Message from the CEO
The last couple weeks have shown how the COVID-19 fight continues and evolves. On the concerning side: Vermont has recently experienced more patients hospitalized with COVID than at any time in the pandemic. New virus variants around the world—already finding their way to the U.S.—can make COVID even more contagious and dangerous.
On the positive side: Vermont’s vaccine rollout continues moving forward effectively and is protecting more people every day. Even with the federal supply still so blurry and unpredictable, nearly 11 percent of state residents have received their first dose of a vaccine. That keeps Vermont near the top of the list when it comes to administering vaccine.
The main reason for this progress, and for Vermont’s success throughout the pandemic, is collaboration. It may sound cliché or convenient to talk about people working together during tough times. But it is no exaggeration here. Health care leaders and providers are doing well in the effort to defeat COVID because they are doing it together.
Just a few examples of amazing collaboration from recent days and weeks:
  • Rep. Peter Welch paid a virtual visit to Vermont’s hospital lab directors, who have been convening for months to share ideas, information and sometimes even supplies and equipment. Our good friend Peter thanked the lab leaders for their commitment, saying that their critical, behind-the-scenes work has fueled the pandemic response.
  • State health and emergency management officials coordinated with leaders at Southwestern Vermont Medical Center, as well several regional hospitals in Vermont and two other states, to help move patients as SVMC experienced a COVID surge.
  • Hospitals are stepping up to continue vaccinating the general public, working closely and creatively with the state of Vermont, one another and area health care providers to safely and quickly inoculate as many people as the supply will allow.
  • The state’s network of non-profit home health and hospice agencies has partnered with emergency medical services (EMS) teams to begin home vaccinations this week for Vermonters 75 and older who are homebound and unable to go in person to the state’s vaccination clinics. Taking doses out into our communities is a complex undertaking, but together, they will reach even the most rural and remote corners of Vermont.
Vermont stands out for so many reasons; among them its spirit of genuine collaboration. I see it every day at the hospital association as our state and health care leaders grapple with the toughest issues imaginable, but keep their cool and work constantly to maintain a collective, rather than splintered, response.
To accelerate the march toward a post-COVID Vermont, we have to stay together. And, of course, we have to honor the time-tested phrase: six-foot spaces, masks on faces, uncrowded places. It has worked so far.
Legislative Update
by Devon Green
VAHHS Vice Preident of Governmental Relations

Sometimes legislative resolutions have so many “whereases” and words that the sentiment can get lost during the formality. This was not the case last week, when the full House and Senate passed a simple resolution recognizing the unwavering dedication of Vermont’s health care workforce during the COVID-19 pandemic. More importantly, both the legislature and administration have supported this sentiment with regulatory flexibilities and funding throughout the entirety of the pandemic. I’ve talked to my counterparts in other states as they battle legislation prohibiting mask requirements and have openly fought with their Departments of Health. Whereas, VAHHS and its hospitals continue to be grateful for a legislature and administration that listens to and supports its health care workers. Resolved: Thank you.

Last Week

DVHA budget: The Department of Vermont Health Access presented a budget with an $18.5 million increase in budget to the Senate and House Appropriations Committees. A large portion of this increase, $16.9 million, is due to an increase in caseload and utilization changes. DVHA is also starting to implement a federal requirement that shifts federal funding for inpatient psychiatric care hospitals, or IMDs, to the state with a $56,000 technical change.

DMH budget: The Department of Mental Health presented a budget to the House Committee on Appropriations with a $45 million increase, including payment reform, $2.5 million to annualize the cost of the Brattleboro Retreat’s level-1 beds slated to open in FY 2022, and replacement of the Middlesex secure residential facility with a new building where Woodside Juvenile Rehabilitation Center is currently located.  

Regulatory flexibilities: The Senate Health and Welfare Committee took testimony last week on extending current COVID-19 regulatory flexibilities under Act 91 and Act 140 around licensure and insurance coverage. The coalition of Vermont health care associations testified in favor of extending these provisions, and the Office of Professional Regulation proposed extending the regulations to a date certain—March 2022—to avoid confusion while allowing time for the legislature to step in and make changes during next session if necessary.  

Suicide Prevention: The Department of Mental Health presented their comprehensive initiative to reduce suicides, Vermont Addressing Suicide Together (VAST). Several legislators noted DMH may want to reconsider the name due to confusion with the highly popular Vermont Association of Snow Travelers. Efforts include transitioning the National Suicide Hotline phone number to a three-digit number—988—starting in July 2022 and having calls answered in Vermont with local Lifeline Centers.  

This Week 

Audio-only Telehealth: House Health Care will likely vote on extending audio-only telehealth coverage and reimbursement beyond the COVID-19 state of emergency.
In the News
Vermont health care workers headed to Super Bowl
WCAX

The last year certainly has not been pleasant for health care workers.

“The staff had to not only be there for their patients and support the fear and anxiety that their patients were going through, but they were going through it themselves,” said Kristin Baker, the emergency department nurse manager at the UVM Medical Center in Burlington.

“We have limited our contacts obviously, limited who we’re around for the last year,” added Lyndi Demico, a registered nurse at Northeastern Vermont Regional Hospital. “Me and my husband and son, we’ve been very diligent about it.”

The sports world has been largely spared the worst effects of the COVID-19 pandemic, but teams and leagues around the world have had to adapt as well.

“We’re big hockey fans,” Baker said. “When the NHL figured out how to create a bubble for the playoffs, I don’t think I’ve ever looked forward to sports so much because it was just such a wonderful distraction. So odd to see a stadium completely empty.”

But it would have been too weird to see empty stands for the biggest game in American sports, so the NFL found a way to kill two birds with one stone. The league allocated 7,500 free tickets for vaccinated health care workers to attend Super Bowl LV in Tampa. Robert Kraft and the Patriots will personally fly 76 New Englanders down on the team plane, including Baker and Demico.
State employee health care plan to participate in ACO
Vermont Business Magazine

The State of Vermont finalized an agreement with Blue Cross and Blue Shield of Vermont to support the state’s All Payer Model health care payment and delivery system reform effort by attributing the members of the State Employees Health Plans to OneCare Vermont, the Accountable Care Organization (ACO), for the 2021 plan year.

BCBSVT is the administrator of the State of Vermont’s self-insured employee health plans and has a contract with OneCare to enable its commercial and self-insured customers to easily attribute members to the ACO model. An estimated 13,300 Health Plan members will be newly attributed to the ACO model.

The Administration thoroughly examined the ACO program offered by OneCare Vermont to ensure the attribution of members will not impact employee benefits, premiums, co-pays, or the financial health of the Plans.

The Administration also worked closely with the Benefits Advisory Committee, a joint union and management committee created to advise the Administration on issues related to the State Employee Health Care Plan and crafted an agreement with BCBSVT that included input from the Committee.

State of Vermont employees will have the option to “opt out” of sharing their information with OneCare.
State auditor sues OneCare Vermont in effort to obtain salary information
VTDigger

State Auditor Doug Hoffer has sued OneCare Vermont after the company refused to hand over salary information.

Attorney General TJ Donovan filed the suit on Hoffer’s behalf on Wednesday, trying to force OneCare to provide payroll data from 2019 and 2020 — including 1099s, W2s, and benefits information — to the state for review.

OneCare is obligated to provide the documents, the state argued in its filing. The private, for-profit company is under contract with the state to distribute Vermont’s Medicaid money to doctors and hospitals, and the agreement requires that the company submit to state or federal audits.

“When you sign a contract, you have to comply with all the terms, not just ones that you like,” Hoffer said in an interview Wednesday. OneCare has refused to provide the information for more than a year, he said.

“They are not above the law,” Hoffer said. “This is troubling, actually. It’s about nothing more than transparency and accountability.”

OneCare CEO Victoria E. Loner denounced Hoffer’s request as “baseless overreach.”

“It really intrudes upon our employees’ privacy,” she said. “We intend to fight this request.”

Picturesque and unpolarised: how Vermont crushed the coronavirus
Sydney Morning Herald

Until recently, Vermont was best known to outsiders as America’s biggest manufacturer of maple syrup, the birthplace of Ben and Jerry’s ice cream and the home of progressive icon Bernie Sanders.

But over the past year Vermont has gained national recognition as the US state that has done better than anywhere else at keeping the coronavirus pandemic under control.

It’s a rare bright spot in a country that has recorded over 430,000 coronavirus deaths - the most in the world in absolute terms and one of the highest on a per capita basis.

With just 172 COVID-19 deaths since the start of the pandemic, Vermont has the country’s lowest per capita death rate according to Johns Hopkins University - outperforming even the island state of Hawaii and sparsely populated Alaska. The death rate in neighbouring New Hampshire is almost three times as high and ten times as high in neighbouring New York and Massachusetts.

In September Anthony Fauci, the country’s top infectious diseases expert, praised Vermont as a “model for the country”, saying it had shown other states “that you can actually start opening up the economy in a safe and prudent way”.

Mark Levine, Vermont’s health commissioner, tells The Sydney Morning Herald and The Age: “We have our share of tragedy like everyone else but we’ve been applauded for doing well compared to the rest of the country.”
Vermont cases slowly decline, but many people are still hospitalized
VTDIgger

Vermont reported 113 cases of Covid-19 Monday, in line with the average over the past few weeks.

The state’s numbers have slowly dropped from the peak they hit around Jan. 6, according to the latest Department of Health data.

The state’s test-positivity rate has gone down to 2%, another sign that the state has turned the corner on combating the virus. National and regional positivity rates and case numbers have also declined, according to analysis from the Department of Financial Regulation last week.

But even as case numbers decline, hospitalizations have remained stubbornly high. The state reported that 60 people are hospitalized with the virus as of Monday, one of the highest numbers since the start of the pandemic. Six people are in the ICU.

New vaccine clinic at Brattleboro Memorial Hospital offers relief
Brattleboro Reformer

Under a contract with the state, a new clinic at Brattleboro Memorial Hospital is getting COVID-19 vaccines to older community members.

“It’s kind of a relief,” Helen Robb said Wednesday in the observation room, where a nurse is on standby to see if patients are having adverse reactions.

“It truly is a relief,” said Charlie Robb, her husband.

Helen and Robb own the Robb Family Farm in Brattleboro. They were one of the first few community members to get shots at BMH as part of the state’s next round of vaccinations focused on Vermonters who are 75 and older.

Rutland Regional Medical Center to become vaccine site Wednesday
WCAX

VRUTLAND, Vt. (WCAX) - Starting Wednesday, the Rutland Regional Medical Center will be a COVID-19 vaccination site.

The site will be open Wednesday through Saturday, 1 p.m.-6 p.m., for people 75 and older.

The hospital will administer between 850-900 shots over the four days each week.

With Vermont Gov. Phil Scott’s announcement of allocating more doses across the state, the hospital says it expects to provide more shots to people in the region.

Vaccine outreach ramps up to reach Vt. immigrant communities
WCAX

As more Vermonters get vaccinated for COVID-19, there is a push to make sure immigrant communities are getting the correct information in the correct languages they need.

The Vermont Department of Health and the UVM Medical Center are spearheading multiple info sessions on the vaccination effort similar to four that have already been held. It comes after officials last fall heard from more than 100 members of immigrant and refugee communities about how to improve the state’s response after criticism from some that outreach at the start of the pandemic was lacking.

“The vaccines are pretty safe for anybody to be able to access them right now, so we just try to reinforce this idea for everybody,” said Dr. Mercedes Avila with the UVM Medical Center. Dr. Avila along with Karen Vastine has been working with new American communities making sure everyone is getting the correct information.
105-year-old Colchester woman lines up for opening of Expo vaccination clinic
WCAX

The UVM Medical Center Wednesday began vaccinations for Vermonters 75 and older at the Champlain Valley Expo.

Among the first 160 people through the door for a shot was 105-year-old Sophie Connors of Colchester. She lived through the Spanish flu pandemic in 1918 and said getting the COVID-19 vaccine made her “feel good and secure.”

“It’s the thing you have to do to get rid of this COVID. You have to get your shot, wash your hands, wash your hands, wash your hands, and keep your distance -- and get your shot!” she advised.
Hospitals in the News
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