By Devon Green

All the big spending bills have passed out of the House and are now in the hands of the Senate, including $650 million in spending of the COVID relief federal funding. As of now, we have limited information about the funding, and VAHHS will be keeping an eye out for further federal guidance.

Budget: The House passed funding for the FY22 budget in H.439, including:

Federal COVID Funding: The House also laid out its priorities for spending $650 million of the federal funding from the American Rescue Plan Act (ARPA). The state will have an additional $600 million to allocate over the next few years. It should be noted that the Governor has not yet submitted a spending plan, and we are still waiting for further federal guidance. Plans include:

Vermont reported 251 new Covid cases Friday, the highest ever one-day total and a significant rise over the daily numbers in the past week.

“This is a concerning number of new cases and should not be dismissed,” said Dr. Mark Levine, Department of Health commissioner.

“Our efforts to vaccinate Vermonters is a race against what the virus does best: move easily from person to person,” he said. “Throughout the country, including up and down the Eastern Seaboard, case numbers are up.”

Half of the cases announced in the past two weeks were in people under 30, which Levine attributed to multiple reasons. Young people being more mobile and social, warmer weather encouraging activity, and the spread of the variant, particularly on the University of Vermont’s college campus.

Vermont recently reopened restaurants and bars, loosening restrictions around the number of people who can sit at each table. Gov. Phil Scott said they haven’t been open long enough to affect the data.

He defended the reopening measures, pointing to data that shows hospitalizations in Vermont have remained mostly flat even as cases rise.

The Vermont Department of Health updated its website Wednesday with new information about how Black, Indigenous and people of color Vermonters and their households can obtain Covid-19 vaccines.

People of color who are currently eligible for the vaccine based on the Department of Health’s criteria — age, certain chronic conditions and certain occupations — can register themselves and household members for vaccine appointments at specific clinics.

Because of the disproportionate impact of Covid-19 on Vermonters of color and disproportionately low rates of vaccine uptake, the Department of Health has partnered with organizations across the state to administer vaccination clinics specifically focused on these populations.

Vermont is throwing the doors for Covid-19 vaccination sign-ups wide open, allowing every adult resident to register by April 19. Last week, Gov. Phil Scott promised to provide a shot to every Vermonter who wants it by the end of June.

To do so will require a major lift.

The state is inoculating about 7,000 people a week. To reach every Vermont resident, the state may have to ramp up vaccination efforts to as many as 35,000 people a week, a five-fold increase. While state officials have expressed confidence in the timeline, it remains unclear how many vaccine doses will be available and when.

“Everyone’s trying to look around and read the tea leaves about what they’ll receive and when they’ll receive it,” said Neal Goswami, spokesperson for the University of Vermont Medical Center.

In the last three months, the state has vaccinated about 171,000 Vermont residents — roughly a third of the adult population. About 92,000 of those people have received both doses.

With COVID-19 vaccines becoming more available, some medical professionals are worried vaccine hesitancy could delay the effort to reach herd immunity levels, but local doctors said they’ve been able to reach some patients by listening to their concerns.

Dr. Elizabeth Suiter, the medical director of Central Vermont Medical Center’s Adult Primary Care in Barre, said they are seeing some patients who are hesitant about getting the COVID vaccination and others who are concerned about a relative or friend who is resistant to taking the shot.”

“I think it makes sense. So people are nervous, right? This is a very new disease, and it’s a new vaccine.” she said.

The hesitation is not surprising, Suiter added, and it’s important to acknowledge.

She said her approach, which she believes is shared by many of her colleagues, is trying to get to the heart of a patient’s concerns.

The American Cancer Society (ACS) has selected Southwestern Vermont Medical Center (SVMC), part of Southwestern Vermont Health Care (SVHC), as a Hospital Systems Capacity Building (HSCB) Community of Practice (COP) site to increase colorectal cancer screening rates.

The HSCB COP initiative is 3-year project including 20 hospitals and their community partners nationwide. The aim of the project is to bring well-performing health systems together to share tools, resources, and capacity-building assistance and to solidify evidence-based methods to improve community health.

“I am thrilled to embark on this journey with SVMC over the next three years. I have witnessed the great work they already do around Colorectal Cancer Screening, so it came as no surprise they were recognized,” said Amy Deavitt, cancer control strategic partnerships manager for the American Cancer Society, Inc., Northeast Region. “We look forward to increasing our communities’ awareness around Colorectal Cancer Screening.”

The Vermont Department of Health, Dartmouth-Hitchcock Medical Center, Vermonters Taking Action Against Cancer, ACS, and professionals from multiple SVMC departments served as instrumental partners in SVMC’s previous work to increase colorectal cancer screening rates and will remain on the team throughout this COP project.

State officials noted the northern counties of Vermont have seen a large share of the state’s recent COVID-19 cases but say it’s too soon to say if it’s a trend or attribute the cases to low vaccination rates in comparison to other parts of the state.

The Northeast Kingdom was a frequent topic of discussion during Governor Scott’s media briefing Tuesday as he and administration officials were asked about the prison outbreak in Newport, the ongoing low vaccination rate in Essex County, the potential role political persuasion may have on the choice to get vaccinated, and schools shifting to remote learning.

“The northern part of the state certainly has a higher disease prevalence than even the central or southern part of the state as you can see on the heat map and that has become more pronounced over the last couple of weeks,” said DFR Commissioner Michael Pieciak who oversees the state’s data reporting and case projections. The state’s heat map of active cases shows all of the Northeast Kingdom along with Lamoille, Franklin, Grand Isle and Chittenden counties have significantly higher active cases than the rest of the state.

Gov. Phil Scott has promised that vaccines will deliver a return to normalcy this summer. The entire adult population will be eligible by mid-April, meaning that anyone who wants to get the vaccine could get it by mid-June.

“To put a finer point on it for high school seniors, this timeline means that in June, if we have the vaccination uptake we need, you should be able to have a more traditional graduation and celebrate what you’ve accomplished with your friends and family,” Scott said.

But as the state celebrates, one sizable population won’t be able to take advantage of the loosening restrictions: Children younger than 16 and, by extension, their parents.

None of the vaccines approved by the federal government are currently recommended for children younger than 16, since the initial vaccine trials didn’t test that population. Only the Pfizer vaccine is recommended for children 16 and 17 years old.

With estimates for a kid’s vaccine ranging from summer to fall to 2022, parents are left wondering what they’ll be able to do with their children.

The ongoing challenges and sacrifices brought about by the coronavirus pandemic have tested each of us in ways that might not have been imaginable just a year ago. Yet during this unprecedented time, we have learned that adversity can inspire new approaches to solving our common problems. We are encouraged to say that such is the case with the relationship between union and management at the Brattleboro Retreat.

To describe the Retreat’s union/management relationship over the past few years as “tense” would probably be an understatement. That said, it’s a credit to the people and parties involved that in spite of some well-publicized differences, we have maintained a dialogue and tried hard to appreciate the other side’s point of view.

We should also point out that even amidst the difficulties of the past decade, union and management have still been able to reach collective bargaining agreements, provide market adjusted wage increases (including a major wage adjustment in 2018 that brought Retreat in line with industry standards) and stand together successfully in the recent and continued fight to keep patients, staff, and others safe from COVID-19.

So what has changed?

Words can transmit stigma. Studies have shown that people with psychiatric and/or substance use disorders often feel judged, outside and inside the health care system. This can lead them to avoid, delay or stop seeking treatment. The way we talk about people with a behavioral disorder can change lives – in either a positive or negative manner.

The AHA, together with mental health and language experts from member hospitals and partner organizations, will release a series of downloadable posters to help your employees adopt patient-centered, respectful language. Please consider downloading, printing and sharing each poster with your team members and encourage them to use this language both in front of patients and when talking to colleagues. People matter and the words we use to describe them or the disorders they have matter.