Legislative Update

Feb. 24, 2009

Rep. Anne Donahue

This week we spend considerable time on the floor with the budget adjustment bill and the reform bill for addressing sexual abuse of children.

Budget adjustment is usually a fairly noncontroversial process that allows for moving budgeted money between departments based upon actual spending year-to-date for the remainder of the current year that ends in June.

This year, the question of adding new cuts (more than $75 million has been cut already) to balance shortfalls rather than plugging the gap with federal bailout money made for extensive debate.

Next year, we face roughly a $250 million (including Medicaid) mismatch between state revenues and current state spending after this year’s cuts. Part is due to the economic crisis, and part will be relieved by the federal ability to print extra money and sent it to states to help move out of the recession. (We will pay that back later in inflation.)

However, part of it is “structural” – that is, over the long term, Vermont is spending more than it earns. I’ve been warning for years that we were passing artificial budgets passed upon “hoped-for” revenues. Previously, those revenues ended up coming in. Now, this practice is coming back to bite us.

The bill passed with a strong majority.

Saving V-Pharm

We need to do a lot more digging into facts before we can make reasonable calculations between what kinds of further spending cuts are necessary, and what kind of new revenue (taxes) may be necessary. In some cases, eliminating programs could simply result in shifts to mandatory programs at higher cost.

What does digging mean?

In my Human Services Committee, after extensive testimony, we made a firm recommendation to the Appropriations Committee that V-Pharm – pharmacy assistance to seniors and those on disability – needed to be on the “do not cut” list for budget adjustment. We asked the administration to report to us regarding a list of measures that could save the program a good deal of money, while keeping it intact, for next year’s budget that starts in July.

It was distressing to find out that the elimination of the program was recommended by the governor without doing such a review.

Clearly, these decisions must be informed ones.

The Sexual Offender Bill

The second major debate was over the sexual offender bill.

I was one of only two who voted against the bill; perhaps a Quixotic statement against a bill that will undoubtably be signed into law with overwhelming support before the town meeting break. There will be further expansion on this topic yet to come this session.

This bill was a political response that does not fit into the rest of our state criminal justice system. It establishes that sexual abuse of a child is more heinous and the damage more irreversible than the premeditated murder of a child.

A blunt example: if a depraved individual tortures a child in the cruelest possible ways, and then buries him alive to suffocate him to death, that person will face less aggressive penalties than a person who molests a young teen and kills her immediately.

The US Supreme Court said just last year that the despite the permanent damage and years of anguish that victims of such crimes face, “in terms of moral depravity and of the injury to the persons and the public, they cannot compare to murder in their severity and irrevocability.”

Victims advocates in that case said that, “Life is not over for child sexual abuse survivors and the law should not take any action that suggests that it is.” The equation of rape with murder “sends the wrong message to child victims; that they are irreparably damaged and that their lives are effectively over.”

Sexual abuse as defined in Vermont is not just rape; it includes any touching of genitals to genitals, and the absolute 25-year-penalty without regard to any mitigating factors can thus apply to an 18-year-old having such contacts without consent with a 15-year-old. For a brutal, premeditated murder, mitigating factors [youth, and a history of vicious abuse as a child, as examples] can bring a sentence down to 15 years.

We are also changing some fundamental civil rights that protect all of us against wrongful conviction, for this one crime. Are we assuming, for this crime alone, the person accused is always the guilty one?

Perhaps even more out of context is the several million dollars in new expenditures that will accompany the bill to enhance prosecutions.

In a budget facing deep cuts, we will at the same time be reducing some of the very programs that build stronger families. Most sexual abuse crimes occur within families – families that lack the strength on their own to become stable and protect their children.

Among the proposed cuts is the reduction of 96 staff positions in the Department of Children and Families, the department that works to investigate and prevent child abuse.

We have already significantly cut funding to mental health counseling agencies, where long term victims of sexual trauma are treated. Sexual offenders were most often once victims themselves, and that cycle must be broken if we truly hope to effect change.

In Rutland, a residential treatment center for child sexual offenders has just been cut from 14 to 10 beds.

Where is our sense of context?

I respect the heartfelt intentions behind this bill, but our legitimate horror over a horrific crime should not be the driver behind changes in the law that are established in isolation of all of our other priorities for a just and safe society.

Colonoscopies

Why will we probably not achieve health care reform in our lifetimes? Because we want to cut costs and keep all the bells and whistles, necessary or not. A bill last week crystalized our backwards approach.

A “single payer” system will not make health care costs sustainable if it leaves out the other half of the equation: restriction of our free choice to make less cost-effective health choices.

There are two methods for the vital early screening, detection, and prevention of colon cancer. Almost every national guideline – include the Centers for Disease Control (CDC) – ranks them as equivalent.

One requires enough personal responsibility to “scoop a little poop” (as I described it on the House floor) at home for three days in a row every few years and have it tested. The other, the colonoscopy, is only required once every 10 years but costs a couple thousand dollars worth of high-tech internal examination under sedation at a hospital.

Many more Americans are willing to have the colonoscopy, and many more doctors direct them that way.

So we passed a “health care reform” bill last week to mandate private insurance to limit co-pays for colonoscopies to $25. The cost shift to each individual premium will be between $80 and $150 per year. Yes, that will also end up on your property tax bill, since it will be an added cost to every salary in our schools.

Recognizing the measure would pass, I successfully offered an amendment to prevent discrimination against seniors on Medicare, who must pay about $170 as a co-pay. That will add a further cost shift through hospitals to all of us, but at least would be fairer. I still voted against the full bill.

We often point to France in contrast to our failed system, because it has far lower-cost, government-run health care and ranks among the top in health care outcomes in the world. We are pathetically low on that scale.

I found, and shared on the floor, a 2008 review of France’s successful pilot program on population-wide screening and its plan to expand it throughout the country. How can they afford to do this critical screening for everyone?

They scoop the poop.

Human Services Committee Work

Besides V-Pharm, my committee is hearing testimony and reviewing the impact of cuts to family assistance programs. Other committees are doing likewise with parts of the budget in their jurisdiction, and all of our recommendations will fall in the lap of the Appropriations Committee – not a job I would envy with a $250 million shortfall.

The Ways and Means Committee has the job of evaluating the revenue side, and what tax options might be considered that would have the least impact on economic recovery.

Our committee also reviewed the progress being made on implementation of the 2006 statute on eliminating wrist, waist-chain and ankle shackling of children being transported (even to foster homes). There has been fundamental cultural change – for example, no longer are children being taken to medical appointments by sheriff in shackles as a routine method of transportation for convenience.

However improvements have leveled off and we learned that after the “soft restraints” (those used around the country for non-criminal, medical restraint) that were ordered in 2006 were found to not work effectively, there was never any effort to find another supplier. The departments involved will now follow up.

We have taken significant testimony on the issue of improving palliative care, pain management, and end of life care, with the goal of developing a committee bill. There is much headway we can make as a state through policy and education, not necessarily money.

We also took testimony on the administration’s planning for further alternatives to state hospital beds. There is no “end plan” in sight, and therefore some concern about large scale investments now being proposed for early phases without knowing what will be coming later for the main component of hospital bed replacement that will be needed to actually close VSH.

We heard from Rutland hospital CEO Tom Huebner about his willingness to have 12 VSH replacement beds through building a 25-bed new wing if funded by a 10-year state contract to repay the bond through the bed rate for the 12 state beds.

I am grateful for all of your insights and the priorities you identify and share with me throughout the session. Please continue – it helps me to do a better job as your representative. I can be reached at counterp@tds.net or by phone message at home (485-6431) or at the state house (828-2228).