Message from the CEO
Tough Times, Signs of Strength

Last week was busy, like most have been since the pandemic arrived almost a year ago. In Vermont we worked hard to continue vaccinating the general public. Hospitals, physicians and public health officials closely monitored counties where case counts have been high or growing. 

We also saw some snow, but nothing worrisome or out of the ordinary for our state. In other parts of the country, however, unusual snow and ice presented instant and dangerous challenges. 

As people in Texas struggled for power and water, hospitals too faced difficult, if not dire, circumstances.

From the Washington Post: 

“In a stretch of Southeast Texas from Houston to Corpus Christi, 45 of roughly 100 hospitals declared an ‘internal disaster’ status Wednesday night to dissuade emergency medical crews from taking patients to them. The area is home to about 8 million people.”

At Houston Methodist Hospital, according to the Post, staff members used a “swiftly rigged system to sluice rainwater from the roof into a large laundry bin, then used it to fill buckets and flush toilets.”

Since the onset of COVID-19, we have become accustomed to seeing problems and finding fixes. Hospitals have all but moved mountains to respond to the pandemic in real time while also creating a safe space for urgent, emergent and routine health care.

Non-pandemic emergencies and problems did not take a break to accommodate COVID. Here in Vermont, a massive cyberattack hit our academic medical center, and the mental health and opioid addiction crises continue. Parts of the country have managed civil unrest and violence. Now, our friends in Texas and other states are working through rare storms, severe cold, power outages and water shortages. 

Hospital leaders there are doing everything they can to keep their facilities running and their patients safe. And, thankfully, they are not alone. This headline from the Texas Hospital Association’s daily newsletter, caught my eye: “Texas Restaurants Offer Food to Hospitals.” The article included a link to sign up for assistance and coordination. 

Restaurants hit hard by the pandemic still stand ready to help fuel hospitals through the tough winter. Here at home, they’ve similarly been stepping up since last March. It is encouraging to see people in Texas and elsewhere working together to fill gaps, meet need and deliver care—whether it be a hot meal, a hospital bed, a vaccine vial or a home health visit.

igns of pain and suffering are all around us, but so too are signs strength and perseverance. We just need to keep looking for those. And help create them. Have a good week.
Legislative Update
by Devon Green
VAHHS Vice President of Government Relations

COVID-19 continues to double the fun of the legislative process, and the budget is no exception. In addition to the to the regular FY 2022 budget, legislators are also considering a fast-track budget comprised of one-time funds to address immediate needs related to COVID-19 and to jumpstart projects that are ready to go. Within this bill, the House Health Care Committee recommended $10.5 million to expand the health care workforce, respond to urgent mental health needs, and address health care disparities. The House Health Care Committee recommendations break down to the following:

Workforce$5 million
  • $3 million over three years for the nursing and primary care scholarship program, a legislative priority for VAHHS
  • $2 million to bring Vermont Technical College’s LPN program to skilled nursing facilities to train current employees
Mental health needs$5 million
  • $5 million to the Department of Mental Health to distribute for organizations providing housing supports in community settings
  • $850,000 in urgent case management at designated agencies and specialized services agencies
  • $150,000 for training of front-line health care workers
Health care disparities$500,000
  • $66,000 to the Green Mountain Care Board to make payer reporting of race and ethnicity data possible in the all-payer claims database
  • $134,000 for other demographic data reporting
  • $300,000 to the Department of Mental Health for grants to peer-led organizations and organizations supporting the needs of LGBTQ youths to address COVID-19- related needs. 
The House Health Care committee recommended that anything not included from this list in the fast track COVID-19 budget bill should be included in the regular FY ‘22 budget.
 
Last Week

Nurse Tax Incentives: The House Ways and Means Committee was skeptical of the Administration’s proposal to provide three years of graduated state income tax exemption to recent graduates of nurse education programs. The program would provide 100 percent state income tax exemption in the first year after graduation, 70 percent the second year, and 50 percent the third year. The committee is not convinced that such a tax exemption would incentivize individuals to enter nursing programs, but the committee may entertain other proposals such as tax credits instead of a tax exemption.
 
Audio-only telehealth: Testimony from Bi-State Primary Care supported the current proposal to continue covering and reimbursing audio-only telehealth to ensure access to patients who currently rely on audio-only care that is the same as an in-person visit while also maintaining “triage calls” that are reimbursed at a lesser amount. As with current treatment, health care providers are held to the same standard of care under audio-only, so patients are not in danger of receiving lesser quality care. 
 
This Week

Interstate Nurse Licensure Compact: The Senate Health and Welfare Committee may vote this bill out of committee. 
 
Addressing disparities and promoting equity in the health care system: The House Health Care committee will be hearing testimony from Xusana Davis, Executive Director of Racial Equity and Maria Mercedes Avila, Ph.D, Assistant Professor of Pediatrics and Adjunct Assistant Professor of Nursing at the University of Vermont, and the keynote speaker at VAHHS’s 2020 Annual Meeting.

Extending COVID-19 regulatory flexibilities: The Senate Health and Welfare Committee will review the bill and decide whether to include continued coverage and reimbursement for audio-only telehealth.
In the News
Vermont removing travel quarantine requirement for those with both vaccine doses
NBC5

Vermont's top officials announced Friday that they plan to ease some of the state's travel guidelines for anyone who has received two doses of a COVID-19 vaccine.

Effective Tuesday, anyone at least two weeks removed from their second shot will not be required to quarantine following out-of-state travel. Those visiting Vermont who have completed inoculation will also be exempt if they can provide proof of their vaccinations.


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"I want to be very clear: We're going to do this carefully and methodically like we have throughout the pandemic, and I'm asking for your patience as we work our way through this process," Scott said.

The change follows more than three months under one of the most stringent travel policies in the nation that barred out-of-state travel without at least a week of quarantine. It was attributed, in part, to a decision from the Centers for Disease Control and Prevention that said anyone who has completed both doses and a two-week immunity period should not be required to quarantine.
Vermonters age 70 and over rush to register for Covid vaccines
VTDigger

A flood of Covid vaccine signups by Vermonters 70 and older has caused long wait times and glitches in the state’s website.

Registration opened at 8:15 Tuesday morning. Within 15 minutes, the Vermont Department of Health received 7,000 calls to sign up. By late Tuesday afternoon, nearly 19,000 Vermonters, close to 60% of eligible people in that age group, had signed up for an appointment.

The health department warned of long wait times “as the call center works full bore to schedule appointments.”

“I urge you to remain patient,” said Mike Smith, secretary of the Agency of Human Services, noting that average caller wait times hovered around five minutes, though the wait was somewhat longer when the system was jammed.

The state has offered three ways to sign up: Through the Department of Health, Walgreens and Kinney Drugs. By noon, Kinney Drugs was scheduling appointments more than five weeks out.

Drop in long-term care COVID patients freeing up UVM Medical Center beds
WCAX

The head of the UVM Medical Center says the number of COVID patients in his hospital is down.

At a press conference with Burlington Mayor Miro Weinberger Friday, Dr. Stephen Leffler said a dramatic drop in outbreaks at Chittenden County long-term care facilities is having a positive impact on hospital capacity.

“In the hospital today, we do have 11 COVID patients. Over the past week or so we’ve been running around 10 to 12 in that range. That’s less than it was two weeks ago when I was telling you we had 21 or 22. We do have five in our ICU today. That’s a little higher than it’s been but we have plenty of beds, plenty of ventilators, plenty of capacity. So, from a hospital capacity standpoint, we’re in very good shape on COVID,” he said.

Leffler urges everyone to get the vaccine when their turn comes no matter what type is offered.
A costly donation: How organ transplant patients pay for lifelong medications
Rutland Herald

After receiving an organ transplant — for the rest of their lives — patients must take medications to keep their bodies from rejecting the new tissue. These medications are expensive and some aren’t covered by insurance, leaving people to raise funds or seek other forms of financial help.

The Health Assistance Program at UVM Medical Center serves about 1,200 people who need help paying for medications, said Erin Armstrong, manager of community benefits at the hospital.

Armstrong said it varies from person to person what their insurance will cover, if they have it.

“We serve anybody, you don’t have to be a medical center patient to give us a call to see if you qualify,” she said. “We enroll people who are under 400% of the federal poverty level. So we’re really able to help a lot of people above what the standard would be for food stamps or things like that.”
Vermont Conversation: Drug overdoses break records in ‘the other epidemic’
VTDigger

As the Covid-19 pandemic grinds into its second year and dominates headlines, another epidemic rages in silence, hardly mentioned in the major media: opioid overdoses. A new study indicates that nationally, emergency department visits for opioid overdoses were up 29% last year. According to the CDC, 81,003 people died from drug overdoses in the 12-month period ending last June: a 20% increase and the highest annual number of fatal overdoses ever recorded in the U.S.

Vermont is also breaking overdose records: 134 Vermonters died from overdose deaths as of November 2020, compared to 99 deaths in that period the previous year.

Covid-19 is playing a role in this overdose crisis. Isolation, economic turmoil, and stress can all trigger relapse and addiction. At the same time, many support systems and treatment options have become unavailable.

We discuss the overdose crisis and possible solutions, including drug legalization and harm reduction efforts, with Vermont Attorney General TJ Donovan, anti-poverty and opioid policy advocate Brenda Siegel, Rep. Selene Colburn and Chittenden County State’s Attorney Sarah George. And we hear about the personal experience of addiction, homelessness and recovery with Jedediah Popp, co-director for the Windham County Consortium on Substance Use, who is in recovery from substance use disorder.

Vt.: Heavy volume of phone-ins on first day of 70-older vaccines
The Sun

As of 8:15 a.m. Feb. 16, scheduling for the 70 and older age group for COVID-19 vaccination opened. In just the first 15 minutes the Health Department received more than 7,000 calls from people making appointments to be vaccinated.

People may experience long wait times (and some are getting all circuits are busy) as the call center works full bore to schedule appointments.

Given this call volume, the Department suggests people go online at healthvermont.gov/MyVaccine(link is external) to make their appointments, and thanks callers for their patience. Everyone will get scheduled and there are enough appointments for all.
Hospitals in the News
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