[{"_1":2,"_87":-5,"_88":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6278285,"mediaKeyId","2641582-01e92166712c645082f0fe8d14edec1c","parentId",2641582,"title","Committee amends and passes S.53 to create perinatal doula certification; Medicaid coverage contingent on federal waiver","audioSeconds",420,"startMs",571960,"endMs",992240,"viewUrl","/Search/View?dp=1&key=2641582-01e92166712c645082f0fe8d14edec1c&start=571&end=992","thumbnailUrl","https://assets.pipeline.soar.com/2641582-01e92166712c645082f0fe8d14edec1c/thumbnail_571960.jpg","articleUrl","/articles/6278285/Vermont/Committee-amends-and-passes-S53-to-create-perinatal-doula-certification-Medicaid-coverage-contingent-on-federal-waiver","mediaUrl","https://secure.pipeline.soar.com/6278285-84854272f950dde245813ea08f2d524d/orig.mp4?Expires=1773658173&Signature=EMcGtamXUpEgpJVY4SEqMvRYbpmIqS1FmuLb8Vu7X5t01Z7tcaXuTe-6F1eyyrBMu-5gpMZp-dDWqQ5TfeBsBYhmlNOiMI3QaS4lAFlfMsgXtLy8qSmnYI~Qt1CVtTIp5a-42UDkrnhCKvNTIDhv0dDoeIMeaprSHz7eSPlZkr3ALPcbpNXk~HT6fmgcteYqCgi76SfgcYHMqmRhLS1Gp0aFzf36Hnq~IDHirT5HXOwaZbWYW9bW3mtTsm9Wh~d3oNK8-Xv3tovrj-htarB8f8BvWBmHkA03SwTdufPzEhnR~62dMRml1FzGz9C7fJ2pAWnlOMcsz8IMe73CltfEbA__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-03-14T14:55:05Z","article","The Senate Government Operations Committee voted to amend and then pass S.53, legislation to establish a certification program for community-based perinatal (community-based perinatal doulas) and to direct Medicaid coverage for certified services contingent on federal approval.

At the meeting, committee members considered an amendment (draft 1.1) that added a $25,000 appropriation at the request of the Office of Disability and Rehabilitation (as described in committee discussion). The committee chair called the roll for the amendment and recorded affirmative responses from Senator Hartman, Senator Demings, Senator Douglas and Senator Lyons; the amendment carried and the bill was amended.

After the amendment, the committee debated whether the bill, without an explicit Medicaid appropriation, would achieve the policy goals. A Medicaid representative (identified in committee discussion as Alex) explained three main concerns: there is currently no appropriation in the bill to pay for Medicaid coverage; securing Medicaid coverage would require federal approval (a state plan amendment or waiver) and that OPR’s voluntary certification process must comply with federal reimbursement requirements. “Firstly, we don't have an appropriation here for Medicaid coverage, but we do have a mandate here for Medicaid coverage,” Alex told the committee. Alex further outlined timing and cost considerations and said that coverage could not begin until federal approval is obtained.

The committee also discussed estimated program costs and utilization scenarios. Committee testimony cited a proposed maximum reimbursement model of $2,100 per patient; using that model, 10% utilization would translate to roughly $425,000 and 30% utilization to about $1.3 million in annual reimbursement obligations, according to the figures provided to the committee.

Following discussion, a motion to report S.53 favorably out of committee as amended was made and seconded. Committee members recorded affirmative votes from Senator Hart, Senator Hopkins, Senator Douglas, Senator Bullock and Senator Hawkins; the motion passed and S.53 was reported favorably out of committee.

The committee and witnesses stressed that implementing Medicaid coverage requires multiple steps beyond committee passage: establishing the certification infrastructure, applying for federal approval or a state plan amendment with the Centers for Medicare & Medicaid Services, and then identifying funding in a future budget. The bill’s effective date discussed in committee appeared to be July 1, 2026, giving time for federal and budgetary steps before coverage would begin if federal approval is granted.

Votes at a glance
• Amendment (draft 1.1) — recorded affirmatives: Senator Hartman (Yes); Senator Demings (Yes); Senator Douglas (Yes); Senator Lyons (Yes). Outcome: amendment adopted.
• Final committee vote on S.53 (as amended) — recorded affirmatives: Senator Hart (Yes); Senator Hopkins (Yes); Senator Douglas (Yes); Senator Bullock (Yes); Senator Hawkins (Yes). Outcome: reported favorably out of committee.

The committee indicated it will continue to work with the Office of Professional Regulation and the Agency of Human Services on implementation details and on pursuing any required federal approvals before Medicaid reimbursement could begin.","mediaType","Video","parentTitle","Senate Health and Welfare - 2025-03-14 - 10:55 AM","oneSentenceSummary","The Senate Government Operations Committee amended and reported S.53 favorably; the bill establishes perinatal doula certification and directs Medicaid to cover certified services, but state officials said federal approval and funding remain unresolved.","taxTitle","Health & Welfare, SENATE, Committees, Legislative , Vermont","taxId",38585,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6278290,"Senate committee reviews S.64 to let optometrists perform specified advanced procedures",1344,8560,1353090,"/Search/View?dp=1&key=2641582-01e92166712c645082f0fe8d14edec1c&start=8&end=1353","https://assets.pipeline.soar.com/2641582-01e92166712c645082f0fe8d14edec1c/thumbnail_8560.jpg","/articles/6278290/Vermont/Senate-committee-reviews-S64-to-let-optometrists-perform-specified-advanced-procedures","https://secure.pipeline.soar.com/6278290-9ad9b52d2a92350052f9b35ba2b7fd14/orig.mp4?Expires=1773658173&Signature=ftIvY9HvHAuphJZZ9UncwGF9oNtZgkkQAA3qIN0oy8U-8U8cnsrm-nC-bS~3kw3sgMVBaSJPWgrgxA2hHtyh07J2~V1IFMNwTa0h2Ru0UzkfugUcYaS0u6mlXaB4Rxu0CsWSmTw9nNmjRGSUDoh64NuoxiXvGGquE38GjpI2mRpCQOrhZBQm1W731zGQjfU1KHrJ1R9QAPlb2QETA8ezUwbMrdrn-aqtSNgiqD4GpKvOgf1HAzXHAfgS~3hqaYAyPYdbWTb4r-FC6Xm935jqYCCJp0rpK64KsfD8JI8ujp96l6CN53chkfvN90b3P6zxhINoxJudPoLz8CR0ZdtYUw__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Government Operations Committee discussed S.64, a bill that would expand the scope of practice for optometrists in Vermont by authorizing an advanced therapeutic-procedures specialty for licensees who meet new education, training and competency requirements.

The committee’s discussion, led by the bill’s sponsor and staff, described the Office of Professional Regulation’s (OPR) 2023 report recommending a specialty endorsement and noted that OPR “stands by the recommendations made in the 02/2023 report,” while the Board of Medical Practice raised concerns about patient outcomes.

OPR staff testified that the 2023 study, following an earlier 2020 sunrise review, concluded specified surgical, laser and injection procedures could be performed safely if optometrists complete the listed qualifications: a Vermont optometry license, a postgraduate residency or equivalent postgraduate training, a preceptorship, and passage of two examinations administered by the National Board of Examiners in Optometry. Jennifer Collin, general counsel for OPR, told the committee OPR supports the bill language and noted the agency would need to establish rulemaking, IT and outreach infrastructure to implement the endorsement if S.64 becomes law. “OPR does support the language of this bill,” Collin said during testimony.

Representatives of the Board of Medical Practice, including its physician representative, expressed continuing objections. Dr. Hildebrand, speaking for the Board of Medical Practice, said the board previously voted against expansion and remains concerned the available evidence does not show improved access or reduced costs, and that optometrists’ surgical training differs substantially from ophthalmologists’. “Our assessment is this is a solution without a problem,” Dr. Hildebrand said, summarizing the board’s concerns about patient outcomes and limited evidence of access benefits.

Supporters and advocates told the committee that the bill would improve access to eye care and reduce patient travel and referral delays. Committee testimony noted that optometrists complete a lengthy educational path (described in testimony as eight years of education and postgraduate training with at least 2,000 patient encounters) and that 12 states already allow a similar expanded scope, while parts of the requested procedures are permitted in another 14 states. The committee also heard that the bill would require reporting of adverse events and biennial reporting of outcomes to OPR to ensure monitoring and safety.

Committee members and witnesses emphasized that only optometrists who hold the specialty endorsement could perform the advanced procedures and that the proposed Vermont requirements aim to be among the most stringent in states that allow scope expansion. No committee vote on S.64 was taken at this meeting; the item was set aside to return later with further testimony, including additional presentations from the Office of Professional Regulation and the Board of Medical Practice.

Background: The committee record shows OPR issued an initial sunrise review in February 2019 and a more detailed report in February 2023; the 2023 report is the basis for OPR’s present recommendation to authorize an advanced therapeutic-procedures specialty for optometrists.

The committee indicated it will invite additional witnesses back for fuller testimony before acting further on S.64.","The Senate Government Operations Committee discussed S.64, a proposal to create an advanced therapeutics endorsement allowing qualified optometrists to perform specified laser, injection and minor surgical eye procedures.","actionData","errors"]

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Committee amends and passes S.53 to create perinatal doula certification; Medicaid coverage contingent on federal waiver

Senate committee reviews S.64 to let optometrists perform specified advanced procedures