Devon Green, VP of Government Relations
VAHHS Update
With all the new legislators, I worried about endless introductory presentations and a slow start before delving into the issues. I’m happy to report that I was wrong. Whether it’s the joy of being back in person, or the infusion of new members, or the sheer amount of work that needs to be done, there’s a new energy in the building. Legislators get that the “village is on fire” and they’re getting down to work.
Health Care System Priorities: VAHHS testified on the access and financial issues facing our hospitals and laid out the need for workforce development, mental health resources, long term care support, regulatory flexibility and action on workplace violence. The Vermont Medical Society testified about provider stress and the financial risk facing primary care, particularly with the potential loss of $20 million due to Blue Cross Blue Shield pulling out of OneCare Vermont.
FY 2024 Budget
Governor Scott presented the FY 2024 budget on Friday afternoon. We’ll have to wait for further details, but we appreciate that the governor wants to build Vermont’s workforce, acknowledged the need for housing, and signaled support for the health care continuum, including mental health, long term care, and dental.
Budget Adjustment Act
Before we fully turn towards the FY 2024 budget, the legislature is looking to tie up loose ends in the FY 2023 budget with the Budget Adjustment Act (BAA). Included in the proposed bill are:
- $9.3 million for inpatient psychiatric beds for children and adolescents: thank you to Matthew Dove from Brattleboro Memorial Hospital and Dr. Maya Strange from the University of Vermont Health Network for their testimony describing the conditions of children waiting days or weeks for care and outlining the immediate need for resources to go towards the entire continuum of mental health care.
- Graduate Medical Education program: the Department of Vermont Health Access is proposing increasing the total funding of the Graduate Medical Education program at the University of Vermont Medical Center from $30 to $51 million. This would be achieved through federal dollars and would require no additional state funds.
- Workforce: Due to federal restrictions and staffing issues, the Administration has been unable to administer the $400k towards preceptor grants for Critical Access Hospitals and $2.5 million in grants for pipeline programs at health care facilities. VAHHS will be testifying next week on a proposal in the BAA to expand the preceptor funding beyond Critical Access Hospitals and to create flexibility in the pipeline funding for wraparound services.
All Payer Model: Ena Backus, the Director of Health Care reform, in her final week before leaving to work for Sen. Peter Welch, testified on the extension of Vermont’s current All Payer Model and discussed the federal government’s priorities for a multi-state model starting in 2025, including:
- Hospital global budgets
- Total cost of care target
- Inclusion of government and commercial payers
- Investment in primary care
- Inclusion of safety net providers
- Addressing mental health, substance use disorder and social determinants of health
- Addressing health equity
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Final Reading: Vermont’s health care system is a ‘village on fire’ |
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VTDigger
Two health provider groups brought alarming anecdotes and statistics to the House Committee on Health Care this week, causing one new lawmaker to compare the state’s health care system to a village on fire. Unlike the evacuation of the Statehouse earlier in the week, this was not a drill.
“In the last couple years, we were hoping it was Covid. We were hoping it was the aftereffects of Covid. We were hoping we could dig our way out of it,” Devon Green of the Vermont Association of Hospitals and Health Systems said on Thursday morning.
But this week, systemwide, inpatient medical surgical beds in local hospitals are at 97% capacity, with UVM and Dartmouth Hitchcock medical centers both entirely full. As has become the norm, over one-third of those beds are being used by patients who could be transferred to lower-level care facilities that can’t accept them due to their own lack of staffing, Green said.
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Brattleboro Retreat and Rescue Inc. partner to provide transportation for mental health patients |
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NBC5
The Brattleboro Retreat and Rescue Inc. signed a one-year contract to help transport voluntary mental health patients from emergency rooms to the retreat.
“I think this is really going to have a significant impact on those that are waiting in the emergency departments, with transportation being the sole reason for why they can't get to the place where they've been admitted,” said Erik Rosenbauer, vice president of the Brattleboro Retreat.
The shortage of transportation is impacting voluntary mental health patients across Vermont.
The pilot program will allow the Brattleboro Retreat to find solutions for patients who often have to wait days to get care in emergency rooms.
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Need for youth psych beds prompts unusual budget request for Southwestern Vermont Medical Center |
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VTDigger
The midyear administrative budget adjustment that absorbs the first weeks of every Vermont legislative session usually involves requests to transfer money between already existing programs. And normally a hospital will take several years to launch a new service.
This year those norms have been turned upside down. In the budget adjustment package released late last week, Gov. Phil Scott’s administration requested approval to reallocate $9.25 million from this year’s budget to support the rapid development of an inpatient youth psychiatric unit at Southwestern Vermont Medical Center.
However, the Bennington hospital has not yet committed to the project. Administrators with the Vermont Department of Mental Health now say they would like to see the legislative language broadened to allow the funds to go elsewhere if SVMC leadership decides not to move forward.
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Dartmouth Hitchcock Medical Center over capacity amid staffing shortages, surge in respiratory viruses |
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NHPR
Dartmouth Hitchcock Medical Center has been operating at 110% of its capacity for several weeks amid a surge of respiratory viruses and short staffing, and as it continues to be difficult to discharge patients to lower levels of care, such as nursing homes.
As a result, DHMC has been boarding patients in its emergency department and perioperative areas, typically used to prepare patients for surgery, Dr. Colin Stack, medical director of the capacity coordination center at DHMC, said in an emailed statement last week.
“As we continue to help more patients with fewer available spaces, some patients are experiencing longer wait times and delays in scheduling appointments and procedures,” Stack said.
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Up to 250 units planned to help address Middlebury’s affordable housing shortage |
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VTDigger
While housing shortages are common across Vermont, Addison County is particularly strapped. According to research done by Rights and Democracy, the Addison County housing vacancy rate was 2.4% in 2021; a 6% to 8% rate is considered healthy.
In an effort to combat that problem, South Burlington-based Summit Properties has partnered with Middlebury College to build 150 to 250 units of affordable and market-rate housing in downtown Middlebury. The development will include a mix of apartments, multifamily homes and single-family homes.
The project is Middlebury’s largest affordable housing development in years, according to Brian Carpenter, chair of the town’s selectboard.
Construction is planned on a 35-acre plot of land on Seminary Street Extension that the college bought from Marjorie Mooney for $1.5 million in April 2022. As it begins construction, Summit Properties will pay the college back over time for each housing unit; the project is expected to cost about $40 million in total.
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Leffler: UVMMC starting 2023 with creativity and commitment amid challenges |
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Here’s one place I didn’t expect to find myself in my health care career: Standing at a construction site on a snowy December afternoon, applauding as my colleagues officially broke ground on a new apartment building and child care center for employees of the University of Vermont Health Network.
As a trained Emergency Department physician and now President of the University of Vermont Medical Center, I know how much there is to be done inside the walls of our hospital – which serves as the region’s community hospital, academic medical center, Level I Trauma Center, children’s hospital and NICU.
A few years ago, I might have asked why we were partnering to invest in apartments and child care, when there is so much else to be done. But anyone who has lived through the past few years – every patient who has waited too long in our extremely busy emergency department or for an appointment to see a specialist; any nurse, doctor or other employee who has struggled to maintain or even find housing and child care – knows the answer today.
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Graceful Health | Tanya Noyes: Your Blood Donation is Vital |
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January is National Blood Month. According to the American Red Cross, winter is “one of the most difficult times of year to collect enough blood products to meet patient needs,” partly because of busy holiday schedules and bad weather, which sometimes results in canceled blood drives. Also, seasonal illnesses such as the flu sometimes force potential donors to forgo their blood donations.
National Blood Donor Month is a reminder that, despite these challenges, blood donations are crucial all year round.
National Blood Donor Month has taken place each January since 1970, and it is such an important observance. Donating blood saves many lives and improves health for many people. According to the World Health Organization, “blood is the most precious gift that anyone can give to another person — the gift of life. A decision to donate your blood can save a life.”
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