Senate panel agrees to concur on S.36 with House changes; bill adds reports on services for incapacitated people and Human Services Board review

The Senate Committee on Health & Welfare indicated it will concur with the House amendment to S.36, which keeps existing Medicaid reimbursement language for high- and low-intensity residential treatment intact, replaces the phrase “public inebriate” with the statutory descriptor “persons who are incapacitated,” and requires multiple agency reports and presentations to the policy committees.

The House amendment preserves sections of S.36 on Medicaid payment models and the effective date while changing the language that identifies the population the bill addresses, and it adds reporting requirements. The amendment directs the Departments of Health and of Mental Health to prioritize Chittenden County in a plan to expand services and programming for persons who are incapacitated and requires a joint presentation to policy committees on or before Feb. 15 of the coming year. The Department of Corrections must also present, by the same date, on efforts to reconnect persons held in correctional facilities because of incapacitation with community substance-use recovery providers.

The bill retains the committee’s earlier Medicaid reimbursement provisions for high- and low-intensity residential treatment and a required report on a Medicaid payment model. Legislative counsel told the committee the human-services committee replaced the term “public inebriate” with the statutory term describing “persons who are incapacitated” to match existing statute language and to use more respectful terminology.

Representative Bishop, speaking for the House, told the Senate committee that human-services committee testimony included medical staff from emergency departments and providers who said the loss of public inebriate programs has put pressure on emergency departments and the Department of Corrections. Bishop said testimony supported repealing an option that would have eliminated DOC as a potential lockup, but committee witnesses also urged retaining DOC as an option in some cases where no alternative exists. Bishop said the Department of Mental Health has a two-year plan to rebuild public inebriate programs and that the new language asks the department to prioritize Chittenden County because it has the least capacity and the greatest need.

On the Human Services Board, the House amendment directs two written reports. The Agency of Human Services (AHS), in consultation with the Human Services Board, the Office of the Attorney General, departments with cases before the board, community partners, and individuals with lived experience, must submit a report by Dec. 15 describing proceedings before the board and offering recommendations. That report should include proposals about attorney training that balances ethical duties with trauma-informed treatment of appellants, analysis of varying appeals processes across AHS, proposals to identify and collect currently unavailable uniform data (including cases resolved before hearing-officer or full-board involvement), and recommendations for resolving appeals earlier where appropriate.

A second report, led by the Human Services Board in consultation with relevant stakeholders, must propose ways to improve appellant access and understanding of board processes (including use of media and graphics), suggest exchange-of-feedback mechanisms for continual quality improvement among the board, agencies, the Office of the Attorney General and Vermont Legal Aid, analyze how appellants can present personal narratives without jeopardizing cases, and recommend improvements to reporting data to the General Assembly.

Committee members asked whether agencies have capacity to prepare the requested reports; committee members were told the reports are part of oversight and accountability for rebuilding services. After discussion, committee members indicated, via a straw poll, they were willing to concur with the House amendment. The transcript records a straw vote and verbal agreement from several members but no formal roll-call tally in the committee minutes.

Key timelines and deliverables in the House amendment include the Feb. 15 presentations on services and corrections linkages, and a Dec. 15 consolidated report to the General Assembly on Human Services Board proceedings and recommendations. The amendment would retitle the bill on passage to: “An act relating to the delivery and payment of certain services provided through the Agency of Human Services, services for persons who are incapacitated, and Human Services Board proceedings.”

The committee’s discussion identified persistent operational concerns: emergency departments receiving incapacitated people when no community program is available; witness testimony that DOC sometimes remains the only practical option; and the need to restore pre-COVID processes that linked people in correctional custody to community recovery providers on release. The Human Services Board report requirement includes proposals to address the imbalance between agency-represented parties and largely unrepresented appellants in hearings, including training, data collection, and possible legislative fixes.

The committee did not take a formal roll-call vote on concurrence; staff said detailed report requirements and presentations will inform later oversight work and any required budget or statutory changes.

Ending: The committee paused further action pending receipt of the required reports and presentations. Members asked staff to refine bill language and timelines as needed during final drafting and to ensure the Feb. 15 and Dec. 15 deliverables are clear in the amended text.