Adoptions

The Vermont Commercial Building Energy Standards (CBES) regulate the design of building envelopes for adequate thermal resistance and low air leakage and the design and selection of mechanical, ventilation, electrical, service water- heating and illumination systems and equipment in commercial building construction. This is an update to the CBES to allow the 2020 Vermont Commercial Building Energy Standards as an option for the purposes of complying with Vermont’s commercial building energy code. This update allows adherence to the requirements in either the 2020 CBES or 2024 CBES for compliance purposes with no substantive changes to the 2020 CBES or 2024 CBES as originally adopted.

The Vermont Residential Building Energy Standards (RBES) regulate the design and construction of residential buildings to require adequate thermal insulation, low air leakage, effective and efficient mechanical, ventilation, electrical, service water-heating and illumination systems and equipment to enable effective use of energy in residential buildings. This is an update to the RBES to allow the 2020 Vermont Residential Building Energy Standards as an option for the purposes of complying with Vermont’s residential building energy code. This update allows adherence to the requirements in either the 2020 RBES or 2024 RBES for compliance purposes with no substantive changes to the 2020 RBES or 2024 RBES as originally adopted.

These proposed rules implement the statutory amendments adopted by the Legislature effective 7/1/25, including (1) a process for injured workers to request medical case management services; and (2) increased penalties for late payment of weekly benefits. The proposed rules also include page limits for reply briefs filed in formal workers' compensation proceedings with the Vt. Dept or Labor.

The proposed amendments to the Use of Public Waters Rules clarify the petition submission and review process and clarifies the procedures for municipal delegation under 10 V.S.A. § 1424 by authorizing full or partial delegation with State oversight, auditing, and revocation authority. Further, the amendments establish a process for emergency temporary use restrictions and clarifies enforcement of aquatic invasive species transport and decontamination requirements. The wakesports provisions are substantially modified by eliminating the "Home Lake" rule and proof of decontamination requirements, prohibiting wakesports within 500 feet of loon nesting sites and from other users, and requiring wakesports zones to meet new acreage, length, and configuration standards. The Department of Environmental Conservation will maintain an online list of eligible lakes, reducing the number of wakesports-eligible waters from 30 to 18.

This proposed hospital budget review rule amends the existing rule to conform to statutory amendments made with the passage of Act 49 (2025), Act 62 (2025), and Act 68 (2025). These Acts set forth revised standards and processes by which hospital budgets are reviewed, established, and monitored by the Green Mountain Care Board (GMCB). The proposed rule also streamlines and simplifies certain parts of the hospital budget review process. The proposed rule clarifies hospital budget submission obligations, the process for requesting that information be exempt from public inspection and copying, and the Board's ability to disclose this information. The proposed rule revises the Board's process for exempting hospitals from public hearings, the process for reviewing mid-year budget performance, the process for reviewing significant deviations from established budgets, and the process for reviewing hospital applications for budget adjustment.

The purpose of these regulations is to protect public health through the control of communicable and dangerous diseases. These regulations require the early and prompt reporting of listed diseases so that the Department of Health may take any necessary protective action. This rulemaking does the following:1) Modifies and reorganizes the lists of required reportable findings in humans and animals; 2) Changes the required reporting period for Brucellosis from "immediately" to "within 24 hours” and Rubella virus from "within 24 hours" to "immediately"; 3) Adds information about how to report positive tuberculin skin test (TST) results; 4) Clarifies the reporting of blood lead results.

This rule establishes revised standards and processes, consistent with Act 62 of 2025, that the Green Mountain Care Board (GMCB) will use to certify Accountable Care Organizations (ACOs) and review, modify, and approve the budgets of ACOs. First, as of January 1, 2026, the GMCB will no longer review the budgets of all ACOs operating in Vermont, as required by the current GMCB Rule 5.000. Instead, the GMCB will only review the budgets of ACOs that contract with Vermont Medicaid and/or Vermont commercial payers. The GMCB will not review the budgets of ACOs that contract only with Medicare. Second, as of January 1, 2027, all ACOs operating in Vermont must be certified by the GMCB. This is a revision from the current GMCB Rule 5.000, which requires certification only for ACOs that contract with Vermont Medicaid and/or Vermont commercial payers. Third, this revised rule includes revisions to ACO certification and budget review criteria, consistent with Act 62 of 2025.

The proposed rule amendments would update Green Mountain Conservation Camp (GMCC) tuition rates from $250 to $300 per week, and modify the Day Use and wedding facility rental fees at Buck Lake and Kehoe Education Centers. Day use rentals of Buck Lake and Kehoe would increase to $300 per day for partnering organizations, and $600 per day for private entities.

The Vermont Saves Program Rule makes two amendments to the existing Rules implemented in 2024 pursuant to 3 V.S.A. Chapter 18. These amendments change the following definitions in CVR 03-000-003, Sec. 1: 11. “Covered employee” means a “covered employee,” as that term is defined in 3 V.S.A. § 531(2). 12. “Covered employer" means a ‘covered employer,’ as that term is defined in 3 V.S.A. § 531(3), that employs two or more employees at any time during a calendar year. These changes will require the participation of more employers and employees in the program by broadening the membership criteria in statute.

The Vermont Securities Regulations set out requirements for issuing securities in Vermont and regulating those who provide investment advice and offer and sell securities to the public. The primary changes include: for investment companies offering federally covered securities in Vermont, the revised Rule mandates electronic filings through a system to be designated by the Commissioner (allowed but not required under the current Rule); adding a requirement that Vermont domiciled investment advisers controlling client funds carry errors and omissions insurance; clarifying provisions for administering restitution assistance for victims of securities violations, including the application process; adding into regulation a current Department policy governing the privacy of client financial information held by broker-dealers and investment advisers; updating certain provisions to match national model rules from North American Securities Administrators Association; and drafting changes for clarity.

The Risk Retention Group Holding Company System Rule sets out reporting, organizational and operational requirements for Risk Retention Groups (RRG) organized as holding companies. This update to the rule tells RRGs how to comply with changes made in Subchapter 13 of Title 8, Act 101 by Act 110 (H.659) of 2024. The amended statute permits exempting RRGs from certain filing requirements and requires certain terms in RRG management agreements, in each case based on Department rules. This update provides those rules. The update also explains what it means for a non-U.S. jurisdiction to "recognize and accept" a group capital calculation under 8 V.S.A. § 3684(m)(2)(D). Lastly, this update provides administrative changes and technical corrections to the rule.

The Groundwater Protection Rule and Strategy is the framework the state uses to protect groundwater in permit programs and clean up groundwater when there is a release. This amendment proposes to adopt more stringent standards adopted by EPA's 2024 Maximum Contaminant Level (MCL) for five PFAS compounds (HFPO-DA, PFHxS, PFNA, PFOS, and PFOA) and a hazard index to address mixtures of two or more identified PFAS (HFPO-DA, PFBS, PFNA, PFHxS). This amendment proposes to not require the permitting review to apply to stormwater, indirect discharge (sewage), or wastewater and potable water supply (wastewater) rules and those programs would address the public trust and groundwater protection in their respective rules. It also makes minor changes to how compliance boundaries are established for cleanups.

The rule includes provisions that govern: (1) application-based process for the issuance of a certificate of public good for certain energy storage facilities under the provisions of 30. V.S.A. § 248; and (2)other requirements for all energy storage facilities that address: (a) interconnection; (b) safety standards; (c) respective duties of distribution utilities, transmission utilities, and energy storage facility owners and operators and energy storage aggregators; (d) participation in wholesale energy markets; and (e) decommissioning.

The proposed rule change to CVR 01-130-001 updates Vermont’s Lottery regulations to align with statutory changes following the legislative consolidation of the Department of Liquor Control and the Vermont Lottery Commission into the Department of Liquor and Lottery. It replaces outdated references (e.g., “Director” to “Commissioner,” “Commission” to “Board”), expands the Commissioner’s authority, clarifies licensing eligibility, and outlines updated conditions for license suspension or revocation. The revisions introduce new definitions, streamline administrative procedures, and reinforce consumer protections—such as prohibiting prize payouts to minors and requiring conspicuous license display. These changes modernize the rules to reflect current business practices and statutory authority.

The purpose of the rule is to provide the requirements for the safe and sanitary manufacturing, packing, holding, and distributing of human food offered for sale in Vermont. This rulemaking does the following: 1) Defines cottage food operation, cottage food operator, and cottage food product, non-potentially hazardous baked good, and time or temperature control for safety; 2) Substitutes the more narrow bakery product exemption for a broader exemption categorized as the cottage food exemption and raises the exemption threshold of gross annual sales to $30,000; 3) Amends the existing exemption filing requirement frequency from prior to operation to an annual filing; 4) Creates a required annual training for license-exempt food manufacturers; and 5) Creates a process for cottage food operators to submit requests to the Department for determination whether the product they are making is a cottage food.

This rule sets forth the standards that apply to the licensing of psychiatric residential treatment facilities for youth (PRTF) in Vermont. This rulemaking establishes the process by which a psychiatric residential treatment facility for youth can apply for a license in Vermont. This rulemaking also establishes the minimum requirements a PRTF must meet in order to be eligible for licensure.

This rule establishes BMPs for use of: (A) neonicotinoid treated article seeds when used prior to January 1, 2031; (B)neonicotinoid treated article seeds when the Secretary issues a written exemption order pursuant to section 1105b of this chapter authorizing the use of neonicotinoid treated article seeds;(C) neonicotinoid pesticides when the Secretary issues a written exemption order pursuant to section 1105c of this chapter authorizing the use of neonicotinoid pesticides; and (D) the agricultural use after July 1, 2025 of neonicotinoid pesticides the use of which is not otherwise prohibited under law.

These proposed rules amend Parts 1-5 and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 4, and 5 were last amended effective January 1, 2024. Parts 2, 3, and 7 were last amended effective January 1, 2025. Substantive revisions include: adding coverage of pre-release services for up to 90 days before release for sentenced, incarcerated individuals enrolled in Medicaid; using the Low Income Subsidy (LIS) family size definition for Medicare Savings Program (MSP) eligibility determinations; raising the income limit for Qualified Medicare Beneficiaries from 100 to 145 of the Federal Poverty Level (FPL) and Qualifying Individuals 135 to 195 FPL; changing the household composition for the Access Plan; modifying noticing requirements for eligibility verifications; providing earlier Qualified Health Plan (QHP) effective dates for special enrollment periods and voluntary terminations.

These proposed rules amend Parts 1-5 and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 4, and 5 were last amended effective January 1, 2024. Parts 2, 3, and 7 were last amended effective January 1, 2025. Substantive revisions include: adding coverage of pre-release services for up to 90 days before release for sentenced, incarcerated individuals enrolled in Medicaid; using the Low Income Subsidy (LIS) family size definition for Medicare Savings Program (MSP) eligibility determinations; raising the income limit for Qualified Medicare Beneficiaries from 100 to 145 of the Federal Poverty Level (FPL) and Qualifying Individuals 135 to 195 FPL; changing the household composition for the Access Plan; modifying noticing requirements for eligibility verifications; providing earlier Qualified Health Plan (QHP) effective dates for special enrollment periods and voluntary terminations.

These proposed rules amend Parts 1-5 and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 4, and 5 were last amended effective January 1, 2024. Parts 2, 3, and 7 were last amended effective January 1, 2025. Substantive revisions include: adding coverage of pre-release services for up to 90 days before release for sentenced, incarcerated individuals enrolled in Medicaid; using the Low Income Subsidy (LIS) family size definition for Medicare Savings Program (MSP) eligibility determinations; raising the income limit for Qualified Medicare Beneficiaries from 100 to 145 of the Federal Poverty Level (FPL) and Qualifying Individuals 135 to 195 FPL; changing the household composition for the Access Plan; modifying noticing requirements for eligibility verifications; providing earlier Qualified Health Plan (QHP) effective dates for special enrollment periods and voluntary terminations.

These proposed rules amend Parts 1-5 and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 4, and 5 were last amended effective January 1, 2024. Parts 2, 3, and 7 were last amended effective January 1, 2025. Substantive revisions include: adding coverage of pre-release services for up to 90 days before release for sentenced, incarcerated individuals enrolled in Medicaid; using the Low Income Subsidy (LIS) family size definition for Medicare Savings Program (MSP) eligibility determinations; raising the income limit for Qualified Medicare Beneficiaries from 100 to 145 of the Federal Poverty Level (FPL) and Qualifying Individuals 135 to 195 FPL; changing the household composition for the Access Plan; modifying noticing requirements for eligibility verifications; providing earlier Qualified Health Plan (QHP) effective dates for special enrollment periods and voluntary terminations.

These proposed rules amend Parts 1-5 and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 4, and 5 were last amended effective January 1, 2024. Parts 2, 3, and 7 were last amended effective January 1, 2025. Substantive revisions include: adding coverage of pre-release services for up to 90 days before release for sentenced, incarcerated individuals enrolled in Medicaid; using the Low Income Subsidy (LIS) family size definition for Medicare Savings Program (MSP) eligibility determinations; raising the income limit for Qualified Medicare Beneficiaries from 100 to 145 of the Federal Poverty Level (FPL) and Qualifying Individuals 135 to 195 FPL; changing the household composition for the Access Plan; modifying noticing requirements for eligibility verifications; providing earlier Qualified Health Plan (QHP) effective dates for special enrollment periods and voluntary terminations.

These proposed rules amend Parts 1-5 and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 4, and 5 were last amended effective January 1, 2024. Parts 2, 3, and 7 were last amended effective January 1, 2025. Substantive revisions include: adding coverage of pre-release services for up to 90 days before release for sentenced, incarcerated individuals enrolled in Medicaid; using the Low Income Subsidy (LIS) family size definition for Medicare Savings Program (MSP) eligibility determinations; raising the income limit for Qualified Medicare Beneficiaries from 100 to 145 of the Federal Poverty Level (FPL) and Qualifying Individuals 135 to 195 FPL; changing the household composition for the Access Plan; modifying noticing requirements for eligibility verifications; providing earlier Qualified Health Plan (QHP) effective dates for special enrollment periods and voluntary terminations.

The primary focus of these rules is to update the currently adopted 2021 International Plumbing Code to the 2024 edition. The 2024 International Plumbing Code and updated rules will allow for more current methods and materials to be utilized. Rules are amended to clarify intent of the code and answer frequently asked questions. Some of the new changes include gender neutral/multi user restroom provisions, a clarification of specialist license fields, new definitions, additional clarifications and terminology.

The Proposed 2023 Vermont Electrical Safety Rules (VESR) will update the technical codes and standards, including the adoption of the 2023 edition of the National Electrical Code (NEC) also known as the National Fire Protection Association (NFPA) 70. This will better coordinate the license examination with the state apprenticeship program, establish an expiration date for a permit and a process for refunding permit fees. These rules also provide requirements for filing an electrical work notice, inspection and energizing procedures, details powers of enforcement and licensing disciplinary procedure.

The 2025 Vermont Fire & Building Safety Code establishes the minimum standards to protect the public from the risks of fire, explosion, hazardous materials, dangerous structural conditions and carbon monoxide poisoning within public buildings. These amended rules provide updates and incorporate more recent editions of the same national codes and standards that are currently adopted. These rules include requirements for the addition of carbon monoxide detection in some occupancies, protection of lithium ion batteries, building energy storage systems, escape window clarifications, sprinkler system requirement modifications, and the inclusion of grab bars to prevent slips and falls. These amendments are also intended to provide clarity of the intent of currently adopted codes and standards and to incorporate existing interim operational guidance.

It is not uncommon for designated home health agencies, despite their best efforts to recruit and retain staff, to lack the necessary staffing to provide designated services, as currently defined, to all individuals who are referred. The severe workforce shortage of personal care attendants prevents home health agencies from complying with the requirement to serve all individuals on Choices for Care who are referred for services. As a result, most agencies are operating under a variance to this requirement. The proposed rule would remove Choices for Care services, including personal care, respite, companionship, and homemaker services, which are not "home health services," from the Rule's definition of "designated services," to ensure that agencies are not held responsible for providing services that they frequently lack staffing to provide, while allowing them to continue to provide these services when they do have sufficient staff. The proposed rule makes other technical changes for clarity.

The changes to this rule consist of updates to current language and references. The changes proposed do not significantly affect the intent of the rule or current practice.

he changes to this rule consist of updates to current language and references. The changes proposed do not significantly affect the intent of the rule or current practice.

The changes to this rule consist of updates to reflect current organizational structure and better align with current practice. The changes proposed do not significantly affect the authority or delegation of this authority, the intent of the rule or current practice.

The Insurance Holding Company Systems Rule sets out the rules and procedural requirements necessary to carry out 8 V.S.A. Chapter 101, Subchapter 13, which establishes regulatory requirements governing registration, acquisitions and other transactions, and solvency of insurance holding company systems as a whole (and not limited to insurance companies within the system). The update is necessary to bring the rule into compliance with 8 V.S.A. §§ 3681, 3684, and 3685 as modified by Act 110 (H.659) of 2024. The revisions to the rule are intended to provide regulators with more transparency regarding insurance holding company systems as a whole and to make risks and solvency concerns within the system easier to identify. Changes to the rule clarify some of the statutory exemptions to filing requirements and required terms in agreements for cost sharing and management services. Other changes are for clarity and to simplify the process for filing certain documents.

This Health Care Administrative rule sets forth the criteria for Medicaid coverage and reimbursement of mental health services provided under supervised billing in Vermont. The amendment of this rule updates the language to remove non-eligible provider types, updates the supervised billing structure, aligns the program with best practice, and clarifies policy and program requirements.

This amendment to the Employment Security Board Rules implements provisions of recent legislation regarding unemployment insurance; specifically, unemployment benefit overpayments. The amended rule adds a procedure to apply for waiver of repayment of overpaid unemployment benefits where the individual is not at fault for the overpayment, and where ordering repayment would be contrary to equity and good conscience. The amended rule adds definitions for "fault" and "contrary to equity and good conscience" and outlines the application process; notice requirements; determinations on applications; and appellate procedure.

The proposed rule amendments include substantive changes to the current deer management rule including establishing expanded archery zones, moving youth weekend back to the weekend before the regular season, reinstating the antler point restriction in Wildlife Management Unit (WMU) D1, allowing antlerless permits to be used during the regular season, removing the archery season closure during the regular season, allowing hunters to hold two antlerless permits in different WMUs, and allowing hunters to take a conditional second buck.

The proposed rule amendments include technical and substantive changes, including updated langauge related to moose permit allocation through the auction to bring the rule language in compliance with statute, the creation of a Special Opportunity Season concurrent with the current archery season to allow Special Opportunity permit holders to hunt with a gun during this time period, the extension of the regular season from six to nine days, and technical changes for consistency and clarity.

The proposed rule amendments extend the fall archery season to begin on October 1, and extend until the Friday prior to the regular deer season. The rule also makes technical corrections to clarify the type of license required during each turkey season.

The proposed rule change is a minor amendment amending every reference to "deer and elk" to "cervids."

The proposed rule amendments allow for the use of larger minnow traps, allow for the transportation of personally-harvested baitfish between non-restricted waters within the same zone, modifies the requirements for personally harvested baitfish on seasonally closed waters, modifies the use of personally-harvested fish eggs for use in the same water in which they were harvested, and eliminates the administrative requirements that commercial bait sellers keep carbon copies of receipts.

The Board proposes to strike in its entirety 10 V.S.A App. § 124, which declares the Valley Brook tributary to Seymour Lake in Orleans County a spawning ground, closed annually for the taking of fish from October 1 through October 31.

The proposed rule language imposes a new requirement that any person selling fish in the State possess a valid Vermont fishing license and a Fish Seller's endorsement issued by the Fish and Wildlife Department (FWD). It also requires that anyone with a Fish Seller's endorsement submit quarterly reports to FWD reporting data on fish sold. Finally, the Rule proposes to ban the sale and purchase of black and white crappie caught in Vermont.

The proposed rule amendments add Mud Pond to the list of seasonally closed waters; create a state-aggregate daily bag limit for all panfish on inland waters; add a segment of the Deerfield River to the list of Trophy Trout streams; increases minimum length and reduces daily bag limit of Lake Trout on Memphremagog; consolidates Bullhead requirements under Panfish requirements and amends bag limits accordingly; adds panfish bag limits for Berlin and Stiles Ponds; extends the closure season for trout spawning grounds; and adds certain waters to the list of closed seasonal spawning grounds.

Following the passage of Act 127 in 2024, the Department of Financial Regulation was directed to adopt rules to establish the licensing application, financial and reporting requirements for PBMs. Pharmacy Benefit Managers (PBMs) are intermediaries between health insurance companies and drug manufacturers. They negotiate prescription drug prices with manufacturers and separately, they negotiate the reimbursement payable to pharmacies to dispense the drugs.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This update reflects changes in pharmacy's legal and practice landscape since 2015 by regulating, among other things: - new types of pharmacy entity, such as virtual distributors and manufacturers, 503B outsourcers, and third-party logistics providers; - the prescribing of opioids; - devices containing prescription drugs; - naloxone dispensing; and - changes to prescriptions for schedule II controlled substances. The rule also reflects statutory changes to pharmacy professionals' scopes of practice, including immunizations, and simplifies the licensing of pharmacy technicians into a single credential instead of the current two-tiered system. The rule creates standards for workplace conditions pharmacy staffing necessary to protect the public. The rule streamlines and narrows the legal duties of Pharmacy Managers, clarifying that licensed pharmacies are themselves responsible for compliance with the Rules.

The rule prescribes guidelines for distinguishing between “primary” and “specialty” mental health and substance abuse services. This revision designates interprofessional consulting and peer support services as "primary" mental health and substance abuse services and makes technical and stylistic changes to the rule.

The proposed rulemaking outlines Vermont Medicaid's obligations according to federal law in establishing, managing, and upholding an incident management system designed to safeguard the well-being of individuals enrolled in home and community-based services sanctioned under the Global Commitment to Health Waiver. The proposed rulemaking aligns with the federal law stipulating the essential components of such a system, which includes the identification, reporting, prioritization, investigation, resolution, tracking, and analysis of critical incidents.

This proposed rulemaking aligns with federal regulation for person-centered planning in delivering home and community-based services under the Global Commitment to Health Waiver, approved by CMS. The proposed rule establishes the requirements for the planning process, service plans, annual reviews, and the required documentation for modifications to the additional qualities of a home and community-based setting.