Committee amends S.36 to add Human Services Board reporting; debates repeal of DOC use for public inebriate beds

The House committee on Housing and Services on an undated afternoon reviewed a proposed amendment to S.36 that would add a new report requirement for Human Services Board proceedings, discussed Medicaid payment models that currently tie residential substance use disorder payments to 14‑day “episodes,” and debated whether to repeal a statute that allows Department of Corrections beds to be used for public inebriate placements after July 1, 2025.

Katie, legislative counsel with the Office of Legislative Council, summarized the amendment: “This would be an amendment to S36, and it would add a new Section 6 to the end of the bill right before the effective dates.” The added section would require, on or before December 15 of this year, the Human Services Board, in consultation with the Office of the Attorney General, the agency’s departments with cases before the board, community partners, and individuals with lived experience, to submit a written report to the House Committees on Healthcare and Human Services and to the Senate Committee on Health and Welfare. The required report would include proposals for trauma‑informed training for agency attorneys, an analysis of differing appeals processes across departments and suggested legislative steps to improve consistency, proposals to collect currently unavailable data in a uniform way across the agency, recommendations for resolving some appeals before they reach the Board, and any other recommendations requiring legislative action.

Committee members pressed staff to sharpen the language in several places. Representative Bishop asked staff to ensure the bill also protects appellate records, noting concern that appellant testimony should not “jeopardiz[e] the appellant’s case” and should preserve a record that could be needed on further appeal. Katie and other members agreed to clarify subsection B(3) to explicitly reference preserving the record and the obligations of the board and agency attorneys.

Members also discussed data collection and analysis. Committee discussion sought to broaden the amendment’s reporting requirement so it would capture appeals that are filed and then resolved at the department or agency level before reaching a hearing officer or the full Human Services Board. One committee member said the committees “don’t have data on what’s resolved at the agency level,” and members asked the report to include how data are collected from the first step of an appeal through any subsequent steps to avoid gaps and double counting.

The committee also revisited sections 1–3 of S.36, which staff described as directing Medicaid payments to be based on medical decision‑making documented in a treatment plan and calling for a review of how episode‑based payment (the current 14‑day episode structure) may be influencing clinical decisions and lengths of stay. Members described section 3 as “probably the most important” of the early sections because it directs a review of payment methodology that some providers said has created a perception that stays cannot exceed 14 days.

Sections 4 and 5—treated together—cover the public inebriate program (PIP). The amendment under consideration would leave in place repeal language tied to an effective date of July 1, 2025, which would end the statutory authorization for DOC beds used as part of the PIP. Committee members were split on whether to keep the repeal, delay it, or add additional reporting and transition language. Several committee members and outside witnesses reported that DOC bed use had been limited (for short periods and as a last resort) and that hospitals, emergency rooms and law enforcement still see situations where a secure placement is needed. Other members emphasized the policy goal of reducing use of correctional settings for health‑related crises.

Rather than reaching a final vote, the committee conducted a straw poll on whether to proceed with the repeal language as drafted. The transcript records a straw poll but not a formal roll‑call vote; committee staff characterized the result as mixed and noted that several members said they would support the bill while preferring a delay rather than immediate repeal. Because a formal vote was not recorded in the transcript, the committee did not adopt an outcome on the floor of the meeting.

Committee members gave staff direction that the S.36 amendment should include (1) added language asking Departments to prioritize redevelopment of public inebriate services in Chittenden County; (2) a requirement that the Department(s) give a presentation to the committee by February 15 describing efforts to expand or reinstate PIP services and how those efforts will prioritize Chittenden County; and (3) a requirement that the Department of Corrections present by February 15 on practices for connecting people who are placed in correction‑affiliated holding spaces to community‑based substance use recovery providers and other supports (the discussion called this a “warm handoff” though wording in the amendment was left for staff to draft).

Committee members said staff should fold the new Human Services Board report section and the PIP report/presentation language into a single amendment to S.36 for the committee’s next action. Staff indicated the amended language would be ready for the committee to consider at its next meeting and that the committee will hold a vote on the revised S.36 language the following day.

The committee did not take a final formal vote on S.36 during the session recorded in the transcript; the text of the amendment as discussed would (if adopted) require: a December 15 Human Services Board report on appeals processes and data; a February 15 presentation by health agencies on PIP expansion with prioritization of Chittenden County; and a February 15 DOC presentation on referral/connectivity practices for people placed in correction‑affiliated holding beds.