Legislative Update
Devon Green, VP of Government Relations

Second Crossover
We already had crossover for the pure policy bills, but any bill with a fee or appropriation attached to it needed to pass out of the money committees last week. As of this writing, the budget bill has not been finalized, but there were plenty of last minute amendments and maneuvering on other bills to keep us on our toes.
Workforce: The governor signed into law the FY’22 Budget Adjustment Act, which includes $15 million in a recruitment and retention grant funding program open to hospitals and other providers.
Health Care Reform: On Friday afternoon, the Senate Appropriations amended S.285 to require greater coordination between the Green Mountain Care Board and the Agency of Human Services and added oversight by the Health Reform Oversight Committee. The Agency of Human Services can only allocate $1 million to the Green Mountain Care Board prior to Oct. 1, 2022. For the Green Mountain Care Board to receive the remaining funding, the Green Mountain Care Board and Agency of Human Services must present a detailed plan for the funding that includes short-, mid-, and longer-term strategies to address workforce challenges in health care and human services to the Health Care Oversight Committee by Oct. 1, 2022.
Mental Health: The Senate Appropriations Committee advanced S.195, the bill that creates peer support certification and establishment of four new peer-operated respite centers. Funding for the respite centers is still to be determined in the budget.
Freestanding Birth Centers: The Senate Finance Committee had a last-minute amendment to eliminate the explicit addition of freestanding birth centers to the Certificate of Need process. Some senators were concerned about continually adding new services to the Certificate of Need process. Sen. Cummings noted the potential impact of freestanding birth centers on the financial viability of hospital birthing units and that money committees do not typically do policy work without hearing from witnesses. Ultimately, the amendment failed, but VAHHS suggests that any service with regulations requiring that hospital services be accessible, such as ambulatory surgical centers and birth centers, should undergo a CON process.
In the News
Vermont hospitals take a DIY approach to the housing crisis

When Northeastern Vermont Regional Hospital’s chief executive talks about the challenges facing his organization, housing is near the top of the list.

“It’s really astounding,” Shawn Tester, who heads the hospital in St. Johnsbury, said last month. “ … We ended up having to rent a dorm from one of our local high schools for travelers because there’s literally no place for them to live when they come work at the hospital.”

Tester has plenty of company. Every one of the leaders who spoke at a Feb. 16 press conference organized by the Vermont Association of Hospitals and Health Systems had a housing story to tell — from prospective employees who backed out of job offers for lack of housing to existing staff struggling with the state’s meager options. 
Rutland Regional hospital projects $7.6 million operating loss due to COVID-19

Vermont is at the tail end of its most potent Covid-19 wave to date, but the pandemic’s financial implications continue to squeeze the state’s hospitals. 

The latest budgetary pressure point will be on display this week when executives from Vermont’s second-largest hospital ask state regulators to allow a 9% increase in service charges on commercial insurers — on top of the 3.6% regulators approved at the beginning of the fiscal year. 

Rutland Regional Medical Center executives say inflation and the surging cost of personnel will cause a projected $7.6 million operating loss in the current fiscal year. 

Rutland Regional’s chief executive and president, Claudio Fort, outlined the situation in a March 11 letter to the Green Mountain Care Board. Fort warned of painful cuts in necessary clinical services if the board rejects the hospital’s request. But if the care board approves the request at Thursday’s hearing, people with commercial insurance could face ballooning insurance premiums next year. 
Updated COVID-19 recommendations for Vermont

Health officials have announced that starting on Monday, March 14, the COVID-19 public health recommendations have been updated. Previously, guidance recommended wearing a mask in all indoor public spaces, but the new guidance recommends Vermonters to consider their circumstances and risk in deciding what precautions to take, including wearing a mask around others.

Those who have tested positive should isolate for five days, regardless of vaccination status or whether they are symptomatic and no longer need a negative test to end isolation or need to wear a mask for an additional five days after isolation.

Those who have been in close contact with someone who has tested positive are no longer required to quarantine, however, if they are not vaccinated or up-to-date with vaccines, they should get tested five days after contact. Anyone who has been in close contact should get tested if they develop symptoms, regardless of vaccination status.

Vermont by Degrees: Nursing expands in the NEK
Times Argus

It is no secret that hospitals and health care providers around the state are in dire need of skilled nurses. In Vermont, professional nursing is the largest single segment of the health care workforce. And nursing provides a good, high-paying job for those who choose this profession. Highly skilled nurses can have their choice of multiple sectors and many different high-paying jobs. The average nursing salary in Vermont is over $70,000 and nursing jobs abound statewide. Recognizing the intense need for nurses that our hospitals and health care providers have, and the quality of jobs that the nursing profession provides, Northern Vermont University (NVU) recently announced the expansion of a Vermont Technical College (VTC) nursing program at the Lyndon campus, fulfilling a much-needed gap in northern Vermont.

Last fall, NVU, VTC and Northern Vermont Regional Hospital received a $240,000 grant from the U.S. Department of Commerce’s Economic Development Administration awarded to Vermont State Colleges to expand NVU’s nursing program. Under this expansion, NVU’s Vail Hall will be transformed into the Clinical Nursing Education Center complete with nursing instruction classrooms and skills and simulation lab spaces. The center will allow students to practice, research, learn and succeed in their nursing studies.

Projecting Millions in Losses, Vermont's Largest Hospitals Ask for Rate Increases
Seven Days

Vermont’s three largest hospitals are projecting tens of millions of dollars in losses this year amid rising labor costs and record inflation. They want help covering their budget gaps and have asked state regulators for permission to demand higher payments from commercial insurance companies.

Their requests, if approved, could substantially increase the cost of health care in Vermont.

“Please remember the Vermonters who are paying these staggering bills,” Sara Teachout, director of government affairs at Blue Cross and Blue Shield of Vermont, told regulators at a hearing on Thursday.

Hospitals have no say over what Medicare and Medicaid reimburse them each year, which is why the rate that they can charge commercial insurance companies is so important: It's one of the only levers they can pull to bring in more money.
Hospitals in the News
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