Legislative Update
Devon Green, VP of Government Relations

I get it. No one wants to talk about COVID anymore. Let’s put this thing in the rearview mirror and move on with our lives, but a lot of the health care workers I’m talking to are more demoralized than ever as we continue to deal with capacity issues and various shortages from COVID therapeutics to blood. If you encounter someone in the health care field, please give them a kind word.

Workforce: The Director of Health Care Reform presented the workforce initiatives from Governor Scott’s FY ’23 budget to the House Commerce and Economic Development Committee, including:
  • $3 million to expand nurse scholarship programs
  • $2 million to expand nurse student loan repayment programs
  • $1,000 refundable tax credit for nurses
  • Creation of a state marketing campaign to attract health care workforce from outside Vermont and to increase enrollment in health care education programs
  • Investments in childcare and housing
Rep. Mari Cordes also advocated for additional initiatives to address the nursing shortage, including:
  • Required wage increases and a state wage standard
  • Available childcare in the workplace
  • Mandated leave benefits
  • LNA to RN bridge program
  • Greater transparency of hospital executive pay
The committee plans on taking additional testimony on health care workforce initiatives.

Mental Health: VAHHS testified in support of bills S.194, peer-operated respite centers, S.195, certification of mental health peer support specialists, and S.197, coordinated mental health crisis response working group, in the Senate Health and Welfare Committee. VAHHS broadly supports more coordination and resources across the mental health care continuum. For the coordinated mental health crisis response working group, VAHHS urged the committee to have the workgroup address the issue of patients who have assaulted health care workers being returned to the same emergency department to await in-person treatment.

No Surprises Act: The Department of Financial Regulation provided a high-level overview of the federal No Surprises Act and its proposal to enforce the federal law at the state level. The Department of Financial Regulations envisions a complaint-based enforcement process. The Vermont Medical Society and Bi-State Primary Care testified on the difficulty of implementing the new federal requirements and the Department of Financial Regulation said it will work with providers prior to any punitive actions. The House Health Care Committee drafted H.489 to move this framework forward.

Telehealth: The House Health Care Committee took up H.655, which creates a tiered approach to telehealth licensure, which would take effect on July 1, 2023:
  • 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
The current telehealth flexibilities remain in effect until March 31.th From April 1st until March 30, 2023 health care providers must undergo a quick registration process to practice telehealth in Vermont under H.654.

Health Care Regulation: Donna Kinzer, the consultant hired by the legislative Task Force on Affordable, Accessible Health Care presented recommendations to manage costs and improve the health care delivery system to the Senate Health and Welfare Committee, including:
  • Allocating funding the Green Mountain Care Board to hire a consultant to perform per capita benchmarking analyses to compare Vermont nationally and peer-to-peer, as well as an analysis of avoidable utilization and waste. This analysis will cost $500-$750k.
  • Expanding fixed global payments to further move away from the fee for service system. This work will cost $2M-$5M.
  • Escalate the process for data model options and strategies to drive care delivery transformation and cost containment.
Prohibition of Firearms in Hospitals: The House passed the latest version of S.30, which prohibits firearms in hospitals and closes the “Charleston Loophole.” The bill will now head back to the Senate.
In the News
Welch and Others Urge Investigation of 'Exorbitant' Travel Nurse Prices
Seven Days

Nearly 200 federal lawmakers — including Rep. Peter Welch (D-Vt.) — are urging the White House to investigate agencies that employ travel nurses, suggesting that the “exorbitant” rates charged during much of the pandemic may amount to illegal price gouging.

The bipartisan group of lawmakers, led by Welch and Rep. Morgan Griffith (R-Va.), cited reports of travel nurse staffing agencies doubling or tripling their rates during the thorniest months of the pandemic in attempts to profit off the crisis.

In a letter to the White House COVID-19 Response Team, the lawmakers asked for a federal investigation of these price increases to determine whether they violate any anti-competitive or consumer protection laws.
Blood shortage now a 'crisis,' hospital supplies short
The Islander

According to officials with the American Red Cross, hospitals in Vermont are experiencing a blood shortage akin to a “crisis.”
In an interview with The Islander, Bradley Howort from an American Red Cross branch in Burlington said the region’s blood shortage had left hospitals with less than a day’s worth of blood for surgeries, as opposed to the five-day supply preferred by most hospitals.

“What that means is that elective surgeries might be postponed,” Howort said. “If someone needs a transfusion, they might have to wait on it.”

The shortage, seen in much of the U.S. as well as in Vermont, was deemed a “national crisis” by the American Red Cross, the first time the nonprofit organization had ever declared a crisis over a shortage in blood donations.
Vermont House advances hospital gun ban, strengthened background checks

The Vermont House on Thursday gave preliminary approval to legislation banning guns from hospitals and strengthening background checks for those purchasing firearms. The vote was 97-49 in favor.

A more limited version of the bill, S.30, passed the Senate in March, but the House tacked on a provision closing the “Charleston Loophole.” That allows a person to buy a gun whether or not they pass a federal background check if the check takes longer than three days. The legislation would require a buyer to wait up to 30 days if a background check is not completed. 

Though the bill has been favored by gun-control advocates, it includes a concession to supporters of gun rights: It would allow out-of-staters to bring high-capacity magazines into Vermont for shooting competitions.
In Super-Vaxxed Vermont, Covid Strikes — But Packs Far Less Punch
Kaiser Health News

Even Eden, a snow-covered paradise in northern Vermont, is poisoned by omicron.

The nearly vertical ascent of new coronavirus cases in recent weeks, before peaking in mid-January, affected nearly every mountain hamlet, every shuttered factory town, every frozen bucolic college campus in this state despite its near-perfect vaccination record.

Of all the states, Vermont appeared best prepared for the omicron battle: It is the nation’s most vaccinated state against covid, with nearly 80% of residents fully vaccinated — and 95% of residents age 65 and up, the age group considered most vulnerable to serious risk of covid.
Vermont health professionals explain COVID's toll on mental health

Mental health is a phrase we hear a lot these days, as we head into the Covid-19 pandemic's third year. A recent University of Vermont study found that nearly half of respondents indicated anxiety or depression during the pandemic. But a shortage of psychiatrists and counselors means help isn't always available. This hour, we talk with Vermont health professionals and others about the mental health hurdles children and adults are facing.
Our guests are:

  • Andy Rosenfeld, assistant professor and child psychiatrist at University of Vermont Medical Center
  • Cath Burns, independent psychologist and quality director at Vermont Care Partners
  • Tom Murphy, co-founder of Sweethearts and Heroes
How are Vermont’s hospitals faring?

The surge in new COVID patients in the state appears to be subsiding, but health care providers say they have a long way to go as new challenges continue to arise.

Dozens of patients are stuck at the University of Vermont Medical Center in Burlington, waiting to get into nearby nursing homes. Many in the region have not been accepting new patients for more than 10 days.

The hospital’s blood supply has also reached a critical low. The gift shop has been converted into an area for employees to donate blood.

More staff are out at Southwestern Vermont Medical Center in Bennington than at any point in recent weeks, while staffing levels have improved at other hospitals.
Vermont reports 14 straight days with more than 100 Covid patients in the hospital

The Vermont Department of Health reported that 108 people were hospitalized for Covid-19 as of Thursday, with 27 people in intensive care.

That’s a drop from 115 Covid patients on Wednesday, and well below the peak of more than 120 patients a few weeks ago. But the state has reported 14 straight days with more than 100 people in the hospital for the virus, by far the worst streak since the pandemic began.

Hospital staff and administrators have reported significant strain on their systems as the rise in Covid patients coincides with serious staff shortages.

The health department also reported 1,490 new Covid cases on Thursday, leading to a seven-day average of 1,053 new infections per day — a slight uptick from Wednesday, when that figure was just over 1,000. The number of people testing positive tends to increase later in the week because of testing patterns.
Hospitals in the News