[{"_1":2,"_98":-5,"_99":-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",[32,75,87],{"_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",6093213,"mediaKeyId","2848372-9829ae402647d2f98da9b828b0b411ca","parentId",2848372,"title","State regulators back advertising and delegation provisions, press for edits and pharmacy implementation help in S.28","audioSeconds",1292,"startMs",3443205,"endMs",4735280,"viewUrl","/Search/View?dp=1&key=2848372-9829ae402647d2f98da9b828b0b411ca&start=3443&end=4735","thumbnailUrl","https://assets.pipeline.soar.com/2848372-9829ae402647d2f98da9b828b0b411ca/thumbnail_3443205.jpg","articleUrl","/articles/6093213/Vermont/State-regulators-back-advertising-and-delegation-provisions-press-for-edits-and-pharmacy-implementation-help-in-S28","mediaUrl","https://secure.pipeline.soar.com/6093213-4318388b3d2ff25ca10f908b87cbd264/orig.mp4?Expires=1770440153&Signature=Qbfx3IvNerCHHssSLCusTf7KSBLAlCdwGSO0rQI1504vNnesDnF7VVKTczW0S-AQbVPYpdxNxIMT4oum8opZISVO8qWseRX6-63dE7-gbPM7ty~CYBWxxAlNV9LYusoQPqHCo0FY2f-aFjYgdyCl20BvRTQG21doNweJtVGrlDQ-qZ-XA-JJYwoOm4D9LX-V7jqigj3JBTb5EvBXE~B5KI3lIXNAjVrudVMyEVq8ZFWGu4rcU5o~Jj04QPZshsdU7DJZUyrT3gqbBS-p8mCMbMG4mXnrp4gbSDva0UCm72KlK3ywEKUmTMSy-eWLEnKKqQypnkg6qIhmHrrE8xwGtQ__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-04-02T13:02:34Z","article","The Secretary of State's Office and the Office of Professional Regulation (OPR) told the House Committee on Health Care they support several changes in S.28 that target deceptive advertising, strengthen oversight of delegated clinical tasks and alter certain pharmacy labeling and prescriber‑naming requirements — but asked lawmakers for precise drafting edits and for more information from pharmacy organizations before finalizing some operational changes.

For the record, Lauren Hibbert, deputy secretary of state, and Jen Collett, general counsel at OPR, testified section‑by‑section. \"We strongly support this section of the law being changed\" on public‑records exemptions for licensee contact information, Hibbert said, explaining OPR routinely receives commercial requests for lists that include email addresses.

Why it matters: S.28 would add false or misleading advertising about health care services to the unprofessional‑conduct statute, tighten language around delegation and supervisory responsibility for delegated tasks, allow certain prescribing by adaptive questionnaire in limited circumstances, and permit a prescriber to request limited dispensing label information be omitted from pharmacy labels. Regulators argue the changes protect patients but asked for narrower drafting in places to avoid unintended legal defenses or enforcement gaps.

Major regulator requests and concerns

- Public records and licensee safety: OPR supports removing some licensee contact fields from public disclosure so that the office need not publish licensees' email addresses and other contact details that have been used for unsolicited commercial outreach.

- Advertising and delegation: OPR supports adding \"advertising about healthcare services that is intended or has a tendency to deceive or mislead\" to the unprofessional‑conduct list. It also proposed removing the phrase \"any combination of\" from a proposed delegation clause because OPR said that wording could allow unlicensed providers to assert sufficiency of training alone as a defense. OPR asked that the statute expressly state that delegation \"may not expand the scope of practice for a licensed professional\" and that delegating licensees be liable for acts of those to whom they delegate.

- Delegation and preceptorships: Committee members asked how the delegation language would apply to supervised trainees or preceptors; OPR replied the statute language is intended to defer to profession‑specific rules: \"if you're required to hold a license while you're receiving that supervised training or preceptorship, then that person has to have it in order for the preceptor to be doing their work,\" Collett said. OPR recommended retaining the clause that ties supervision requirements to what individual professions already require.

- Adaptive questionnaires and certain prescribing: OPR signaled narrow support for use of an adaptive questionnaire to screen for eligibility to prescribe medication to terminate a pregnancy in limited, specified circumstances and asked that the statute say the questionnaire be \"prescriber approved\" so prescribers have clinical input on how it operates.

- Pharmacy labeling and prescriber anonymity: OPR supports limited statutory changes that would allow, in narrow circumstances, a prescriber to request that a pharmacist not include the prescriber's name on a medication label. But OPR urged the committee to consult pharmacy groups such as the National Association of Chain Drugstores and the Vermont Pharmacists Association to assess feasibility and federal requirements. OPR also suggested changing wording from \"to the extent not expressly prohibited under federal law\" to \"to the extent not expressly required under federal law\" and recommended using the term \"pharmacy professional\" rather than only \"pharmacist,\" because technicians and interns perform many labeling tasks.

Committee discussion and operational questions

Committee members sought clarification about whether cooperative agreements or collaborative practice agreements could address supervision issues in settings where delegation is routine; OPR said such agreements are helpful in some professions but that requiring them across all professions could be burdensome.

On the labeling provisions, Collett said OPR's pending pharmacy rules have anticipated some of the bill's changes but counseled the committee to get practical input from practicing pharmacists and national pharmacy organizations before finalizing statutory language.

The committee did not take votes on S.28 during the hearing. OPR said it will submit suggested drafting language and spelling edits to address the delegation and advertising clauses and recommended the committee seek operational input from pharmacy organizations about label changes before final passage.

","mediaType","Video","parentTitle","House Healthcare - 2025-04-02 - 9:00 AM","oneSentenceSummary","The Secretary of State and the Office of Professional Regulation said they generally support S.28's additions to the unprofessional‑conduct statute and changes to pharmacy labeling but urged drafting edits and consultation with pharmacy organizations before finalizing operational rules.","taxTitle","Health Care, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont","taxId",30956,"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},6093219,"State regulators back freestanding birth centers but ask clarifying language on scope, pharmacy oversight",3367,31240,3398770,"/Search/View?dp=1&key=2848372-9829ae402647d2f98da9b828b0b411ca&start=31&end=3398","https://assets.pipeline.soar.com/2848372-9829ae402647d2f98da9b828b0b411ca/thumbnail_31240.jpg","/articles/6093219/Vermont/State-regulators-back-freestanding-birth-centers-but-ask-clarifying-language-on-scope-pharmacy-oversight","https://secure.pipeline.soar.com/6093219-25fa107f726aaebb8ed0a2c15723a2e2/orig.mp4?Expires=1770440153&Signature=F9WuyfIcG2afkV3UD~o8~AuZvkx4BP3QWQ3XXW1NOeIVAAsLTb3kmba~gaoo6NgSLI0zLztjCQfnG4yrMyZg7Vy0PwTm8602ZpOqD9nwL5hdNMRhra1vCL7f0Nw6hMD9pBuz9s08MHknqWffT4lpPe7r~6AnRXhy7olwtlLDpcokjqmgTWEnHj-mfIfspPx4nqiVtLVRGGr1XF4~8XWJ0Qd3cM0mE-EDqs7sms2s4XXBvcQJ9lWDp-bwVG1y1xcc~6DBiPpeTSJtEpPvnFmK0yD-PHhz7iLhUMyZC-uNUkFoCYezKPjjc~q5B9CrLvXwpyH7hpZJBDcAnBVWnRDvow__&Key-Pair-Id=KUT5TJCACFTXG","The Secretary of State's Office and the Office of Professional Regulation told the Vermont House Committee on Health Care that they support S.18, legislation to license freestanding birth centers, but asked lawmakers to tighten definitions and rulemaking consultation around medication storage and scope of services.

Deputy Secretary of State Lauren Hibbert, representing the Secretary of State and OPR, said the agencies \"support the creation of freestanding birth centers\" and recommended amending the bill to define what counts as a \"low risk\" birth and to state explicitly that epidurals and cesarean deliveries are prohibited on site. \"We think that the definition for what is a low risk birth should be added to the bill,\" Hibbert said.

Why it matters: the bill would create a licensing pathway for facilities intended to serve people with uncomplicated pregnancies who want a non‑hospital setting. Regulators want the statute and later rules to make clear which procedures and medications are allowed so pharmacies, clinicians and inspectors apply consistent safety standards.

Key points from testimony and discussion

- Scope and definitions: OPR recommended adding a statutory definition of \"low risk\" because the draft bill repeatedly uses the term without specifying medical criteria. The office also asked legislators to explicitly prohibit onsite epidurals and cesarean sections to limit the centers' procedural scope.

- Pharmacy and medication oversight: OPR said it does not expect freestanding birth centers to require a full hospital pharmacy and that creating that requirement would be \"extremely burdensome, probably cost prohibitive.\" Still, OPR asked that the Board of Pharmacy be consulted during the Department of Health's rulemaking so rules about medication storage and dispensing are consistent with existing pharmacy standards and with OPR's ongoing review of clinic 'brown bag' and 'white bag' medication practices.

- Workforce and licensing: OPR noted most professions expected to work in the centers — certified nurse‑midwives, licensed midwives, naturopathic physicians with childbirth endorsements and others — are already regulated by the office, so the new centers are not expected to add large licensing workloads. Hibbert said she did not expect a major increase in unprofessional‑conduct cases attributable to the centers.

- Ownership and governance questions: Committee members asked whether hospitals or private entities could open centers. The bill's draft definition of a freestanding birth center excludes facilities that \"are a hospital, part of a hospital, or owned by a hospital,\" which led to follow‑up discussion about whether hospitals could establish a separately licensed entity or provide birth‑center‑style services as part of a hospital unit. OPR told the committee that the current language would not license a hospital‑owned unit under the freestanding birth center chapter; such a unit would remain governed under hospital chapters.

- Inspections and surveys: Pamela Cota of the Department of Aging and Independent Living said her division — the state's CMS survey agency — would conduct licensing inspections for the Department of Health under an existing memorandum of understanding. Cota told the committee the division has 17 nurse surveyors and felt confident it could absorb oversight for an estimated one to two Vermont centers, but she said she could not yet predict complaint‑investigation volume.

- Certificate of Need (CON) and transfer of ownership: Laura Bellabo of the Green Mountain Care Board said the board supports exempting freestanding birth centers from the CON subchapter but prefers a standalone statutory exemption rather than tacking the exemption onto an existing practitioner‑office exclusion. The board asked for more time to consider how transfer‑of‑ownership provisions should apply if centers later change hands.

- Payer and cost concerns: Sarah Teachout of Blue Cross and Blue Shield of Vermont said the insurer is generally supportive but urged removing a clause that would mandate payment of \"birth center facility fees\" from the required‑coverage section. Teachout argued the bill mixes coverage requirements with contracting language and that network and contracting implications should be resolved outside this statutory coverage mandate. In committee discussion Teachout cited data comparing facility charges in New Hampshire: \"A freestanding facility was $2,870\" for a vaginal delivery, compared with higher facility charges at several hospitals.

Committee dynamics and next steps

Committee members asked how many centers Vermont might expect; OPR said it had not done an economic study and had heard estimates of \"1 or 2\"; it also noted Vermonters already travel out of state for birth‑center services or give birth at home. Questions raised by members included whether centers would draw patients away from hospitals and how ownership rules could limit or enable private investors or outside groups to buy centers in the future.

Hibbert and other witnesses urged clearer statutory language on definitions and pharmacy rulemaking consultation to guide subsequent administrative rules and consistent inspection standards.

The committee did not take formal votes during the hearing. The bill's supporters and OPR indicated they will propose specific drafting language to add a definition of \"low risk,\" expressly prohibit cesarean delivery and epidural analgesia on site, clarify the definitions relating to who may own or operate a center, and require the Board of Pharmacy to be consulted during Department of Health rulemaking.

Looking ahead: testimony established that Vermont has no current licensing category for a freestanding birth center and that S.18 would create one. OPR and the Department of Aging and Independent Living said they are prepared to participate in rulemaking and inspections, and the Green Mountain Care Board recommended a standalone CON exemption and asked for more time to consider transfer‑of‑ownership language.

","The Secretary of State's Office and the Office of Professional Regulation told the Vermont House Committee on Health Care that they support S.18 to license freestanding birth centers but recommended adding a statutory definition of \"low risk\" births and clearer pharmacy and ownership language.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":91,"_47":92,"_49":93,"_51":94,"_53":95,"_55":56,"_57":58,"_59":96,"_61":62,"_63":64,"_65":97,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6093208,"Treasurer proposes $1 million for statewide medical‑debt buyback and credit‑report protections, plans partnership with nonprofit",0,4754275,"/Search/View?dp=1&key=2848372-9829ae402647d2f98da9b828b0b411ca&start=4754&end=4754","https://assets.pipeline.soar.com/2848372-9829ae402647d2f98da9b828b0b411ca/thumbnail_4754275.jpg","/articles/6093208/Vermont/Treasurer-proposes-1-million-for-statewide-medicaldebt-buyback-and-creditreport-protections-plans-partnership-with-nonprofit","https://secure.pipeline.soar.com/6093208-4dbabbaf3c31289b2252191573a835e6/orig.mp4?Expires=1770440153&Signature=imXrMjKcwijJRSwjmJIbc-7l4cAXO7hv45wI5eo4cdeNWF3Ze7NwxyS46sS-vVvtc1UT9XFVLMaAYaGyKKO3ZkwFI29WuM6326EhDV3RlHm4Cr7BQ82TiAdeSzdX8BU7ad1~uvmH799MtLzaKgQ4PCmrM~SGdFdsmvhV8ylCivC-l0NUKiVCwdSZlO4olNB-AC7SKa1rAhmeA3kfbyvtI-xP5V0qWZklr1paBYo1GkXI2AjDb6~tb7JVk02poQlH--HJVv9ETIDEE3uTODbwECHll-ogLjsYniQCQXdC8bkI2cnzhKNu5rg9jON7psOT7e1DoThdpFYPdcq1hmWYVQ__&Key-Pair-Id=KUT5TJCACFTXG","The state treasurer told the House Committee on Health Care that S.27 would pair a one‑time medical‑debt purchase program with a ban on reporting medical debt to consumer credit bureaus, and proposed using $1 million in reallocated funds to purchase qualifying debt through a contract with Undue (formerly RIP Medical Debt).

The treasurer described medical debt as distinct from other debts because patients often have no opportunity to delay care or shop for lower prices. The treasurer said the proposed program would target Vermonters at or below 400% of the federal poverty level and would focus on eligible debts that are at least 12 months old and have completed billing and collection steps.

How the program would work

- Contract and outreach: The treasurer said the office would contract with Undue to negotiate with participating providers (hospitals and other liable providers), receive de‑identified debt files, and evaluate accounts for eligibility based on income and age of account.

- Purchase and abolition: Undue would propose purchase offers for qualifying debt, typically at very low purchase prices (often described as pennies on the dollar). Participating providers would accept offers and transfer those debt accounts; Undue would then notify affected patients that their debt has been forgiven.

- Scale and cost: The treasurer estimated about 60,000 Vermont residents hold medical debt meeting the program's eligibility criteria and said Undue estimated around $100 million in face‑value medical debt could be eligible. The treasurer proposed a $1,000,000 appropriation, consistent with purchase ratios used in other jurisdictions; that sum would cover the purchase cost plus Undue's administrative fee.

Why the treasurer and proponents say the program is needed

Treasury staff argued that medical debt is a major barrier to health and financial stability, can deter people from seeking care and disproportionately affects low‑income, rural and other vulnerable populations. The treasurer pointed to recent federal Consumer Financial Protection Bureau activity on medical‑debt reporting but said a state program would protect residents even if federal actions change.

Voluntary provider participation and scope

The treasurer said provider participation would be voluntary. Hospitals and other providers would choose to provide debt files for review; some providers in other jurisdictions have also chosen to donate the debt rather than accept purchase funds. The treasurer said Undue has worked with nonprofit hospitals and other providers in many states and cities and that the nonprofit has experience processing large debt files and conducting eligibility screening.

Implementation details raised in questioning

Committee members asked how much of the $1,000,000 would go to Undue for administrative fees; the treasurer said Undue typically charges a percentage of the purchase amount and that the program design anticipates that administrative costs are included within the $1,000,000 estimate. The treasurer also said hospitals often receive a small payment when debt is sold (for example, a check for $1 on a low‑value account) and sometimes choose to donate proceeds back into patient programs.

The treasurer characterized the proposal as a one‑time, targeted effort and said the treasury had identified $1,000,000 previously appropriated for bond buy‑down that was available to reallocate to this program; the office said reallocating that money would produce greater immediate benefit to vulnerable Vermonters than the original bond buy‑down purpose.

No vote was taken during the hearing. The treasurer said the office would return with more implementation detail if the committee asked and anticipated negotiating participation and confidentiality agreements with providers before purchases occur.

","State Treasurer testified in favor of S.27, proposing a $1 million appropriation to contract with nonprofit Undue (formerly RIP Medical Debt) to purchase and abolish qualifying medical debt for low‑ and moderate‑income Vermonters and to bar medical‑debt reporting to credit bureaus going forward.","actionData","errors"]

Article not found

State regulators back advertising and delegation provisions, press for edits and pharmacy implementation help in S.28

State regulators back freestanding birth centers but ask clarifying language on scope, pharmacy oversight

Treasurer proposes $1 million for statewide medical‑debt buyback and credit‑report protections, plans partnership with nonprofit