Legislative Update
Devon Green,
VP of Government Relations

There’s a saying in negotiations along the lines of “a good compromise leaves everyone unhappy.” Last week was full of tense negotiations, particularly around the health care reform bill, S.285. While everyone is walking away from that bill sufficiently unhappy, I was struck by what a joy it was to sit in-person around a table for the first time in over two years to hash things out. We’ve accomplished amazing things remotely, but nothing quite compares to the flow of ideas that happens when you’re face-to-face.
Workforce: The Senate Health and Welfare Committee recommended the following changes to H.703, the health care workforce bill:
  • $1 million over two years instead of $3 million over three years to increase nurse faculty pay
  • Nurse preceptor incentives reduced from $2.4 million to $1.4 million
  • Nursing pipeline grants reduced from $3 million to $2 million
  • Nurse and physician’s assistant loan program expanded to include dental hygienists, medical technicians, primary care physicians, child psychiatrists, surgeons and other fields experiencing workforce shortages. Increases funding from the house-passed $2 million to $3 million
  • Increased nurse faculty incentives from $500,000 to $1 million with $500,000 each going to forgivable loans and loan repayment
The Senate Economic Development Committee will continue to work on the bill and vote it out this week.
Health Care Reform: For the second time this session, a legislator compared passing a bill to the long painful process of giving birth as the House Health Care Committee advanced S.285, the health care reform bill. Amidst the discussion, AHS announced that the federal government intends to grant a two-year extension under the existing All-Payer Model agreement. The bill now includes the following:
  • $1.4 million to the Agency of Human Services to work on value-based payments for the next iteration of the All-Payer Model and report back to the legislature in January
  • $3.6 million for the Green Mountain Care Board to report back on the following in January:
  • Developing value-based payments for hospitals, including:
  • Determining how to incorporate value-based payments into the hospital budget process
  • Assessing the impacts of regulatory processes on the financial sustainability of Vermont’s hospitals
  • Plan for an engagement process around hospital sustainability
Mental Health: The House Health Care Committee advanced S.195, which requires the Department of Mental Health to help develop a statewide peer support specialist certification program. The Department of Mental Health must report back with its recommendations by December 15.
In the News
Why Vermonters carry less medical debt

Medical debt continues to hang over the heads of Americans. The average American with bills in collections are behind nearly $800. In 2019, Vermont hospitals reported $85 million in uncollected medical bills. That sounds like a lot of money, but on average, Vermonters are actually carrying a lot less medical debt than people in most of the country.

Data compiled by our investigative team shows that 5.1 percent of Vermonters have medical debt that has gone into collections. That compares to 13.9 percent nationally. While six states have more than 20% of their citizens in collections. Experts say that’s because Vermont is one of the best-insured states in the country. But even with good insurance can come crippling out-of-pocket costs for care.
Vermont nurses worry for future incident reporting following Vought conviction

Last month, former Tennessee nurse RaDonda Vaught was convicted of negligent homicide after giving a 75-year-old patient the wrong medication in 2017.

Now, numerous Vermont health care organizations released a statement saying the verdict could have grave impacts on the industry. Among the organizations that signed the statement were the University of Vermont Health Network, the Vermont Association of Hospitals and Health Systems, and Vermont's Office of the Health Care Advocate.

Vaught now faces up to 12 years in prison following her conviction.
House lawmakers soften Senate proposal for tighter regulations on hospitals

A proposal to grant the Green Mountain Care Board greater control over hospital budgets has fallen prey to the status quo.

The five-member independent board already regulates service charges at Vermont hospitals. But members this year have argued before legislators that giving the board the additional authority to regulate budgets would further address the ballooning cost of health care. 

The Vermont Senate last month passed a bill, S.285, that would appropriate almost $5 million for the care board to study and implement a model that would grant the board budget-setting authority. 
After major budget shortfall projection, UVM Health Network suspends adolescent mental health unit project

Just after projecting a massive budget deficit for two of its hospitals, the largest health network in Vermont has paused plans for an inpatient psychiatric unit for children and adolescents in Burlington. 

The Vermont Department of Mental Health in February began looking for candidates to open as many as 10 psychiatric beds for children and adolescents outside of the Brattleboro Retreat, the only hospital that offers such services.

Only the University of Vermont Medical Center responded, but did not commit, to the state’s request, according to Alison Krompf, the department’s deputy commissioner. The health center proposed setting up a psychiatric unit at its pediatric hospital in Burlington.

Hospitals in the News
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