Message from the CEO
There are few places in the U.S. today where partisanship isn’t front and center, too often clouding common sense and derailing progress on critical issues. Given the state of affairs in Washington and the stress of our third year managing a pandemic, it was hopeful last week to see some unity and common purpose in our corner of the country.

Our independent Senator Bernie Sanders, Republican Governor Phil Scott and State Senate President, Democrat Becca Balint, joined forces on the steps of the State House to highlight the critical importance of bolstering our health care workforce. That is no small thing. We should be proud they came together, not just because this issue is among the most acute and complex to tackle, but because they came together at all.

In that same spirit of collaboration, last week the VAHHS team interfaced directly with our
entire congressional delegation and top state officials on the serious health care challenges facing our state. In both cases—the federal and state leaders—we have serious and thoughtful partners working in unison to ensure Vermont’s response continues to be effective.

It can be easy to take this for granted because working together is more familiar in Vermont than it is foreign. I hope that sense of possibility and collaboration is a feature of the legislative session that just began. Even with a foundation of collaborating more than confronting, the weeks ahead will require hard work, debate and compromise to develop sound public policy at a crucial time. Our health care work force is depending on us to get it right.

That is why the commitment last week to grow and retain our health care workforce was such a unifying and important step. It was welcome news for health care team members who have endured so much over the past 21 months and continue to show up and take care of us through everything COVID has thrown at them.

As lawmakers discuss the workforce proposals and policies, VAHHS will be there every step of the way to advocate for patients, health care providers, hospitals and our system of care. Have a safe, careful and healthy week!
Legislative Update
Devon Green, VP of Government Relations

Although they were firmly in their home offices, the legislators hit the ground running last week and took up our top priorities of health care workforce, extending regulatory flexibilities and telehealth. The amount of activity during what is usually a “getting up to speed” week speaks volumes. Hopefully we will see even more activity when Governor Scott presents his FY 2023 budget, which is tentatively scheduled for January 18th.

Health Care Workforce: The legislature took up the issue of workforce right away, with the Scott Administration presenting its mid-year FY 2022 budget adjustment proposals, including:
  • $25 million to cover current traveler contracts, including those for ICUs and long term care facilities
  • $15 million in retention funding with priority for employers with highest need and greatest impact
  • $1.4 million in staffing incentives to open beds at the Vermont Psychiatric Care Hospital
The Director of Health Care Reform presented the Health Care Workforce Strategic Plan’s findings to the Senate Health and Welfare Committee, House Health Care Committee and House Commerce and Economic Development Committee. All committees will continue to work on this issue.
Extending regulatory flexibilities: The Senate Health and Welfare and House Health Care Committees dug right into Act 6 and regulatory flexibilities for health care organizations during COVID-19. Representatives from the Health Care Association Coalition, which includes VAHHS, supported extending almost all of the regulatory flexibilities until March 31, 2023. The committees stressed their commitment to addressing these issues prior to their expiration on March 31, 2022.
Telehealth: The health care committees also met on the future of telehealth licensure in Vermont. The Office of Professional Regulation presented the Act 21 Interstate Telehealth Working Group’s findings and recommendations for short term and long term telehealth licensure:
  • Near Term: The current flexibility of allowing health care clinicians to practice telehealth in Vermont as long as the clinician has a license in good standing in another state ends on March 31, 2022.
  • Short Term: From April 1, 2022 to June 30, 2023, telehealth practitioners will register with the licensing authority.
  • Long Term: Going forward from July 1, 2023 there would be a tiered approach:
  • Registration: for less than 120 days and fewer than 10 patients
  • Telehealth License: for up to two years, renewable, up to 20 patients
  • Full License or Compact: for two years, renewable, and 20 or more patients
In the News
Vermont doctors warn of perfect COVID storm in coming weeks

As COVID cases continue to surge throughout Vermont, doctors are warning the next few weeks could put the health care system under severe stress.

At the UVM Medical Center, they say every major service is beyond capacity as a perfect storm of staffing, holidays and a new variant in omicron has brought challenges.

After a brief and subtle lull in cases, hospitals are once again busy reflecting the surge of omicron in the population.

“People aren’t seeing quite as many ICU cases as with previous variants. We are hoping that is the silver lining to the dark cloud, that our hospital is well beyond capacity for yet another year,” said Dr. Tim Lahey, an infectious disease specialist at the UVM Medical Center.
How are Vermont's hospitals faring? In 1st week of January, they're managing amid COVID surge, staff testing positive

Hospitals across the state are contending with severe staffing shortages amid higher-than-usual demand for services, from COVID patients and others.

Still, several hospital leaders say they’re not in crisis mode. Many medical centers continue to perform elective surgeries and more ICU beds are now available across the state than in recent months, according to a COVID modeling report released by the state this week.

The same cannot be said of many hospitals in New Hampshire and the North Country, where unvaccinated COVID patients are overwhelming hospitals, and preventing other patients from getting care.
Vermont daily infection count breaks 2K mark; hospitals brace for rough ride

Vermont COVID rates continued to explode Thursday with state health officials reporting a one-day count of 2,188 cases, another record.

There are 91 people hospitalized with 17 in the ICU. The death toll remained level at 482.

As high infection rates stretch Vermont hospitals to the limit, officials we spoke to say they are again buckling down for a rough ride. “I think the next few weeks are going to be challenging it’s not only our patients that are coming in with covid and requiring a very high level of care but it’s also our staff who have been affected,” said Pamela Duchene, the chief nursing officer at Southwestern Vermont Medical Center in Bennington.
Opioid overdose deaths in 2021 likely to break Vermont record set a year earlier

Opioid overdose deaths among Vermonters increased so much during the first nine months of 2021 that the death toll could overtake the record set in 2020.

Between January and September, 150 Vermonters died from accidental opioid overdoses, according to recently released data from the state Department of Health. The figure is just shy of the 2020 total of 157 deaths — the highest number the state has seen since comparative records were established in 2009.

With the final quarter of last year still unaccounted for, 2021 is poised to rewrite the books.

“I would be very surprised if we don't surpass the 2020 numbers,” said Amanda Jones, a public health analyst with the state health department. “I just don’t know how much higher.”
Sanders, Scott address critical nursing shortage
Brattleboro Reformer

Federal and state leaders from different political parties joined forces Monday at the Statehouse to address the critical nursing shortage in Vermont, highlighting funding proposals to recruit and train additional health care workers to stem the shortage that is costing the medical system millions of dollars to rectify and threatening to undermine the hospital system during the pandemic.

“Nurses are the backbone of our health care system in Vermont and across the country,” said U.S. Sen. Bernie Sanders, I-Vt. “Simply stated, we will not have the quality health care we need unless we have an adequate number of nurses who are well trained and well compensated. I have absolute confidence that this is a problem that can be solved. I look forward to working with the governor, the legislature and the congressional delegation to make certain that we do that.”
Department of Mental Health asks for nearly $2 million to staff psychiatric facilities

As pandemic burnout decimates Vermont’s health care workforce, officials from the Department of Mental Health told lawmakers it would cost an additional $1.7 million to shore up staffing levels in psychiatric facilities this fiscal year. 

The bulk of the money — $1.4 million — would cover one-time bonuses to staff members at state-run facilities in Berlin and Middlesex. About $225,000 would cover the cost of temporary staffing at a children’s crisis support center in Burlington. The federal government is expected to cover roughly $1 million. The rest of the money would come from state coffers.  

“We have holes all across the system right now,” said Rep. Bill Lippert Jr., D-Hinesburg, who chairs the House Committee on Health Care. “And we’re having to work collaboratively to figure out how to plug these holes as we try to find some longer-term solutions, none of which are immediate or easy.”
Lawmakers asked to extend law allowing traveling health care workers to fill Vermont’s critical need

With rising concerns about health care staff shortages and the unprecedented spread of Covid-19, Vermont lawmakers may extend a policy that allows retired and out-of-state health care personnel to practice in Vermont.

Before the pandemic, medical providers could not practice without a valid Vermont medical license, and the process of obtaining one can take weeks.

But when the coronavirus crisis hit Vermont in March 2020, that tight regulatory setup went out the window. Act 6 allows providers who are licensed in other states to work in Vermont and allows retirees to return to practice much faster than normal.
CVMC dusts off expansion plan
Times Argus

Plans to expand Central Vermont Medical Center are on again and construction of a four-story addition that would house a 40-bed psychiatric wing and a new emergency department could conceivably be underway early next year.

CVMC President Anna Noonan and Eileen Hee, director of projects and properties for the Berlin-based medical center, briefed the select board on the recently revived project Monday night, have a date with the planning commission next week and hope to start the local permitting process next month.

If all goes well, board members were told the Green Mountain Care Board would issue a certificate of need for the project in April and state and local permits would be in hand by this fall with an eye toward breaking ground by early spring 2023.
Hospitals in the News
Mark Your Calendar