Senate Calendar
wednesday, april 12, 2006
100th DAY OF ADJOURNED SESSION
TABLE OF CONTENTS
Page No.
UNFINISHED BUSINESS OF THURSDAY, APRIL 6, 2006
House Proposal of Amendment
S. 22Off label use of prescription drugs for cancer...... 1283
UNFINISHED BUSINESS OF TUESDAY, APRIL 11, 2006
Third Reading
H. 384Medical ins. for seasonal emp. of Dept. of Forests, Parks & Rec...1287
H. 860Vermont’s participation in the regional greenhouse gas initiative 1287
Sen. Coppenrath amendment...... 1287
H. 876Relating to management of exposure to mercury...... 1287
Second Reading
Favorable with Proposal of Amendment
H. 677Standards board and licensing hearing panels for educators...... 1287
Education Committee Report...... 1287
Appropriations Committee Report...... 1304
NEW BUSINESS
Third Reading
H. 869Relating to the state’s transportation program...... 1304
Sen. Shepard amendment...... 1304
Second Reading
Favorable with Proposal of Amendment
H. 856Sentences/preventing risks posed by dangerous sex offenders.....1305
Judiciary Committee Report...... 1305
Appropriations Committee Report...... 1341
Sen. Sears amendment...... 1341
House Proposal of Amendment
S. 117Relating to state recognition of the Abenaki People...... 1342
NOTICE CALENDAR
Favorable
H. 310Relating to employee ownership of businesses...... 1344
Ec. Dev., Housing General Affairs Committee Report....1344
H. 774Relating to the Vermont economic development authority.....1344
Agriculture Committee Report...... 1344
H. 874Relating to sentencing for first and second degree murder...... 1345
Judiciary Committee Report...... 1345
Favorable with Proposal of Amendment
H. 456Vermont products and nutrition education in schools...... 1345
Agriculture Committee Report...... 1345
Education Committee Report...... 1350
H. 690ID/documentation/advancement creative sector of state’s econ....1351
Ec. Dev., Housing & General Affairs Committee Report....1351
House Proposal of Amendment
S. 246Relating to eminent domain...... 1353
ORDERED TO LIE
S. 112Relating to the practice of optometry...... 1353
S. 157Relating to rulemaking for Vermont origin...... 1353
S. 315Relating to creation of the Vermont Land Bank program...... 1353
S. 316Relating to access to broadband services throughout Vermont..1353
S. 319Relating to expanding the scope of the net metering program..1353
ORDERS OF THE DAY
ACTION CALENDAR
UNFINISHED BUSINESS OF THURSDAY, APRIL 6, 2006
House Proposal of Amendment
S. 22
An act relating to off-label use of prescription drugs for cancer.
The House proposes to the Senate to amend the bill by striking out all after the enacting clause and inserting in lieu thereof the following:
Sec. 1. 8 V.S.A. chapter 107, subchapter 9 is added to read:
Subchapter 9. Off-Label Use of Prescription Drugs for Cancer
§ 4100e. REQUIRED COVERAGE FOR OFF-LABEL USE
(a) A health insurance plan that provides coverage for prescription drugs shall provide coverage for off-label use in cancer treatment in accordance with the following:
(1) A health insurance plan contract may not exclude coverage for any drug used for the treatment of cancer on grounds that the drug has not been approved by the federal Food and Drug Administration, provided the use of the drug is a medically accepted indication for the treatment of cancer.
(2) Coverage of a drug required by this section also includes medically necessary services associated with the administration of the drug.
(3) This section shall not be construed to require coverage for a drug when the federal Food and Drug Administration has determined its use to be contraindicated for treatment of the current indication.
(4) A drug use that is covered under subdivision (1) of this subsection may not be denied coverage based on a “medical necessity” requirement except for a reason unrelated to the legal status of the drug use.
(5) A health insurance plan contract that provides coverage of a drug as required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles, and exclusions to the same extent these provisions are applicable to coverage of all prescription drugs and are not inconsistent with the requirements of this section.
(b) As used in this section, the following terms have the following meanings:
(1) “Health insurance plan” means a health benefit plan offered, administered, or issued by a health insurer doing business in Vermont.
(2) “Health insurer” is defined by subdivision 9402(9) of Title 18. As used in this subchapter, the term includes the state of Vermont and any agent or instrumentality of the state that offers, administers, or provides financial support to state government, including Medicaid, the Vermont health access plan, the VScript pharmaceutical assistance program, or any other public health care assistance program.
(3) “Medically accepted indication” includes any use of a drug that has been approved by the federal Food and Drug Administration and includes another use of the drug if that use is prescribed by the insured’s treating oncologist and supported by medical or scientific evidence. For purposes of this subchapter, “medical or scientific evidence” means one or more of the following sources:
(A) peer-reviewed scientific studies published in or accepted for publication by medical journals that meet nationally recognized requirements for scientific manuscripts and that submit most of their published articles for review by experts who are not part of the editorial staff.
(B) peer-reviewed literature, biomedical compendia, and other medical literature that meet the criteria of the National Institutes of Health’s National Library of Medicine for indexing in Index Medicus, Excerpta Medicus (EMBASE), Medline, and MEDLARS database Health Services Technology Assessment Research (HSTAR).
(C) medical journals recognized by the federal Secretary of Health and Human Services, under Section 1861(t)(2) of the federal Social Security Act.
(D) the following standard reference compendia: the American Hospital Formulary Service-Drug Information, the American Medical Association Drug Evaluation, and the United States Pharmacopoeia-Drug Information.
(E) findings, studies, or research conducted by or under the auspices of federal government agencies and nationally recognized federal research institutes, including the Agency for Health Care Policy and Research, National Institutes of Health, National Cancer Institute, National Academy of Sciences, Center for Medicare and Medicaid Services, and any national board recognized by the National Institutes of Health for the purpose of evaluating the medical value of health services.
(F) peer-reviewed abstracts accepted for presentation at major medical association meetings.
(4) “Off-label use” means the prescription and use of drugs for medically accepted indications other than those stated in the labeling approved by the federal Food and Drug Administration.
(c) A determination by a health insurer that an off-label use of a prescription drug under this section is not a medically accepted indication supported by medical or scientific evidence is eligible for review under section 4089f of this title.
Sec. 2. 8 V.S.A. § 4089f(b)(3) is amended to read:
(b) An insured who has exhausted all applicable internal review procedures provided by the health benefit plan shall have the right to an independent external review of a decision under a health benefit plan to deny, reduce or terminate health care coverage or to deny payment for a health care service. The independent review shall be available when requested in writing by the affected insured, provided the decision to be reviewed requires the plan to expend at least $100.00 for the service and the decision by the plan is based on one of the following reasons:
* * *
(3) The health care treatment has been determined to be experimental, investigational or an off-label drug. A health benefit plan that denies use of a prescription drug for the treatment of cancer as not medically necessary or as an experimental or investigational use shall treat any internal appeal of such denial as an emergency or urgent appeal, and shall decide such appeal within the time frames applicable to emergency and urgent internal appeals under regulations adopted by the commissioner.
Sec. 3. APPLICATION
(a) Sec. 1 of this act shall apply to all health insurance plans issued or offered on and after October 1, 2006 and to all other health insurance plans on and after October 1, 2006 upon renewal or their anniversary date, whichever is sooner, but in no event later than October 31, 2007.
(b) Sec. 2 of this act is intended to clarify existing administrative regulations and shall apply to all appeals subject to 8 V.S.A. § 4089f (independent external review of health care service decisions) pending on and after the effective date of this act.
* * * Wholesale Drug Distributors: Accreditation; Pedigrees * * *
Sec. 4. 26 V.S.A. § 2068 is amended to read:
§ 2068. REQUIREMENTS; APPLICANTS; LICENSES
An applicant shall satisfy the board that it has, and licensees shall maintain, the following:
* * *
(10) Compliance with standards and procedures which the board shall adopt by rule concerning provisions for initial and periodic on-site inspections, criminal and financial background checks, ongoing monitoring, reciprocity for out-of-state wholesale drug distributors inspected by a third party organization recognized by the board or inspected and licensed by a state licensing authority with legal standards for licensure that are comparable to the standards adopted by the board pursuant to this subdivision, protection of a wholesale drug distributor’s proprietary information, and any other requirements consistent with the purposes of this subdivision. The board rules may recognize third party accreditation in satisfaction of some or all of the requirements of this subdivision.
Sec. 5. ELECTRONIC PEDIGREE STUDY
The board of pharmacy shall study the feasibility of an electronic pedigree system that would verify the chain of distribution for all prescription drugs. The board shall report its findings and recommendations to the general assembly not later than January 15, 2007. The study shall include consultation with drug manufacturers, wholesale drug distributors, and pharmacies responsible for the sale and distribution of prescription drugs and consideration of any relevant national standards or initiatives. The board shall include a proposed implementation date in the study.
* * * Drug and Medical Supply Repository Program: Study * * *
Sec. 6. DRUG AND MEDICAL SUPPLY REPOSITORY STUDY
The department of health, in consultation with the office of Vermont health access, the board of pharmacy, the department of disabilities, aging, and independent living, and the board of medical practice, shall study the feasibility of creatinga repository program through which licensed facilities, wholesale drug distributors, and drug manufacturers can donate unused, unopened prescription drugs and medical supplies to pharmacies, hospitals, and clinics in order to dispense such drugs and supplies, for only a handling fee, to persons who are incomeeligible or uninsured. The study shall include findings and recommendations concerning the cost the department would incur in creating and overseeing such a program, including any costs related to consultation with experts, the benefits of a repository program,and any other standards or procedures necessary for the development and implementation of the program. The department of health shall report its findings and recommendations to the general assembly not later than January 15, 2007.
UNFINISHED BUSINESS OF TUESDAY, APRIL 11, 2006
Third Reading
H.384
An act relating to medical insurance for seasonal employees of the department of forests, parks and recreation.
H.860
An act relating to Vermont’s participation in the regional greenhouse gas initiative.
PROPOSAL OF AMENDMENT TO H. 860 TO BE OFFERED BY SENATOR COPPENRATH BEFORE THIRD READING
Senator Coppenrath moves that the Senate propose to the House to amend the bill in Sec. 1, 30 V.S.A., § 254(c)(2) by striking out subparagraph (F) in its entirety and inserting in lieu thereof a new subparagraph (F) to read as follows:
(F) ensure that carbon credits allocated under this program and revenues associated with their sale remain power system assets managed for the benefit of electric consumers. To that end, at least 50% of the revenues shall be used to directly mitigate electricity ratepayer impacts by reducing electric rates paid by consumers, and the remaining credits may be used forinvestments in energy efficiency and other low-cost, low-carbon power system investments;
H.876
An act relating to management of exposure to mercury.
Second Reading
Favorable with Proposal of Amendment
H.677
An act relating to a standards board and licensing hearing panels for professional educators.
Reported favorably with recommendation of proposal of amendment by Senator Collins for the Committee on Education.
The Committee recommends that the Senate propose to the House to amend the bill by striking out all after the enacting clause and inserting in lieu thereof the following:
Sec. 1. 16 V.S.A. § 212(14) is added to read:
(14) Annually, convene a meeting of directors of Vermont educator preparation programs and representatives of school boards, superintendents, principals, educators, and the Vermont standards board to determine subject and geographic areas in which there is a critical need for educators and to discuss ways to meet the need.
Sec. 2. 16 V.S.A. chapter 51 is amended to read:
CHAPTER 51. EXAMINATION AND LICENSING OF TEACHERS PROFESSIONAL EDUCATORS
§ 1691. PURPOSE
The purpose of this chapter is to establish a board of professional educators to oversee the training, licensing, and professional standards of teachers and administrators and to establish hearing panels to determine compliance with those standards to help assure high caliber professionals and high quality public educational programs for Vermont students.
§ 1691a. Definitions
As used in this chapter:
(1) “Administrator”means an individual licensed under this chapter the majority of whose employed time in a public school, school district, or supervisory union is assigned to developing and managing school curriculum, evaluating and disciplining personnel, or supervising and managing a public school system or public school program.
(2) “Applicant” means an individual applying for a license.
(3) “Educator” means any teacher or administrator requiring a license under this chapter.
(4) “Endorsement” means the grade level and field in which an educator is authorized to serve. A license shall bear one or more endorsements.
(5) “Hearing panel” means the persons assigned in individual cases to find facts, reach conclusions of law, and make decisions regarding compliance with standards for obtaining, retaining, and renewing licenses.
(6) “License” means a license to engage in teaching or school administration, as the context requires, in the state and includes, unless the context requires otherwise, the endorsements the licensee has applied for or possesses. “Licensee” means an individual licensed under this chapter.
(7) “Licensing action” means action that suspends, revokes, limits, or conditions licensure or certification in any way and includes warnings, reprimands, probation, and administrative penalties.
(8) “Office” means the office within the department of education responsible for professional standards and educator licensing.
(9) “Standards board” means the Vermont standards board for professional educators established under section 1693 of this title.
(10) “Teacher” means an individual licensed under this chapter the majority of whose employed time in a public school district or supervisory union is assigned to furnish to students direct instructional or other educational services, as defined by rule of the standards board, or who is otherwise subject to licensing as determined by the standards board.
§ 1692. REQUIREMENT AS TO LICENSE; AGE LIMIT
A person shall not teachExcept for a substitute teacher in accordance with rules adopted by the standards board, a person shall not be employed as a teacher or administrator in a public school without having a license then in force. A license shall not be issued to a person under seventeen years of age.
§ 1693. STANDARDS BOARD FOR PROFESSIONAL EDUCATORS
(a) There is hereby established the Vermont standards board for professional educators comprising 13 members as follows: seven teachers, two administrators, one public member, one school board member, one representative of educator preparation programs from a public institution of higher education, and one representative of educator preparation programs from a private institution of higher education.
(b) Appointment and qualifications. When a vacancy occurs, except in the case of the public member position, the state board of education shall solicit up to five nominations from any of the following organizations if their members may be eligible for the vacant position: the Vermont national education association, the Vermont school boards association, the Vermont principals association, the Vermont superintendents association, the Vermont State Colleges, the University of Vermont, and the association of independent colleges. The state board may add other names to the list but may not remove nominations submitted by the organizations and shall forward the list to the governor. The governor shall appoint a person on the list or, in the case of the public position, the governor shall appoint a person of his or her choosing, for a term of three years which shall begin July 1 of the year of appointment. No person shall be eligible for more than one sequential reappointment. The governor shall appoint a replacement to fill any vacancy on the standards board for the remainder of the term. Appointments shall be consistent with the following requirements:
(1) Each member of the standards board shall be a citizen of the United States and a resident of Vermont.
(2) The educator members shall be generally representative of elementary and secondary schools and of programs of study taught in Vermont public schools and of administrative positions in Vermont public schools. Teacher members shall hold a license and have at least five years’ experience in public school teaching, at least three of which shall have been within the five years preceding appointment. Administrator members shall hold a license and be endorsed as an administrator and have at least five years’ experience in public school administration, at least three of which shall have been within the five years preceding appointment.
(3) The school board member shall be a current school district board member or have served on a school district board at some period during the three years prior to appointment.
(4) The public member shall not be a member of the state board of education or an employee of any school and shall not derive primary livelihood in the field of public or independent education at any level of responsibility.
(c) Standards board officers; meetings. The standards board shall elect from its members a chair, vice chair, and secretary who shall serve for one year and until their successors are elected and seated. The board shall meet at the request of the chair or at such other times and places as the board may determine. Seven members of the board shall constitute a quorum for the transaction of business.
(d) Compensation. The department of education shall compensate standards board members for the performance of their duties and reimburse them for their actual and necessary expenses in accordance with section 1010 of Title 32.