Board of Medical Practice urges against exception for questionnaire‑only prescriptions in S.28

David Herlihan, executive director of the Vermont Board of Medical Practice, told the committee the board opposes a provision in S.28 that would allow medication to terminate a pregnancy to be prescribed based solely on an adaptive questionnaire without interaction between prescriber and patient.

“My understanding … is that there should be some kind of interaction between the prescriber and the patient,” Herlihan said. He told members the board accepts asynchronous communication — for example, time‑delayed chat — but opposed a model in which a prescription issues only when a questionnaire’s automated algorithm returns a result without any back‑and‑forth.

Herlihan said the board’s policy and Vermont statutory practice standards require “some level of interaction” and that those standards were created in part to address concerns about prescribing based only on questionnaires and automated systems. He told the committee the board has disciplined providers in the past for operating questionnaire‑only systems and urged the committee not to create “the only exception” in Vermont law that would allow prescriptions to issue without interaction.

Committee members asked Herlihan what the board would consider “meaningful” interaction. He answered that it depends on circumstances but that the standard requires a “meaningful exchange” — not merely the patient filling out a form — so a prescriber can ask follow‑up questions and identify cases where medication might not be safe.

Several committee members raised access and confidentiality concerns. One member said adaptive questionnaires could help people who face monitoring or coercion. Herlihan replied that the systems can be configured to require a chat or other follow‑up in Vermont cases and that creating such a connection need not delay access. “They wouldn't even have to reprogram their system,” he said about providers that use national platforms; “they would have to have some kind of communication.”

The committee also heard from pharmacy representatives and the Department of Health. A pharmacist testifying to the committee said removing prescribers' names from pharmacy labels would “just can't happen,” citing state and federal requirements, pharmacy computer systems and insurer adjudication practices. Christina McLaughlin of the pharmacists’ association told the committee, “That's what Jeff described is technically right,” and said pharmacies are unsure how to comply if law changes require blank labels for certain medications.

Jesse Hammond of the Department of Health described how vital records handle fetal deaths and induced terminations of pregnancy: individual fetal‑death and induced‑termination records are not released to the public, summary statistics are published, and the department provides deidentified aggregate information to the CDC under existing contracts. Hammond said the department had no concerns with a proposed change to shorten the retention window for certain records from five years to two years.

No formal committee votes on S.28 were recorded in the transcript provided; the transcript records testimony, questions, and discussion but not committee action. Several committee members expressed a desire to balance access and safety when drafting final language.