VAHHS Statement

The Vermont Association of Hospitals and Health Systems (VAHHS) represents Vermont’s network of entirely non-profit hospitals. We work tirelessly with state leaders, lawmakers and other health care stakeholders to improve Vermont’s mental health system. Our focus is to ensure every Vermonter gets the care they need when they need it and in the right care setting. Too often, patients languish in our emergency departments for lack of access to appropriate and therapeutic mental health services. This impacts their care as well as the care of other patients in need of those emergency department beds. It also impacts our staff greatly and drives up costs for hospitals.

We have been following the recent federal ruling in neighboring New Hampshire regarding the boarding of patients in need of inpatient mental health treatment in hospital emergency departments. A federal judge declared the state's practice of involuntarily holding psychiatric patients in emergency departments unconstitutional. We experience the same challenges with patients who need inpatient psychiatric care, but are being boarded in our emergency departments, unable to be transferred for lack of available beds. We are working hard to find solutions that can benefit the patients and staff who deal with these situations daily.

In Vermont, our state leaders understand this challenge and are committed to increased funding for workforce and other investments to expand access. For example, the Brattleboro Retreat has been able to increase its number of available beds from a low of approximately 45 to nearly 98 with the financial support of the Agency of Human Services (AHS) to help offset the staggering cost of traveling nurses and other staff to care for patients. In the past year, AHS, hospitals and health care leaders have also done the following:

  • supported the development of outpatient urgent care settings 
  • expanded mobile crisis supports in the community 
  • worked with the Vermont Program for Quality in Health Care to develop a state telepsychiatry network 
  • established a daily rate to increase financial support for hospitals caring for patients waiting in emergency departments 
  • proposed the development of dedicated forensic mental health beds to reduce gaps in the system 
  • continued to support suicide prevention efforts 

This has been an incredible help to patients, provided much needed relief to providers and staff and assisted hospitals greatly, but it is still short of what Vermonters in mental health crisis need. There is much more work to be done in this area. VAHHS will continue to push for solutions alongside our partners for as long as it takes. Our communities deserve the best care we can possibly deliver and that is what we are striving to achieve.
Legislative Update

Devon Green, VP of Government Relations

Happy Town Meeting Week! You may see your local legislator out in the wild at the grocery store or the transfer station. If you do, feel free to share the VAHHS Advocacy Agenda. Next week will be crossover week, where non-money bills must be voted out of committees or else remain on the wall until next year. Stay tuned!
 
Workplace Violence: The Senate Health and Welfare Committee continues to work on S.36. VAHHS appreciates that the committee amended the bill to increase the criminal threatening penalty when the crime is committed against health care workers. The amended bill also requires the Vermont Program for Quality in Health Care (VPQHC) to recommend best practices for trainings at health care facilities, as seen through an equity lens. The committee also took the Health Care Advocate’s recommendation of narrowing disorderly conduct to engaging in fighting, violent, tumultuous or threatening behavior. The committee is still trying to determine if warrantless arrest in a health care facility should apply to any part of disorderly conduct and will return to the issue next week.
 
Budget: The House Health Care Committee provided its priorities to House Appropriations for the FY 2024 budget. The Committees supported several initiatives that were not in the Governor’s budget, including:
  • Increase Medicaid rates to 110% of Medicare for primary care providers and give specialy care providers a 3.8% inflation increase at $5.6 million
  • Bring Medicaid to 100% of Medicare reimbursement for EMS providers
  • Funding for a Regional EMS Coordination Study Committee
  • Expansion of Soteria House, a therapeutic community residence for those in mental health crisis, from 4 to 9 beds
 
The Committee also supports the following from the Governor’s proposed budget:
  • Increasing reimbursement for Medicaid dental to 75% of 2023 commercial rates for a total of $13.1 million
  • Expansion of the mobile crisis unit for response to mental health calls at $3.4 million
  • $1.5 million for an alternative to the emergency department for those in mental health crisis in the Northeast Kingdom
  • One-time funding totaling $10 million to continue to support the health care continuum with the capacity crisis
  • $15.6 million for the Blueprint for health program to integrate mental health into primary care, expand the Hub and Spoke model to include other types of SUD treatment, and expand the DULCE Program assisting families with newborns
 
Abuse of Vulnerable Adults: The House Human Services Committee reviewed its latest draft of H.171, which updates the adult protective services statute. The proposed language expands the definition of abuse to include negligent medical treatment. This definition would counteract health care’s current efforts to encourage providers to come forward with deviations from the standard of care to better improve the system and safety for all patients.
 
The definition of abuse also includes withholding of necessary medical care, which creates an extremely difficult standard when the patient refuses care or in end of life care situations where family members may disagree. VAHHS joined with other health care provider associations to express their concerns on expanding the definition of abuse.
In the News
Vermont's Emergency Medical Services System Is Struggling to Survive. Can It Be Saved?
Seven Days

Colleen Ballard knew her industry was in distress. The seasoned paramedic had been hearing doomsday predictions about the future of emergency medical services for years, and her colleagues at Essex Rescue were feeling the strain of rising call volumes, staffing shortages and underfunding.
But it was not until she took over as chief in early 2020 that she realized just how dire the situation had become.

Essex Rescue needs at least two ambulances and about 16 full-time EMTs and paramedics to cover the 30,000 residents it serves across Essex, Essex Junction, Underhill, Jericho and Westford. But a shortage of volunteers was leaving big gaps in the schedule, forcing the agency to bring on more paid workers — something it couldn't afford.

UVM Cancer Center rolling out innovative new blood cancer treatment
Vermont Public

An innovative cancer treatment that uses a patient’s own immune system to attack the disease is now available for patients in Vermont and northern New York for the first time.

CAR T-cell therapy was approved in 2017 for a variety of blood cancers, and has led to encouraging results for patients.

Dr. James Gerson was among the first physicians in the country to use the treatment in a clinical setting, at the University of Pennsylvania.

He’s now at the University of Vermont Cancer Center, which just began its own CAR T-cell therapy program. And he joined Vermont Public’s Mary Williams Engisch to talk about the treatment. Their conversation below has been edited and condensed for clarity.

Helping Vermonters and their loved ones cope with Alzheimer's and dementia
Vermont Public

More than 13,000 Vermonters have Alzheimer's disease or other forms of dementia, and for every patient, there are twice as many friends or family members providing care. This hour, we'll talk about Alzheimer's and dementia with a UVM neurologist. We'll also hear from an advocate discussing help for patients, caregivers and families.



Our guests:

Dr. John Steele Taylor, neurologist and medical co-director of Memory Program at UVM Medical Center

Meg Polyte, policy and advocacy director for the Vermont chapter of the Alzheimer’s Association
Hospitals in the News
COVID-19 Updates
From Our Hospitals
Julie Tracy: New treatments are available for Treatment-Resistant Depression
We all know someone who struggles with depression. Maybe it is the mother you see every week at soccer practice, or a coworker. There are so many hidden struggles in our world. For me, it is my beloved family members and the many adolescents and adults that I have worked with who simply find no relief from depression. The story is familiar. They have tried everything: therapy, multiple medications, exercise, acupuncture, changing daily routines, changing diets and nothing truly works.

Perhaps you or a loved one are experiencing Treatment Resistant Depression (TRD), a type of major depressive disorder that has not adequately responded to multiple antidepressants and other therapeutic practices. For those with TRD, life can be overwhelming, at times even suicidal thoughts or actions occur, other times TRD can cause a person to feel profoundly numb. It might be hard to feel a connection with others or to sustain interest in work, or practice self-care.
Mark Your Calendar