American Academy of Pediatrics - Vermont Chapter

Each legislative session AAPVT members, officers and staff work to advance the practice of pediatric care and health of children in the state of Vermont by actively engaging with the Vermont General Assembly and the issues it confronts.  AAPVT influences public policy discussions and decisions by sharing the subject matter expertise and perspective that only practicing pediatricians can provide.    

Below is a list of issues that are currently under consideration in the Vermont General Assembly.  Additionally, for a comprehensive list of all health-care related legislation currently under consideration in the Vermont Statehouse, please visit this Vermont Medical Society-maintained document. 

Legalization of Recreational Marijuana  |  Tobacco 21  |  Cuts in Medicaid Funding  |  Pharmacist Prescribing

Legalization of Recreational Marijuana

Last year the AAPVT and aligned organizations successfully helped to defeat legalization that would have legalized recreational marijuana and set up a tax-and-regulate model that would have retail sales of the drug.  Pro-legalization supporters have once again introduced legislation in 2017, mostly focusing on a so-called "decrim 2.0" approach that would eschew retail sales and tax generation in favor of eliminating legal penalties for posession (for persons 21 and older) of up to two ounces of marijuana, and two mature and seven immature marijuana plants.   

Links to related legislation: H.170, H.167 (Senate Amendment)

AAPVT's position: AAPVT opposes the legalization of recreational marijuana because of the risks associated with childhood use of the drug.  Even though proposed legislation stipulates users must be 21 and up, legalization will normalize use of the drug, decrease the perceived risk of marijuana use and potentially lead to increase youth use rates.  Additionally, human brains are still in their developmental stages until the mid 20s, so the health and future prospects of legal, “of age” users, will still be harmed by legalization.

News/Updates:

• AAPVT and VMS statement on the failure of marijuana legalization - June 22, 2017
• AAPVT statement on Gov. Scott's veto of marijuana legalization - May 24, 2017
• Scott's three marijuana options - VT Digger, May 19, 2017
• Marijuana legalization passes legislature, heads to Gov. Scott's desk - May 12, 2017
• Vermont House OKs one ounce marijuana possession - VT Digger, May 2, 2017
• Senate OKs marijuana legalization amendment - VT Digger, April 21, 2017
• House sends marijuana legalization bill for further review - VT Digger, March 29, 2017
• Vermont's Pot Legalization Bill Headed To The House Floor After Committee Vote - VT Digger, March 23, 2016
• Pediatricians issue warning on marijuana - Healthline News, Feb. 27, 2017
• Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis - A Review: Submitted to the House Judiciary Committee by AAPVT President Jill Rhinehart, MD 
• Written comments submitted to the House Judiciary Committee by Dr. David Rettew
• Written comments submitted to the House Judiciary Committee by Dr. John Hughes

Tobacco 21

Every day more than 1,200 persons in the United States die due to smoking.  The younger an individual is when he or she begins using tobacco, the more likely he or she will become addicted. Among youths who persist in smoking, one-third will die prematurely due to smoking. Compared with adults, adolescents appear to display evidence of addiction at much lower levels of cigarette consumption, and their attempts to quit smoking thus may be less successful.

Links to related legislation: S.88, H.52

AAPVT's position: The AAPVT strongly supports raising the legal access for tobacco is raised to 21.  If the age is raised to 21, an Institue of Medicine study conducted in 2015 suggests that Vermont would experience 11,000 fewer adult smokers in the state by the tine today’s teenagers are adults. That would lead to 500 fewer premature deaths for Vermonters born between 2000 and 2020. 

News/Updates:

• Vermont Medical Society legislative wrap-up - June 6, 2017
• Tobacco 21 fails in close Senate vote - April 25
• Dr. Rebecca Bell discussing Tobacco 21 on Vermont Edition - VPR, March 6 
• Dr. Trey Williamms on teen access to tobacco - Rutland Herald, March 23, 2017 
• Dr. John Hughes: Raise age for cigarette purchase to 21 - VT Digger, March 3 
• Dr. George Till: The case for Tobacco 21 - VT Digger, Oct. 16, 2016
• Institute of Medicine: Public health implications of raising the minimum age of legal access to tobacco products
• Written comments submitted to the Senate Committee on Health and Welfare by Dr. Rebecca Bell

Cuts in Medicaid Funding

The AAPVT joins the AAP in expressing serious concerns over Federal efforts to remake Medicaid in ways that would be detrimental to Vermont’s children, including proposals contained within the American Health Care Act (ACHA) that would reduce access to developmental, dental, vision and hearing screenings, and prevent health problems to be diagnosed and treated appropriately and as early as possible. 

According to the AAP, the Medicaid block grants proposed by the AHCA “have a singular purpose, to reduce federal funding to states. In a bill that is supposed to be improving care for Americans, block grants and per capita caps shift costs from the federal government to the states, putting pressure on states to come up with the resources to cover their Medicaid patients when federal funds run out and costs inevitably rise.”

According to a Vermont Medicaid fact sheet prepared by the AAP, 58,000 low-income children in Vermont receive Medicaid and children make up 36 percent of Vermont’s Medicaid population.  And the Medicaid expansion that took place under the Affordable Care Act is a major contributor to Vermont's 99-percent childhood coverage rate.   

News/Updates:

• AAP Urges Congress to Forge New Path to Protect Children's Health Care, March 24, 2017 https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAPStatemen...
• AAP statement on the American Health Care Act, March 22, 2017
• America’s Front Line Physicians Express Serious Concerns with the American Health Care Act, March 8, 2017  
• Protecting Children’s Coverage: An Advocacy Toolkit for AAP Members, Leaders and Chapters, Spring 2017
• Joint Recommendations of the American Academy of Family Physicians, American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists, American College of Physicians, and American Osteopathic Association on Priorities for Coverage, Benefits and Consumer Protections Changes, Feb. 2, 2017  

Pharmacist Prescribing

This bill proposes to enable licensed pharmacists to administer immunizations to individuals seven years of age or older.

Links to related legislation: S.71

AAPVT's position: Undermines the development and continuing of the traditional medical home, potentially leading to missed opportunities to evaluate growth and development, nutrition and exercise counseling and early diagnoses of chronic conditions such as asthma, ADHD and depression. Additionally, AAPVT has concerns about fractious medical records keeping and that pharmacists are not trained recognizing and reacting to the extremely rare but possible causes of adverse reactions to immunizations. 

News/Updates:

• Written comments submitted to the Senate Committee on Health and Welfare by VMS President Wendy Davis, M.D. 
• Written comments submitted to the Senate Committee on Health and Welfare by AAPVT Executive Director Stephanie Winters