by the Vermont medical society who shall be hospital emergency department personnel.

(7)  Two members appointed by the Vermont recovery network.

(8)  Two employees of the department of corrections appointed by the commissioner of the department of corrections.

(9)  A representative of the Vermont Association of Hospitals and Health Systems.

(b)  The task force shall report to the senate and house committees on judiciary, institutions, and appropriations no later than January 1, 2010 with a plan to ensure that public inebriates are given appropriate care rather than incarcerated.  The plan shall ensure the regional availability of supportive voluntary and secure accommodations for public inebriates by January 1, 2011, and shall include a timetable for providing reimbursement of expenses to programs that house and maintain public inebriates.

Sec. 19 CORRECTIONS OVERSIGHT COMMITTEE; CHILDREN OF
  INCARCERATED PARENTS; REPORT

(a)  During the summer and fall of 2008, the corrections oversight committee shall investigate issues regarding minor children of incarcerated parents.  The investigation shall include:

(1)  A report from the commissioner of corrections on data on the prevalence of inmates who are parents of minor children including the number of inmates who are primary caregivers of minor children.

(2)  Identification of mail, telephone, and visiting policies that promote appropriate family contact.

(3)  A report from the secretary of human services on how to provide appropriate support and assistance to the children of incarcerated parents.

(b)  The committee shall make recommendations regarding:

(1)  Ways to increase and improve appropriate contact between minor children and their incarcerated parents.

(2)  Data to be collected to enable the general assembly to understand the impact of incarceration of parents on minor children and to help policy makers access resources and formulate solutions.  The committee shall also make recommendations on how the data will be collected.

(3)  Cost estimates of resources needed to make recommended changes.

(4)  Appropriate support and assistance to the children of incarcerated parents using existing resources, programs, and staff of the agency of human services.

(c)  The committee shall report its findings and recommendations to the general assembly on or before January 15, 2009. 

Mentally Ill Offender Bill Dies

H. 629 the mentally ill offender bill did not arrive in the Senate soon enough for the Senate Judiciary Committee to consider it.  Senator Sears noted that there were concerns about the cost of implementing the bill to the Department of Corrections.

For more information or to take action:

·        Legislative home page: http://www.leg.state.vt.us

·        Sergeant-at-Arms Office: (802) 828-2228 or (800) 322-5616

·        State House fax (to reach any member): (802) 828-2424

·        State House mailing address (to reach any member):     

                                    Your Legislator

                                    State House

                                    115 State Street, Drawer 33

                                    Montpelier, VT  05633-5501

·        Email, home address and phone: Legislators' email addresses and home contacts may be found on the Legislature home page at http://www.leg.state.vt.us

·        Governor Jim Douglas (802) 649-6825 or http://governor.vermont.gov/

The purpose of the legislative update is to inform individuals who are interested in developmental, mental health and substance abuse services about legislative advocacy, policy development and activities that occur in the State Legislature. The Vermont Council is a non-profit trade association whose membership consists of 16 designated developmental and mental health agencies.