Legislative Update
Thank you to all who came out to our A Healthier State House health fair at the State House on Thursday! I had a great time sipping cucumber-infused water and smoothies while munching on pumpkin breakfast cookies and learning about healthy nutritional and lifestyle choices...all while hula hooping. Our hospitals, along with OneCare Vermont and Blue Cross Blue Shield of Vermont, did a great job showcasing their health and wellness efforts. 
In other parts of the building, the big stuff was moving—minimum wage, paid family leave and the 2021 budget.
Last Week
Governor’s Budget Address: The governor’s speech on his fiscal year 2021 budget proposal focused on several important VAHHS health care priorities:
  • Workforce: We were really pleased to see the governor discuss demographics and workforce in his budget address on Thursday. We will be keeping an eye on his proposal to dedicate $1 million to retaining graduates from Vermont’s registered nurse and licensed practical nurse programs here in the state. 
  • Health Care Reform: After admitting initial skepticism regarding Vermont’s move to value-based care through OneCare Vermont, the governor touted the model’s early results that reduced the money spent on health care services by $7.7 million. Governor Scott recommended investing $5.7 million for delivery system reforms as long as OneCare meets the same transparency standards as a non-profit.
  • Mental Health: We also appreciated the governor’s efforts to invest in areas along the mental health continuum, such as the Prevention Lifeline Network and a mobile response unit, that would help keep individuals out of emergency departments. VAHHS would like to see the success of these initiatives tied directly to avoiding emergency department visits. 
Minimum Wage: The House and the Senate came to an agreement on a minimum wage increase of $1.59 over two years—from the current amount of $10.96 to $11.75 in 2021 to $12.55 by 2022. The House voted on Friday with 93 in support and 54 against the legislation. The bill will then head over to the Senate, where it is slated to pass, and on to the governor’s desk.  
Paid Family & Medical Leave: The Paid Family and Medical Leave proposal passed out of the house by 89 votes. The proposal creates a mandatory 12-week paid family leave program funded by a .2 percent payroll tax and a voluntary medical leave benefit funded by a .38 percent payroll tax. Next stop for the bill is the governor’s desk and a likely veto. It remains to be seen whether the House can drum up the 100 votes needed to override a veto.
Prescription Drug Costs: The House Health Care Committee heard Blue Cross and Blue Shield of Vermont present on the rising costs of prescription drugs and heard an update on Vermont’s plans for prescription drug reimportation, as well as proposals giving the Green Mountain Care Board the authority to set an upper payment limit on prescription drugs and limits to out-of-pocket costs for insulin. The committee will be looking at any and all proposals looking to curb the rising costs of prescription drugs as they make this issue one of their priorities.
Flavored Tobacco Ban: The Senate Health and Welfare committee heard testimony on banning all flavors, including menthol, in tobacco products. Witnesses testified that flavored tobacco targets children and that the tobacco industry has historically targeted menthol toward the African American communities with more advertising and lower prices. 
Next Week
Telemedicine: The House Health Care committee will dive into telemedicine legislation and look at H.723 which expands the use of store-and-forward telemedicine and e-consults. 
Physician Assistant (PA) Licensure: The Senate Health and Welfare Committee will continue hearing testimony on reducing supervisory oversight of PAs and replacing the current model with practice agreements.
In the News
Copley Hospital’s ailing finances in recovery
News & Citizen

Looking at graphs that chart Copley Health Systems finances in recent years, the line sometimes looks like one of those electrocardiogram readouts, with jags of peaks and valleys.

Copley’s new CEO, Joseph Woodin, wants to straighten that line out. He’s been on the job three months now and he’s operating under the shadow of one bankrupt hospital in Springfield, and another one — the Brattleboro Retreat — that may be heading that way.

“As we all know, personally, or if you have a business, if your finances aren’t going in the right direction, everything changes. The whole discussion changes all of your hopes and aspirations,” Woodin said during Copley’s annual meeting, held Monday at Charlmont Restaurant in Morristown.

Copley’s finances haven’t been going in the right direction for some time, was Woodin’s message Monday. The organization lost $2.3 million in the last fiscal year, its fourth annual budget deficit in a row. Looked at another way, Woodin said the hospital was over budget by more than $20,000 per pay period.

That deficit followed a $2.2 million loss the year before, a $378,000 loss the year before that, and an $85,000 loss the year before that.

And then there’s five years ago, when the hospital ended the 2015 fiscal year with a $4 million surplus. That’s a significant swing, and the state took notice, penalizing Copley for carrying such a surplus. Until now.

'Only LGBTQ-specific psychiatric inpatient program in US' Vermont's Brattleboro Retreat to stay open
Boston Spirit

Due to financial issues, Vermont’s Brattleboro Retreat has been under intense pressure to close, or severely cut back its services, reported The Keene Sentinel last week.

“In consultation with the Board of Trustees, we are exploring every avenue to change the Retreat’s unsustainable business model and reimbursement but no matter what the outcome, the Retreat, if it exists at all will be a very different organization in the future,” wrote President and CEO Louis Josephson in a letter to Vermont Gov. Phil Scott and Human Services Secretary Mike Smith, the Sentinel reported.

This is significant news for the LGBTQ community in that the mental health and addiction treatment facility—which on the whole serves about 5,400 people each year—also provides the only inpatient psychiatry program geared for LGBTQ people in the country, according to its website.

Boston Spirit reached out to the Retreat last week and this morning, Jan. 20, Jeffrey Kelliher, the Retreat’s communications and media relations manager, told us that their LGBTQ unit, called Osgood 2, “was temporarily closed earlier this month due to a drop in census…but it is open again and we are accepting patients there and in all Retreat programs.”
NEK officials look to lawmakers to address workforce crisis

Leaders in the Northeast Kingdom are mobilizing at the Statehouse next week to pass laws to make it easier for people to live and work in the state's most economically stressed region.

The Northeast Kingdom has the highest unemployment rate in the state and the state's demographic challenges are magnified in the rural region. Community leaders say that if lawmakers want to tackle the problem at its root, they need to start with the region's aging workforce.

Shawn Tester is the CEO at Northeastern Vermont Regional Hospital. He's concerned about the age of his staff. "Clinical professionals, doctors nurse practicioners, PAs, and we really struggle to fill those positions," he said.

Tester says 35 percent of the hospitals nurses are baby boomers while only 24 percent are millenials. As more and more Vermonters age says it's harder to find new doctors. He says the legislature could work on a tax credit for student loan debt, giving recent graduates a break and providing the ability to move to the kingdom.

Chamber celebrates 'great partnerships'
Brattleboro Reformer

Dick DeGray and Missy Galanes, the 2019 Brattleboro Area Chamber of Commerce's Persons of the Year and married couple, are credited with having an outsized role in making the community beautiful.

"They have a sincere love of Brattleboro that they demonstrate every day through their deeds and actions," Kate O'Connor, executive director of the chamber, said during her group's annual meeting Thursday at the Brattleboro Retreat. "In the winter, wreathes, greenery and thousands of white lights make the downtown sparkle like a holiday wonderland. In the spring, summer and fall, it explodes with vivid living colors because of their handiwork and green thumbs."

The Main Street beautification efforts began "modestly in 2012 with buckets, flowers and solicited donations" and has since become "one of the most highly prized programs of the Downtown Brattleboro Alliance funded by downtown property owners," O'Connor said. It now involves a pick-up truck, a 210-gallon water tank and DeGray starting at 3 a.m. five days a week.

Fanny Allen officials say equipment will monitor for future mystery odors

Surgeries are back on the schedule at Fanny Allen Hospital in Colchester. The operating rooms were shut down last month after employees became sick from a mysterious smell. Our Ike Bendavid got a inside look at what is being done inside to help monitor the air.

Fanny Allen operating room nurse Gwen Eckley was back at work this week. "It feels good. I had a smile on my face. We are all ready to get back," Eckley said.

She was one of the employees who got sick from a mysterious smell in October and was sent to urgent care. "I ended up having a little dizziness, nausea. My heart was pounding out of my chest," Eckley said.

She described the smell like two-stroke engine exhaust and that she felt 'hung over' and fuzzy-headed for a few days. Six weeks later, the smell and symptoms came back. "I was worse the second time, smelled a stronger smell," Eckley said.

In early December the University of Vermont Medical Center decided to shut down the Fanny Allen OR to figure out the source of the smell. They still don't know the issue.

Over 30 students attend Castleton nursing program open house
Bennington Banner

In an effort to attract new nurses to the profession and the area, Castleton University held an open house for over 30 potential students to its nursing program at its satellite campus in Bennington on Monday.

By a little before 11 a.m., potential students filled the room at the Vermont Mill building on Benmont Avenue, listening to a presentation. By 11:30 a.m., they'd gathered in small groups to ask questions of administrators and others involved in the nursing program.

Christine Becker, of Hoosick Falls, New York, said she's contemplating a return to nursing school after many years.

Twenty-two years ago, she said, she was a student in the nursing program at Hudson Valley Community College. She did not pass the required licensing exam, so she never became a registered nurse, instead working in bookkeeping and odd jobs over the years.

Kniffin: UVM Health Network affiliation boosting Porter
Vermont Business Magazine

In late November, I was interviewed by a reporter who asked for my perspective regarding the topic of hospital “consolidations,” and to discuss some national studies that indicate that hospitals coming together means higher prices for patients. The reporter wanted to hear about Porter’s experience as an affiliate of the UVM Health Network since we joined the Network in early 2017.

I am not a healthcare finance expert nor a student of national trends. I am, however, intimately familiar with our finances here at Porter and what is happening locally and in our region.

Each of the three years since affiliation, Porter has had a zero percent increase in price for patients. The rates that we have negotiated with third-party insurance payers have been in the range of 2.5% to 3% — well below the rate of medical inflation. Our budget, which includes both the Price and Rate, has been within the guidelines laid forth by the body charged with containing health care cost in Vermont, the Green Mountain Care Board. I cannot prove that a 0% price increase is a direct consequence of affiliation but I am confident that our relationship within the UVM Health Network played a significant part. So, from a Porter perspective, the premise of the interview did not align with our actual experience.

To be sure, driving down the cost of healthcare for patients is essential and is in fact a strategic priority of the UVM Health Network. Porter is a Critical Access Hospital leader in payment reform initiatives and in the efficient delivery of clinical services, and we are proud of that. But there is even more to affiliation than dollars and cents.

People in the News
Mark Your Calendar!
Wednesday, January 29, 8 am
State House, Montpelier

Friday, February 7
Bromley Mountain Ski Resort, Peru

Wednesday, February 12, 8:30 a.m.
Pavillion Auditorium/State House, Montpelier