Legislative Update

Devon Green, VP of Government Relations

The legislature had a busy week last week touching upon key advocacy priorities for VAHHS and more.
 
Workplace Violence: S.36 passed out of the Senate Judiciary Committee. The bill passed with an amendment put forward by VAHHS to address concerns about HIPAA preventing health care providers from disclosing to law enforcement that a patient had been discharged or was medically stable. The one “no” vote was supportive of the bill but worried that the disorderly conduct portion could be too broadly applied. The bill will now go to Senate Health and Welfare for consideration and then to the entire Senate.
 
Workforce Development: The House Health Care Committee passed several compact bills to streamline licensure of health care professionals. Once a state joins a compact, individuals licensed in a compact state can work in other compact states without having to obtain another state license. The committee voted in favor of the following compacts:
  • H.62, the interstate counseling compact
  • H.77, the physical therapy licensure compact
  • H.86, the audiology and speech language pathology compact
We applaud these efforts to streamline the licensure process while keeping Vermont patients safe.
 
Mental Health: The Department of Mental Health presented their FY 2024 budget to House Appropriations, highlighting:
  • Statewide expansion of the mobile crisis program
  • Peer support credentialing
  • Therapeutic alternatives to the emergency department in the Northeast Kingdom
 
Meanwhile, the House Health Care Committee heard testimony on suicide prevention from state officials, health care providers, and survivors of suicide loss. Vermont has a higher rate of suicide than the rest of the nation. Dr. Rebecca Bell from UVMMC and Dr. Thomas Delaney from UVM Larner College of Medicine testified on self-poisoning and suicide by firearm. Impulsivity is a major factor in firearm suicide deaths, and safe storage can prevent suicide by firearm. Health care providers can play a key role in this effort through firearm screening and firearm safety counseling.
 
Post-Acute and Long Term Care: The Department of Disabilities Aging and Independent Living presented their FY 2024 budget, including components to help stabilize the post-acute and long term care system:
  • $17.8 million in rate increases for nursing homes
  • $3 million in rate increases for home health providers
  • $8.2 million for developmental services
 
Regulatory Flexibilities: The Health Care Association Coalition, including VAHHS, presented their recommendations on which COVID flexibilities should be extended for another year and which should be made permanent, including:
  • Extend until March 31, 2024 the deeming health care providers who are licensed and in good standing in another state and working in a health care facility in Vermont to be licensed in Vermont for up to six months
  • To effectively implement this, the coalition also requested that Medicaid and commercial insurers accept deeming for purposes of credentialing and enrollment
  • Make permanent remote witnessing for advance directives and provision for electronic signatures
 
Data Privacy: VAHHS testified for an exemption for HIPAA-covered entities and non-profit organizations under H.121, a data privacy bill. VAHHS argued that HIPAA is comprehensive and struck a good balance of privacy for patients while still allowing for coordinated care and public health research. Several other states with updated data privacy laws include this exemption, as does model legislation from Consumer Reports.
In the News
Attack in the ER: health care workers face spike in violence Part 1
WCAX

It was only a few short years ago when health care workers were praised as heroes for braving the pandemic. Today, many of those workers now face a different fear -- violent attacks by their patients. Health care facilities across the state say their employees are increasingly threatened by the patients they are trying to treat.

It’s an average day for Myla Lindroos and her five-month-old baby, Elina, at their Rutland home.

Reporter Ike Bendavid: What’s it like being a mom?

Myla Lindroos: It’s the best. It’s something I always dreamed about.

Another dream fulfilled for Lindroos was becoming a nurse. “I love it. I love being a nurse and I love helping people,” she said.
Attack in the ER: Vt. lawmakers look to protect health care workers Part 2
WCAX

Health care workers say they are being assaulted by the people they care for at an alarming rate. But some say a proposed law aimed at protecting those workers might not be the answer.

Violence in the emergency department is now in the spotlight at the Vermont Statehouse. Lawmakers in Montpelier have been hearing from health care workers from every corner of the state, like Marc Sacco, the emergency department manager at Mount Ascutney Hospital in Windsor.

“Please take this one step along this long journey whether it duplicates something or not, it’s something that we need because the guy that assaulted me got nothing,” Sacco said.

The one step Sacco and others are advocating for is a new law that would permit law enforcement officers to directly arrest a person who interferes with health care services rather than just issue a court citation.
Vermont system adopts zero-tolerance policy on violence against staff
Beckers

Southwestern Vermont Health Care has debuted a new policy to prevent aggressive and violent behavior toward its healthcare staff, the Bennington, Vt.-based system said Feb. 2. Like many hospitals across the nation, Southwestern Vermont Medical Center has seen an increase in the proportion of staff reporting violent behavior from patients and visitors.

Since 2021, 61 percent of medical and nursing staff at the hospital have reported physically aggressive behavior, and 49 percent have reported verbal abuse. The new policy has been posted throughout Southwestern Vermont Medical Center's campus, making clear that it will not tolerate "threatening language, foul language, sexual comments, physical violence or inappropriate touching."
Hospitals are as full as ever even as triple virus threat eases
WCAX

The triple threat of flu, COVID-19 and RSV is easing in the United States.

Most states are now reporting low or minimal levels of respiratory activity.

According to federal data, emergency room visits for these viruses are a third of what they were a month ago, flu hospitalizations are nearly as low as they have been since October and hospitalizations for COVID-19 has been trending downward for the past few weeks.

However, hospitals are about as full as they have ever been during the pandemic.

At least 75% of available beds across the country were in use for all of 2020.

Experts are warning that the high capacity will not likely change any time soon because people are coming to the hospital sicker than in the past.
BlueCross withdrawal from ACO has Vermont’s primary care practices worried
VTDigger

Every month, Jon Asselin, the chief financial officer of Primary Care Health Partners, divvies up a substantial payment to each of his association’s five primary care practices, located in the Burlington area, St. Albans, Bennington and Brattleboro.

The funds come from OneCare Vermont, the state’s only “all-payer” accountable care organization, through two different payment programs. The amount depends on the number of patients signed up with each practice’s providers and on what type of insurance those patients carry.

Last year, patients with Medicaid, Medicare and BlueCross BlueShield of Vermont all counted. For this year, the anticipated amount changed suddenly with the private insurer’s announcement in late December that it would not participate in the ACO in 2023.
Vermont senators working on bill to extend protections for reproductive, gender-affirming procedures
NBC5

Throughout the week, state senators heard testimony that revolved around a bill that would make reproductive procedures and gender-affirming services legally protected in Vermont.

"At this time in a mounting crisis of child and adolescent mental health care, it is essential that care for gender diverse youth and their families are protected," said Dr. Erica Gibson, an Adolescent Medicine Division doctor at UVM Medical Center.

While the bill will provide protections to patients from Vermont and out-of-state, it also ensures service providers are protected.

"This bill would allow us the ease of being able to do that without worrying about legal ramifications or the medical malpractice that might be associated with that, and just simply providing evidence-based medicine," said Dr. Mackenzie Delzer, an OBGYN resident at UVM Medical Center.
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