Human Services committee staff reviews major acts from 2023–24 biennium, highlighting opioid reforms and overdose-prevention funding

Committee staff on Monday gave members of the House Human Services Committee a rundown of legislation enacted in the 2023–24 biennium, with attorneys from the Office of Legislative Counsel pointing to major changes in opioid treatment policy, new authority for an overdose prevention center pilot in Burlington, and revisions to civil-commitment and residential-recovery procedures.

The review, led by Katie McLennan, Office of Legislative Counsel, and Jen Carvey, Office of Legislative Counsel, covered a broad set of enactments the committee handled last session. "We are gonna spend some time this morning looking at prior legislation and reports due to the committee," the committee chair opened, describing the session as an oversight check to see whether enacted laws are being implemented as intended.

Why it matters: The measures touch Medicaid coverage, criminal-justice protections for overdose-prevention services, mental-health commitment processes and programmatic rules that shape care delivery for people with substance-use disorders, developmental disabilities and other needs. Several laws also require agency reports that the committee will use in upcoming budget and policy reviews.

Most notable policy changes

Act 22 (opioid treatment and harm reduction): McLennan and Carvey summarized comprehensive changes to Vermont’s opioid treatment rules. The law: (a) expanded coverage and reduced utilization controls for medications to treat opioid use disorder (OUD), directing the Agency of Human Services (AHS) to provide Medicaid coverage for medically necessary OUD medications when prescribed by an appropriately licensed and Medicaid-participating provider; (b) required pending Drug Utilization Review Board approval that AHS cover at least one medication in each therapeutic class for methadone, buprenorphine and naltrexone without prior authorization; and (c) barred insurers and pharmacy benefit managers from imposing step-therapy or "fail-first" protocols for substance-use disorder medications. The act also removed some prior training and 911-calling requirements tied to distribution of opioid antagonists and required the Health Department and Blueprint for Health to facilitate regional stakeholder meetings on needle and syringe disposal.

Act 178 (overdose prevention center pilot): The session recap noted the statute establishes rules and limited civil and criminal immunity for participants and operators of a supervised overdose-prevention center (OPC). The law provided $1,100,000 from the opioid abatement special fund in fiscal 2025 for grants to the City of Burlington to establish an OPC after the city submitted an approved grant proposal. The Health Department must contract with outside researchers to evaluate the pilot; interim annual evaluation reports and a final report due in 2029 are required.

Civil commitment and secure/residential treatment (Act 137): The act revised civil-commitment procedures to authorize treatment at a secure residential recovery facility in some cases without a prior hospitalization, permitted certain emergency or involuntary procedures at those facilities, and created a licensing category for a psychiatric residential treatment facility for youth (PRTFY). The act also directed proposals and fiscal estimates related to secure community-based options and competency-restoration programming for individuals with intellectual disability or psychiatric conditions.

Other enacted measures summarized

- Act 10 removed a Vermont residency requirement from the state's patient-choice end-of-life statute. - Act 49 directed the Department for Children and Families (DCF) to report on costs needed to eliminate the "ratable reduction" that halves Reach Up/TANF benefits. - Act 58 established an extended producer responsibility framework for covered household hazardous products and required stewardship organization plans to be approved by the Agency of Natural Resources (ANR). - Act 81 included modernization of Adult Protective Services and a now-expired emergency housing transition benefit created during COVID. - Act 88 made permanent remote witnessing and remote explainer authority for advance directives and permitted digital signatures in certain circumstances. - Act 115 required mental-health response guidelines (de-escalation practices), convenings on social-worker safety, and reporting about safety discharges from home-health agencies. - Act 119 directed a re-envisioning of the Agency of Human Services with a status update and final recommendation due to the General Assembly. - Act 126 created a psychedelic therapy advisory working group and required a report (submitted November 15, posted online). - Act 131 restricted certain consumer products that contain PFAS and directed ANR to propose a systemic regulatory program. - Act 154 raised evidentiary standards and adjusted procedures for child-abuse-and-neglect investigation and substantiation and required model policies and public reporting on registry thresholds. - Act 163 required the Health Department to assess and recommend a voluntary certification program for recovery residences, produce an inventory and collect data tied to a short-term exit/transfer policy that runs through July 1, 2026. - Act 164 required dementia-risk outreach and education across the Health Department, Department of Mental Health and Department of Disabilities, Aging and Independent Living.

Vetoed proposal: The attorneys noted a bill that would have banned flavored tobacco products, menthol tobacco and flavored e-liquids was vetoed and did not become law. The measure would have also included civil-penalty and diversion provisions and an investigator position at the Department of Liquor and Lottery; the committee had invested substantial time on the bill.

Implementation and oversight notes

Committee members were reminded that many of the statutes include reporting requirements and that oversight is a key committee role: "one of the things ... we have a responsibility to do is not just pass bills, but to see if the bills are being enacted as we have intended them to be enacted," the committee chair said. Staff flagged that the Health Department has met multiple statutory deadlines tied to OPC reporting and contract requirements so far, and that other agencies have delivered a mix of required reports.

What the committee will do next: Members were asked to monitor the statutory reporting deadlines and follow up during budget and policy hearings where implementation questions arise. Staff noted several items—such as competency-restoration planning, certification proposals for recovery residences, and the AHS re-envisioning status update—will be matters the committee expects to examine in upcoming budget or policy sessions.

Ending

The counsel team concluded by directing members and their budget teams to use the committee’s reports-and-resources page to track which statutorily required reports have arrived and which are outstanding. "If the report has come in, we hyperlinked it," Jen Carvey said, encouraging members to review posted materials before hearings.