Legislative Update

Devon Green, VP of Government Relations

Senate Appropriations beat expectations by voting the budget out on Friday, which signals that the session will go at a frenetic pace until the expected adjournment date of May 6.
Health Care Reform: A coalition of health care provider associations, including VAHHS, testified in House Health Care last week against S.285, a bill that provides $4.45 million to the Green Mountain Care Board and $550,000 to the Agency of Human Services to develop alternative payment models, including hospital global budgets, and lead a community process on the sustainability of the hospital and health care system. VAHHS testified that the new payment models presented would not address the more immediate and critical issues of workforce, mental health, and patients who are ready for discharge but do not have access to long term care services, and funding is better invested in those areas. The coalition highlighted that it does support the work of the All-Payer Model and views this as the vehicle for change. The committee will take up the bill again this week.
Workforce: The Senate Economic Development Committee considered moving the nurse and physician assistant loan repayment program to the Area Health Education Centers Program (AHEC), and will continue to work on the workforce bill, H.703, this week.
Mental Health: It looks like the version of the budget passed out of the Senate Appropriations Committee includes $500,000 to reimburse emergency departments for patients who are waiting for more than a day for inpatient psychiatric care. Typically, emergency departments get one payment because patients normally stay for a few hours. This new Medicaid rate reflects the intensity of our mental health crisis and the need for systemic change.
In the News
Vermont COVID patient spends 6 months in hospital, says of VA care, "They are the best"

It was an emotional morning at the VA Medical Center in White River Junction on Wednesday, where a COVID-19 patient was finally discharged after six months in the hospital.

Applause filled the hallway of the VA Medical Center as “Buba” Carroll Humphrey was rolled toward the exit. The team that helped save his life gave him a well-deserved send-off.

Six months ago to the day, the veteran from Island Pond was admitted to the VA after experiencing shortness of breath.

“He was quite sick,” said Dr. Peter Delong, the ICU director at the hospital. “He had bad respiratory failure and he really needed maximal medical support.”
Employer-provided housing a possible solution for filling jobs in VT
Burlington Free Press

Shawn Tester, chief executive officer of Northeastern Vermont Regional Hospital, has an ace up his sleeve when it comes to hiring traveling nurses to fill the shortage of nursing staff created by the COVID-19 pandemic.

Free housing.

"We've had a housing issue in this area for many years," Tester said. "It predates the pandemic, but then through the pandemic, as we lost nursing staff and had to lean more heavily on our cadre of travelers, we started running into this roadblock of finding housing for them. It really came to a head last summer."

Luckily, Tester was able to strike a deal with a local day and boarding high school that was no longer using one of its dorm buildings. Tester leased the dorm for a year and used it to house traveling nurses working at the hospital, free of charge.
Vermont reports rising cases, hospitalizations as BA.2 subvariant spreads

Covid-19 cases and hospitalizations continued to tick up over the past week due to the ongoing spread of the BA.2 subvariant, officials said at Gov. Phil Scott’s weekly press conference on Tuesday.

The average number of cases each day has risen 29%, to about 196 per day, Health Commissioner Mark Levine said. Hospitalizations increased as well, hitting 35 Covid patients as of Tuesday, the highest since February.

Levine said this was “not unexpected,” given that the BA.2 subvariant is even more transmissible than its viral cousin, Omicron. He also said the numbers so far are “an order of magnitude different than the original Omicron,” when the state reported a record-breaking two weeks with more than 100 Covid patients.
The Hospital on the Hill: Central Vermont Medical Center Weathers the Pandemic
The Montpelier Bridge

It seems appropriate that our hospital - the Central Vermont Medical Center - sits on a hill, above most of the communities it serves. It's not that we gaze up with reverence, for CVMC is a fallible institution filled with fallible staff. But when we or a loved one falls ill, we need hope. And by custom and intuition, the quest for hope often is attended by an upward gaze.

Seldom have we needed hope more than in the past two years. Since 2020, the Covid-19 pandemic has disrupted every semblance of life as we knew it, and has ended the lives of more than 6 million people world wide, some 980,000, Americans, and more than 600 Vermonters. (Right now - dare we say it aloud? the pandemic seems to be waning in our little corner of the world, although the BA.2 subvariant clouds the horizon.)

The Cruel Lesson of a Single Medical Mistake
The New York Times

We all carry the memory of our mistakes. For health care workers like me, these memories surface in the early morning when we cannot sleep or at a bedside where, in some way, we are reminded of a patient who came before. Most were errors in judgment or near misses: a procedure we thought could wait, a subtle abnormality in vital signs that didn’t register as a harbinger of serious illness, an X-ray finding missed, a central line nearly placed in the wrong blood vessel. Even the best of us have stories of missteps, close calls that are caught before they ever cause patient harm.

But some are more devastating. RaDonda Vaught, a former Tennessee nurse, is awaiting sentencing for one particularly catastrophic case that took place in 2017. She administered a paralyzing medication to a patient before a scan instead of the sedative she intended to give to quell anxiety. The patient stopped breathing and ultimately died.

Hospitals in the News
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