by Devon Green

Vice President of Government Relations

In a dire situation that is growing in severity around the country, our hospital emergency departments are overwhelmed right now—not with COVID patients—but with children and adults in mental health crisis waiting days and weeks at a time to receive proper and complete treatment. The mental health of Vermonters is the next public health emergency. VAHHS hopes to work with the legislature and state agencies to bring to our current mental health crisis the resources, regulatory flexibility, workforce development and data collection efforts Vermont successfully deployed to take on COVID-19.

Children and Adolescents in Mental Health Crisis in Emergency Departments: The House Health Care Committee heard testimony from Dr. Christian Pulcini, Pediatric Emergency Medicine at UVMMC, Dr. Alison Kapadia, Service Director for BMH Emergency Department, and Dr. Kathleen McGraw, Chief Medical Officer at BMH, on children in mental health crisis waiting for days and weeks in emergency departments. VAHHS supported the health care provider testimony with additional statewide data. The committee also heard from the Department of Mental Health, Vermont Care Partners with more information on the Psychiatric Urgent Care for Kids, as well as concerned parents. Chair Lippert expressed his desire that this be treated as a public health emergency with a goal of zero children in mental health crisis waiting in emergency departments for more than a few hours.

Health Equity Legislation: H.210, a bill creating a commission to promote health equity and eradicate health disparities among Vermonters, continued to move forward with an unanimous vote from the Senate Health and Welfare Committee. The commission will consult with stakeholders, including health care providers, and report back with proposals to improve cultural competency and antiracism in the health care system. 

federal vaccine advisory panel has voted to resume Johnson & Johnson vaccinations, paving the way for Vermont to begin allowing residents to receive the shot.

The CDC halted the use of Johnson & Johnson earlier this month after 15 people, of the millions of doses distributed nationwide, developed a rare blood clot complication about a week after receiving the shot.

Gov. Phil Scott estimated that Vermont could resume Johnson & Johnson vaccinations as early as Tuesday.

The recommendation from the Advisory Committee on Immunization Practices, which is run by the Centers for Disease Control and Prevention, would add information to official documentation about the risk of blood clots in women 18 to 49 years old.

Earlier this month, our investigative team highlighted a shortage of doctors in rural areas across the country. That investigation revealed Vermont is home to one of those so-called health care deserts.

Essex County is in the far northeast corner of Vermont with a population of about 6,200 people. Across the entire area, there is just one primary care doctor and no specialist. There is also no hospital in the county. The closest hospital is in St. Johnsbury in Caledonia County, which is quite a drive for many in the Northeast Kingdom.

“Our health center is the only option that we have and they need more help,” said Robin Halfmoon of Island Pond.

People who live in Island Pond say one health center just isn’t enough.

The Island Pond Health and Dental Center serves more than 90% of residents there. Currently, there’s only one physician, one nurse practitioner, two dentists and four hygienists.

Staff members tell us there’s a lack of specialty services in the Northeast Kingdom and there’s no hospital for miles.

Halfmoon has lived in Island Pond for a year and a half and says she has to drive at least a half-hour to get to the nearest hospital.

“Sometimes, down to Dartmouth-Hitchcock which is a couple of hours away. And it’s exhausting. I am disabled and it makes for things being very confusing,” Halfmoon said. “And how long do we have to wait to go to the doctor, the dentist?”

Parents and pediatricians are sounding the alarm about a concerning trend playing out at hospital emergency departments throughout Vermont – on average, children in a severe mental health crisis are facing a wait over four days in the emergency room before receiving treatment.

According to the Vermont Department of Mental Health, children and youth are going to the emergency department for mental health concerns at a much higher rate than before the pandemic, even as overall emergency department visits are declining. The already limited number of beds at inpatient facilities have dwindled even further due to COVID-19 restrictions, and parents say the emergency room is an unforgiving place to wait for a child in crisis.

“There’s nothing that’s kid-friendly about it, we were across the hall from a woman who was screaming for hours,” said Robyn Freedner-Maguire.

Parents and pediatricians are sounding the alarm about a concerning trend playing out at hospital emergency departments throughout Vermont – on average, children in a severe mental health crisis are facing a wait over four days in the emergency room before receiving treatment.

According to the Vermont Department of Mental Health, children and youth are going to the emergency department for mental health concerns at a much higher rate than before the pandemic, even as overall emergency department visits are declining. The already limited number of beds at inpatient facilities have dwindled even further due to COVID-19 restrictions, and parents say the emergency room is an unforgiving place to wait for a child in crisis.

“There’s nothing that’s kid-friendly about it, we were across the hall from a woman who was screaming for hours,” said Robyn Freedner-Maguire.

Gifford Medical Center is partnering with three White River Valley ambulance services to have first responders conduct non-emergency visits with patients who are frequently seen at the Randolph hospital’s emergency room.

The hope is that these social calls can help identify and address issues that may make it difficult for people to take their medication as prescribed or to make it to their regular appointments, Gifford Chief Medical Officer Joshua White said.

Beginning next month, Gifford will pay Chelsea-based First Branch Ambulance, South Royalton Rescue Squad and Bethel-based White River Valley Ambulance a per-visit fee to make non-emergency visits to patients the hospital has identified as having frequent emergency department visits and/or hospitalizations. Ideally, the ambulance crews’ visits will help reduce trips to the emergency room and stints in the hospital, White said.

The program, originally slated to be funded through a $10,000 grant from the state, will be “using the ambulance service as — at least to begin — as just a social outreach tool,” White said.