Legislative Update
by Devon Green
VAHHS Vice President of Government Relations

Just like there’s no such thing as being a little bit pregnant, there’s no such thing as being partially involved with the legislature. I normally love the immersive experience of the legislature because it is filled with interesting issues and debates; but for the first time in many years, I’m unable to dive into this initial full week of the session.

Our hospitals are performing the most important public health effort of our lifetimes by administering COVID vaccines right now, and any other issue pales in comparison. I want to take a moment to personally thank a workforce that is already stretched to the brink for digging even deeper to stand up clinics while still providing the same great care to their communities. This effort isn’t just a few providers putting needles into arms; hospitals are storing the vaccine, preparing the doses, setting up sites that are safe, scheduling appointments, answering phone calls and a million other thorny logistical issues. Our hospitals, along with the pharmacies under the federal program, have put Vermont near the top of the list for vaccination rates, which is not only laudable, but lifesaving.

And with that, back to our regularly scheduled program of legislative happenings.

This week was the first full week of the legislature, which means a lot of updates. We’re also getting a sense of committee priorities. The Senate Health and Welfare Committee, House Health Care Committee and House Human Services Committee held a joint hearing where they discussed their priorities, including:

  • Updating emergency legislation passed in 2020
  • Vaccine protocols and schedules
  • Planning for health emergencies
  • Childcare
  • Food security
  • Health care workforce and passage of the Interstate Nurse Licensure Compact
  • Mental health and substance use prevention
  • Health care reform
  • Broadband deployment for telehealth and telemedicine

Health Care Provider Stabilization Grant Update: The Agency of Human Services provided a detailed overview on the Health Care Provider Stabilization Grant Program. The committees heard about opportunities going forward, including telehealth and continued flexibility in funding and payment reform.

All Payer Model Update: The House Human Services Committee heard from Secretary Mike Smith regarding their report and proposed re-boot of the All-Payer Model presented to the Green Mountain Care Board in the fall. Secretary Smith testified that in order to meet targets set out in the agreement with the federal government, there are four main areas that need to be evaluated:

  • What does the federal government need to do to make the model successful? For example, should Medicare be made a truly prospective payment system?
  • What does AHS need to do to make it successful? Smith indicated that all programs needed to row in the same direction and be aligned.
  • What does the accountable care organization (ACO) need to do? The report had several recommendations for OneCare Vermont.
  • What does the Green Mountain Care Board need to do? The report had several recommendations for the Board.

Smith indicated that the pandemic had strengthened the Administration’s commitment to
move from fee-for-service to value-based care.

Review of Public Health Emergency Authority: Legislative council (the committee’s lawyer) presented an overview of the public health emergency authority in Vermont to the Senate Health and Welfare Committee. The committee looked at proposed language for a task force to develop a strategic plan for future statewide health care committees, but ultimately decided to work on other priorities before taking the issue up again.
In the News
Vermont hits new record of hospitalizations
VTDigger

Vermont has 47 people currently hospitalized for Covid, the highest number since the pandemic started in March, according to Department of Health data as of Monday.

That number includes 10 people in the ICU. Six more people are hospitalized “under investigation” of Covid, meaning they are waiting on test results or confirmation they have the disease.

The hospitalization record comes amid rising case count averages in the post-holiday period. The state reported 109 cases Monday, a decline from daily totals above 200 late last week, but the seven-day average is still high compared to a few weeks ago.

Vaccinations of Vermonters 75 and older will begin week of January 25
VTDigger

Vermont will begin vaccinating people 75 and older the week of Jan. 25, opening the second phase of the state’s vaccination strategy, officials said at a press conference Friday.

Vermonters who qualify will be able to register online or by phone.

Registration details will be announced closer to Jan. 25, according to Mike Smith, secretary of the Agency of Human Services. Call-ins could get backed up, officials said, so the website is the preferred method for making appointments. If older residents need assistance, Smith asked younger Vermonters to help their loved ones register online.

A bit of a bottleneck is expected in the beginning, which is why the state is urging people to register online, Smith said. About 200 people will be staffing the phones for call-in registrations, with plans to scale up to about 400.
Quarantine an acute challenge for most vulnerable Vermont residents
Valley News

Natalie Sinkew has worked her way through more word searches than she can count in her weeks of bedridden isolation at Queen City Nursing & Rehabilitation in Burlington. 

Meanwhile she clings to a singular hope: To return home to her St. Albans apartment, so she can see her companion dog, a 15-pound poodle-terrier mix named Mi-mi, and resume her job at Goodwill.

But as the pandemic stretches on and she remains locked down in her room, that future only grows more distant. Sinkew’s health has deteriorated rather than improved, according to her friend and advocate David Przepioski.
COVID pre-op rules have a purpose, hospitals say
The Times Argus

As the pandemic continues, Vermont hospitals, like Rutland Regional Medical Center and Central Vermont Medical Center, have instituted requirements that patients must meet to be admitted for a surgery or procedure and those requirements are serious and necessary, according to health care providers.

Lisa Bovat, patient experience manager at Central Vermont Medical Center, said there are staff members at the entrances conducting health screenings and asking questions suggested by the Centers for Disease Control and Prevention and the Vermont Health Department. Some of those questions had been about travel, but now they’re more about quarantine, Bovat said.
Trey Dobson, MD: A perspective on Vermont's vaccination program
Bennington Banner

Within days of Vermont receiving its first shipment of the COVID-19 vaccine three weeks ago, concerns emerged regarding vaccine distribution, prioritization, and administration.

The concerns were justifiable, given the incredibly high stakes we all face. With any initiative of this magnitude, opportunities for improvement undoubtedly emerge. And when we look at what has been learned and already accomplished in a very short amount of time, the vaccine program in Vermont is actually going quite well, and it is becoming more effective each day.

The Department of Health is working hard to coordinate vaccine deliveries from federal supplies and follow through with distribution to area health systems. All of the Vermont hospitals have put non-critical projects on hold in order to devote staff and resources to safe vaccine administration. The number one priority for all of us in healthcare in Vermont is to make the vaccine readily available to everyone and quickly pull ourselves out of this pandemic.
Northwestern Medical Center nears finish of first phase of vaccinations
Saint Albans Messenger

Northwestern Medical Center is edging closer to completing its share of the first phase of vaccinations.

As of this week, NMC has vaccinated over 1,700 hospital staff and community providers with either Pfizer-BioTech or Moderna vaccines, according to a notice from the hospital.

“Following the [Vermont Health Department] guidelines, we feel fortunate to be able to vaccinate our partners from EMS, home health, police and fire first responders as well as our other healthcare partners in the community,” said Chief Medical and Quality Officer Dr. John Minadeo. “We are all in this together...We are also proud of our staff who planned out and began operating a vaccine clinic in the midst of all the rest of the work that must continue to provide care for our community.”
Babies come when they want to come,' despite pandemic
Bennington Banner

“Tis impossible to be sure of any thing but death and taxes,” wrote Christopher Bullock in “The Cobler of Preston” in 1716.
That adage has been oft-repeated since it was first penned, but at least one group of people want you to know those aren’t the only two certain things in life.

“Babies come when they want to come,” said Dr. Kimberly DeVore, who became the chairwoman of the Department of Obstetrics and Gynecology at Cheshire Medical Center in October, in the middle of the pandemic.
For calendar year 2020, Cheshire Medical Center had 409 deliveries, up from 398 in 2019.

“This is not what we had anticipated,” said Candace St. John, who gave birth to her son, Bode, in June in Keene.

St. John, who is an epidemiologist at the Center for Population Health at the hospital, said she and her husband, Tyson, had made plans for the summer to be kind of relaxed leading up to birth. Instead, like other staff members at hospitals across the country, she was called upon to support efforts in response to COVID-19.
Hospitals in the News
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