by VAHHS President and CEO Jeff Tieman

Last week brought some good developments in the COVID battle. Dr. Anthony Fauci predicted there will be “open season” on vaccines—enough to reach anyone in America who wants to be inoculated—as early as April. By the end of summer, said the chief medical adviser to President Biden, 75 to 85 percent of our nation is likely to be vaccinated. This is terrific news and I hope it becomes reality.

Now, however, we are still in the midst of the pandemic, with confirmed virus variants found in Burlington wastewater and a growing likelihood that one or more of the dangerous strains have made their way to Vermont. Meanwhile we have a few hot spots in the state, including Bennington, Franklin and Rutland Counties, where community transmission is concerning and hospitals have been in surge status or close to it.

As the reality and threat of growing case counts and hospitalizations continue, we cannot afford to let down our guard. Of course this applies to mask wearing and social distancing. But it also applies to health care providers focusing their time and resources on the urgent and demanding work it takes to manage COVID-19.

To emerge from the pandemic strongly and smartly, hospitals cannot afford to be distracted by activities that do not support the core mission of delivering outstanding care to Vermonters during a still-raging public health crisis. For this reason, we have asked that our regulator, the Green Mountain Care Board (GMCB), exercise authority granted to it by the legislature to simplify hospital regulation this year.

Hospitals in Vermont are very thoroughly regulated—so much so that no other state in the union comes close to the level of oversight and scrutiny involved here. In fact, I was recently asked if I could find other examples where hospital regulation has been relaxed to allow for greater flexibility during the pandemic and the answer was a swift “no,” because no other state is regulated as we are.

Here in Vermont, every hospital’s annual budget is publicly disclosed and reviewed. Voluminous data spanning operations, expenses, quality, access and revenue growth is shared with the regulator and posted for public consumption. Exhaustive hearings on each hospital’s financial and operational status take place every year, at great cost to both hospitals and the state.

Regulation is important, and hospitals comply honorably. For so many reasons obvious to all of us, this year is simply different. Hospitals are not asking for a pass on regulation, but a simplified version that will provide regulators and the public with a clear picture of hospital budgets and not compromise clinical care, slow down vaccine clinics, interfere with surge planning or inhibit systemwide coordination.

Through the analysis of key data indicators, the GMCB can still carry out its obligation to review and approve budgets—and hospitals support this work. What we need to avoid is a lengthy, costly process that would be minimally informative during such an unpredictable year and would stress hospitals at a time when they cannot afford more stress.

If Dr. Fauci’s prediction is true, and sometime this summer we can finally bask in that light at the end of the tunnel, we must maintain total focus on patient care and pandemic response at least until then.

I have never been prouder of our non-profit hospitals. They have stepped up at every turn to serve Vermont and Vermonters, to protect the public and help us all move through and past the pandemic.

by Devon Green

VAHHS Vice President of Government Relations

Audio-Only Telehealth: The House Health Care Committee came to consensus to extend the current coverage and reimbursement of audio-only telehealth until January 1, 2025. This means that an audio-only office visit will be covered and reimbursed in the same way as an inpatient office visit after the patient provides proper informed consent.

Nurse Licensure Compact: The Senate Health and Welfare Committee took testimony on S.48, the Nurse Licensure Compact. The bill has broad support from VAHHS, the Coalition of Health Care Associations, the Vermont Health Care Association, the Board of Nursing, the Vermont Nurses Association, The Organization of Nurse Leaders and the Office of Professional Regulation. VAHHS Board Member Carol Conroy testified on behalf of the Organization of Nurse Leaders and enumerated multiple benefits of the Nurse Licensure Compact, including coordination of treatment via telemedicine, access in rural areas, improved safety through finger-print background checks and support for more rapid staff responses during disasters or public health emergencies.

Nurse Tax Incentives and Workforce Development: The House Health Care Committee heard AHS’s Director of Health Care Reform and the Tax Department present the Administration’s proposed nurse tax incentive that would exempt recent graduates from Vermont nurse education programs from 100 percent of state income taxes in the first year, 70 percent the second year and 50 percent in the third year after graduation. Laura Pelosi testified on behalf of the Health Care Provider Association Coalition in support of the incentive, noting that 33 percent of graduates from Vermont nursing programs leave the state. Pelosi also provided compelling testimony summarizing the workforce needs of Vermont’s health care providers and supporting ongoing funding for nursing and physician scholarships, as well as one-time funding for developing provider and higher education partnerships to increase nurse education programs.   

Regulation of Stem Cell Therapy Not Approved by the FDA: The Senate Health and Welfare Committee heard a summary of S.22, a bill that requires stem cell therapy that is not approved by the FDA to disclose to patients and in its advertising that the therapy is not approved. The committee will act quickly on this bill.

Health Care Budget: The House Health Care Committee started digging into its budget priorities last week and will continue their discussion this week. Topics for potential discussion include funding positions for health equity, suicide prevention, health care workforce and how to spend one-time federal funding related to

COVID-19 Regulatory Flexibilities: The Senate Health and Welfare Committee will likely incorporate the House Health Care’s consensus on audio-only telehealth into a bill that would extend current COVID-19 regulatory flexibilities.