Message from the CEO
Opportunity for Compromise on Guns in Hospitals

Jeff Tieman, President and Chief Executive Officer

I met my friend Mark Glaze when I was a senior in high school and he was a senior in college. He hosted me on a visit to my prospective campus in Colorado Springs. Right away I knew Mark was wicked smart. He was charming. He was student body president and his charisma told me he would be so much more.
Mark Glaze
And he was. Mark went on to do amazing things. As an attorney and advocate, he led work on campaign finance reform and same-sex marriage, among other important issues. But it was his pioneering and brave work in the space of gun safety that made him a hero to so many.

A frequent guest on MSNBC and Fox News, Mark took his story to the people. He was always quick to point out that he didn’t want to prevent people from owning or using guns – he just wanted them to do so safely and without threatening or harming innocent people. His own father was a gun store owner.

Late last year, Mark succumbed to long-time personal demons when he took his own life. The world lost a giant that day. Upon learning of his death, I quickly pledged to do what Mark taught me so early and often – to be a fierce advocate. To stand up for what is right and sensible. To be strategic and careful and not afraid of my own message.

Recently at VAHHS, we worked hard to pass a bill that would ban firearms in hospitals. Caregivers can unfortunately be the victims of violence at work, and we wanted to add a measure of protection for them. The bill we supported, S. 30, passed both chambers of the State House but was vetoed last week by Gov. Phil Scott, who did not object to the hospital gun ban but another provision of the bill.

S.30 requires someone to pass a background check before they can purchase a firearm. This is a change from current law, which allows Vermonters to buy a gun if the background check is not complete in three days (referred to as the Charleston Loophole). Most background checks come through in minutes, and nearly all within the three-day time frame. Occasionally they do not, however, and if the background check isn’t complete within 30 days, the application expires and the buyer must start over.

The good news is that Gov. Scott identified a compromise at seven days. I think our lawmakers should take Gov. Scott up on his offer so we can do right by our health care heroes.

Compromise automatically means we don’t all get all we want. In this case, there is an opportunity to protect hospital personnel and address the Charleston loophole in a reasonable way. Let’s not let the perfect be the enemy of the very good on this one.

My friend Mark would have wanted me to say so.
Legislative Update
Devon Green, VP of Government Relations

Happy Town Meeting Week! The legislators are home this week to get input from their constituents and take a well-deserved break before the big crossover push. Here is where they left things:
Workforce: Thank you to all the Chief Nursing Officers who responded to our request for information on doubling the number of clinical educational opportunities. We will continue to work on this throughout Town Meeting Week.
The conference committee came to agreement on the Budget Adjustment Act—the final bill includes:
  • $25 million in continued COVID financial support, such as funding for contracted workers, to prevent closures and disruptions at facilities.
  • $60 million for health care worker recruitment and retention with grants of $2,000 per FTE. The first $45 million is allocated to long-term care facilities, home health agencies, designated agencies, adult day providers, substance use treatment providers and other human service providers. Hospitals with an identified need for funding may be eligible for $15 million if the needs of the above employers are met with the first $45 million.
Mental Health: In its recommendations to the House Appropriations Committee, the House Health Care Committee supported Governor Scott’s proposal of $500,000 in funding for a daily rate to emergency departments for patients in mental health crisis waiting for treatment.
Health Care Reform: It’s a tale of two health care reform efforts! Over on the House side, the Health Care Committee included $5 million in its budget recommendations for the Green Mountain Care Board to (1) engage a consultant to redesign Vermont’s health care system after community engagement; and (2) develop a methodology of fixed payments for hospitals, but only after engaging providers, payers and communities. The board cannot implement a new methodology before reporting back to both health care committees. 
On the Senate side, the Health and Welfare Committee took testimony on S.285, which also allocates $5 million to the Green Mountain Care Board to engage in health care system redesign with a process that is only “community inclusive” and asks the Board to develop global payments to hospitals without requiring provider or community input. VAHHS has requested to testify and is concerned about moving forward on delivery system and payment reform without the on-the-ground perspective of hospitals and other health care providers at a time when our system is fragile.
In the News
Contract Nurse Agencies Are Making Big Money in the Age of COVID-19. Are They 'Exploiting' the Pandemic?

In the 40 years that Jennie Kahn has worked as a registered nurse, the last two have been by far the most grueling.

A lot of that is due to COVID-19, which transformed health care facilities, including Thomas Health’s hospital system in Charleston, West Virginia, where Kahn works, into triage centers and forced nurses to take on an extraordinary amount of personal risk and heartache. It’s no mystery why some 18% of health care workers quit their jobs between Feb 2020 and Sept 2021, according to a Morning Consult poll.

But another reason these past two years have been so punishing, Kahn says, is that hospital nursing staffs have been subject to extraordinary churn as thousands of nurses have quit their staff positions to become contract travel nurses, where the pay is often two to four times higher. This rapid turnover has triggered a costly feedback loop: hospital administrators, facing shortages in staff nurses, spend a mint hiring contract nurses, which makes them less able or willing to increase their staff nurses’ pay. So more staff nurses quit to become contract nurses, thus further lowering nurse supply and driving demand for contract nurses. “It is a vicious cycle,” says Kahn, the hospital system’s chief nursing officer.
As Omicron loosens its grasp on Vermont, hospitals remain critically understaffed

Vermont’s coronavirus cases are trending down, but hospitals in the state continue to grapple with critical staffing shortages, federal data shows. 

As of Monday, most of Vermont’s hospitals — 10 out of 17 facilities — reported that they did not have enough staff for normal operations, according to data from the U.S. Department of Health and Human Services. Eleven hospitals in the state are anticipating critical staffing shortages in the coming week.

The staffing shortage persists even as hospitals continue to hire expensive temporary staff to fill in the gaps.

Almost 60% of Vermont’s hospitals reported serious staffing issues — the highest number in New England, federal data showed. The percentage of hospitals reporting critical staffing shortages in most states is in the low single digits, though some states lack data from a significant number of hospitals. In Pennsylvania, for example, almost 70% of hospitals did not submit a report to federal regulators Monday. 
State investigation confirms long wait times; hospitals say it's old news
Burlington Free Press

Vermont hospital executives say there's nothing new in an 80-page report released by the state last week confirming patients face months-long waits to see specialists, a problem that has long plagued hospitals here.

Hospitals face a range of challenges in reducing wait times, according to executives, including a burdensome regulatory scheme from the state that slows new building projects to a crawl, and an inability to attract new doctors and nurses to the state because of relatively low pay, a poor job market for spouses and scarce housing.

"This is not news," said Claudio Fort, president and chief executive officer of Rutland Regional Medical Center. "Many of my colleagues and I have spoken about this for years. If Vermont's nonprofit hospitals had not stepped up to the plate, over and over, there literally would be no access to specialists, but we do recognize more needs to be done."

How can we support young people in a time of isolation? Experts say: Listen
Bennington Banner

For school-aged children and teens, their formative years changed all but overnight in March 2020 because of the COVID-19 pandemic.

Students told their friends “see you Monday,” then went home to a state of uncertainty that has lingered to the present day, nearly two years later.

“Young people have certainly faced significant disruption in their lives over the past two years,” said Laura Kelloway, manager of outpatient child, adolescent and family services at the Anna Marsh Clinic at the Brattleboro Retreat.

The jobs of social workers who work with youth and the roles of school counselors also changed in a flash as the professionals grappled with how to safely help those coming of age in a time of global crisis.
Scott vetoes sweeping gun bill, offers compromise

Vermont Gov. Phil Scott on Tuesday vetoed a sweeping gun bill that would ban firearms in hospitals and extend some background checks.

The governor said he’s concerned some gun owners could get caught up in a cycle as they wait for background checks to clear, so he’s offering a compromise.

What began in the last session as a measure to ban guns in hospitals and government buildings evolved into a package of gun measures including a close to what some call the “Charleston Loophole.”

Ninety-seven percent of gun background checks clear within three days, though some can take longer. The S.30 bill would have extended the length of time those Vermonters would have to wait for a background check to clear before buying a gun from three days to 30 days.
Vermont plans policy for Covid’s endemic phase

Vermont’s seven-day Covid-19 average has hit its lowest point since Nov. 2, one of several indicators that the Omicron variant surge is trending down, officials said at a press conference Tuesday.

The state Department of Health reported an average of 220 cases per day, including 68 on Tuesday, the first time the state has reported fewer than 100 new infections since October. 

Health department Commissioner Mark Levine said during the model presentation that the numbers “continue to reinforce the improving picture of Covid-19 here in Vermont.” 

Officials have cautioned that cases could be an unreliable indicator as at-home antigen tests become more widespread in Vermont. But Levine said other data is trending downward, too.
Hospitals in the News
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