On March 24, the Vermont House passed H.202, the Health Care Bill.  Many residents have contacted me with concerns about the steps toward reform outlined in H.202.  To address this, I have asked two experts on the bill to come to Shelburne to speak with us. Anya Rader Wallack, Special Assistant to the Governor for Health Reform, and Mark Larson, Chair of the House Health Care Committee will be at the Shelburne Town Offices on Tuesday, April 5^th from 6:30-8:30 to help explain the House-passed version of the bill and answer your questions.

Although there is much angst about H.202, one thing that seems to bring universal agreement is this: our current system is unsustainable.  We currently spend $5 billion per year on health care in Vermont and these costs are expected to grow at a rate that far exceeds personal income growth, state revenues and the ability of many businesses to pay these costs.

This is not to say that there are not many wonderful things about our current system, and much testimony pointed to concerns about losing the good things that we have.  The problem, however, is the way we deliver and pay for this system is so complex and chaotic, without broad reform, we won’t have the potential to find the savings that we must find and are likely to lose these good things in the process.

H.202 has three reform components that are implemented over a 5-7 year period with checks along the way.  First, it establishes a board whose charge will be to design a more sensible way to pay for health care.  The bill allows for multiple opportunities for public participation in the process.  While the Governor had wanted his office to appoint the board with Senate confirmation, the House felt this gave too much power to that office.  The House version thus mimics the process for the appointment of judges and Public Service Board members.

Second, it sets up an exchange system.  Federal health reform requires every state to either create a “health benefit exchange” or fall back to the federal exchange.  The exchange is similar to websites that allow travelers to compare services and costs for airline travel, however here, purchasers can compare insurance company benefits and costs for one-stop shopping.  Exchanges act as engines for health care reform by implementing and simplifying administration and payment.

Third, it sets the stage for Green Mountain Care, a universal access to essential health care benefits.  If things go according to plan, this would be in place sometime between 2015 and 2017.

During the two days of debate last week on this bill, the primary division seemed to be whether we should start with the concept and then build in the details as H.202 did, or start with the details and then build the system as the opposition preferred.

I came to see that this bill is not a complete system but a first step to address health care delivery and cost containment.  Similar to starting a business, designing a house or marketing an invention, design usually comes first with financing later.  The newly created board would be responsible for developing the financing plan once the direction is more firmly established.  The coming months and years would likely indicate that further analysis would be required and adjustments made.

There are some answers we cannot know at this time.  That is the nature of pioneering work and it is easy to sew angst to try to derail it.

What is known is the current dollars being spent cannot continue. Certainly there is a more efficient use of these dollars that could be used to help us get well and stay well which could ultimately bend that curve on spending.

While the Japanese struggle to recover from the recent tsunami, Libyans fight in the streets, and Vermonters worry about the future of health care, I have been working on one seemingly small issue that actually has broad implications regarding the future of wildlife ownership and management in our small state.  Before I tell this story, I want you to know that I am reviewing your e-mails, phone messages and talking with those of you visiting the State House regarding concerns about health care, and human service budget cuts.  Much is still in flux at this point and I continue to share your concerns with legislative leadership. I expect some clarity on these issues within the next couple of weeks.

If one only catches sound bites, H.91. or “Public Trust bill, “ appears to be about whether a certain moose named “Pete” with friends on Facebook, gets a stay of execution or lives out his remaining years as a partially domesticated pet.  That is not what the bill is about although I would currently guess that Pete is going to be just fine.  H.91 puts in statute that the native fish and wildlife are collectively held by everyone as part of the public trust and cannot be reduced to private ownership.

The Public Trust Doctrine of wildlife is a bedrock concept of the North American Model of Wildlife Conservation and is why this country enjoys the greatest diversity, quality, and quantity of game animals and other wildlife in the world.  There is increasing evidence that this model is under siege around the country as landowners restrict access to wildlife for personal profit.  One way of reducing this likelihood is to formally put this trust relationship into statute.  It is important that states not only define these resources as state held, but also mandate responsibility to maintain these resources, for the wildlife itself and for present and future generations.  This bill does that.

H.91 was developed following public outrage from hunters, sportsmen and conservationists alike stemming from a deceptively small amendment to the Appropriations bill that slipped through in the final hours of the 2010 legislative session.  The pressure to save the celebrity moose resulted in far greater reach, changing the status from public to private control, not just Pete, but all of the native deer and moose in an enclosed hunting facility.

It was the belief of many, and over time, myself, that Pete was simply a tool for media hype used by a very crafty facility owner in an effort to resist the Fish and Wildlife Department closing in on him for lack of a permit, poor fencing and unwillingness to work with the Department to come into compliance for many years. It also drew people away from the reality that Pete was living at a facility in which native and non-native game are hunted for a price.

Also at the heart of the problem here is the grave concern of increased risk of disease being transmitted from captive deer to our vulnerable native population.  Chronic Wasting Disease (CWD), similar to mad cow disease, is an insidious disorder of deer, elk, and moose that is transferred through urine, feces, saliva, blood and food.  It has no cure; no vaccine and can live in the soil and animals undetected for many years.  CWD is not known to be transmissible to humans, but has had devastating effects on free-ranging deer in those states and provinces where it has been found.  Captive hunt facilities and the captive deer trade have long been implicated in the transfer of this disease.   There was conflicting testimony as to the degree of risk for Vermont.  That Vermont is still free of CWD allows us to view this disease as a theoretical problem.  In 2005, Oneida County in New York had a positive test for one deer in a captive hunt facility and two wild deer nearby.  Vermont Commissioner Patrick Berry told us that his counterpart in Maryland facing their first outbreak said that we must do anything and everything we can to prevent this from ever happening.

The second part of the bill will be session law that puts the facility back under the jurisdiction of Fish and Wildlife and gives the owner a generous 5 years to bring the native white tail and moose at his facility to zero and sets up a system for disease surveillance.

One hunter who testified before our committee reminded us of the importance of keeping wild things wild and the need to educate the well meaning public about the wildlife from which we are growing so far away.    I worry that my sons won’t have this, he said, that all of nature will be in a theme park, or experienced only through Internet or TV.

It is very unfortunate that this problem could not be resolved 10 years ago when the fence was erected, entrapping only 5-6 wild deer and moose.  A positive outcome, however, is the public trust doctrine for wildlife will now become state law should the bill pass.

In addition to being a member of the Fish, Wildlife and Water Resources Committee in the Legislature, I also serve on the Citizens’ Advisory Committee (CAC) for the future of Lake Champlain. The mission of the CAC is to gather and disseminate information and make recommendations about the condition and management of the waters of the Lake Champlain basin region. Working with government and non-government groups, we recommend priorities for improving the health of the Lake.  Our 2011 list will be presented to the Vermont Legislature in mid-March.

Most of these priorities have been on the list for some time.  Most will also require additional dollars at a time when budgets are shrinking.  Funding from the EPA, often the biggest source of financial support for programs, is also on the chopping block in Washington.

As I reviewed the list, there seemed to be only one remaining “low hanging fruit” and that was restricting the use of phosphorus (P) in fertilizer on non-agricultural turf.  To implement this, there would be no impact on government spending, no financial impact on taxpayers, and would ultimately put some teeth in the 2007 educational campaign known as “Don’t P on the Lawn.”  I introduced this bill, H.26, in January and it passed the House on a unanimous voice vote on February25^th. It is now on its way to the Senate.

What is the problem with phosphorus anyway? Excessive amounts of phosphorus create a perfect breeding ground for toxic algae blooms that deplete the amount of oxygen available for aquatic life.  This begins a chain of events that has a disastrous environmental and economic impact.  Lake Champlain is now classified as an “impaired waterway” and earned a spot on a New York Times list of places in the world not to visit.  As nitrogen from the Connecticut River was implicated in causing dead zones in Long Island Sound, we included nitrogen restrictions in the bill as well.

While agricultural pollution has often been viewed as the primary source of phosphorus, developed lands are actually bigger contributors to phosphorus pollution.  According to the Lake Champlain Basin Program, 46 % of non-point P pollution comes from urban and developed land while 38% of the non-point P pollution comes from agriculture and 5% from forestland.

Each watershed area has its own breakdown.  The Missisquoi basin region contributes one-quarter of the non-point phosphorus pollution entering Lake Champlain while Chittenden County, including the Main Lake, Burlington Bay and Shelburne Bay contributes another quarter.  The sources of pollution from these two regions however are quite different.  While about two-thirds of the problem can be attributed to agriculture in the Missisquoi basin, agriculture in Chittenden County accounts for only 20% of the problem.  The lion’s share here then, is due to urban and developed land and one of those sources is excess fertilizer applied to turf.

H.26 restricts the use of phosphorus and nitrogen fertilizer to non-agricultural turf, i.e., our lawns.  Golf courses will be required to follow nutrient management plans. Phosphorus fertilizer will still be available when starting a new lawn or for patching when young roots are less able to access available phosphorus in soil.  There will be a fine of up to $500, not for the confused consumer, but for those consumers and sellers who knowingly and intentionally violate the law.

Stores will need to post signs explaining the law and reminding consumers to get a soil test (cost ranging from free to about $14) to determine whether P is actually needed.  If it is, you will be able to buy the product.  If it is not, you have either just saved yourself some money, or you can purchase phosphorus-free fertilizer products that work well to feed lawns and don’t hurt our waterways.  Nitrogen fertilizer will still be available but with restrictions in amount and type.

If this bill becomes law, we will be joining 12 other states that have already banned or restricted the use and/or sale of phosphorus including New York, New Jersey and Maine.

Minnesota enacted a law in 2004 and found that the amount of phosphorus applied through lawn fertilizers decreased 48% between 2003 and 2006.  There were not reports of the law being enforced by local governments; rather, the law created “teachable moments” for extensive yard care and water quality education.  By 2007, 82% of the fertilizer sold was phosphorus-free.

I do not expect to see fertilizer police hanging outside of Aubuchon’s.  Our real hope here is to decrease the amount of P that finds its way to the Lake by strengthening education and making unnecessary fertilizer less available.  With the cost of clean up of Lake Champlain estimated at more than $800 million and possibly 50 years, it seems like one small effort we homeowners can make.

For more information on fertilizer and water pollution, visit www.lawntolake.org