Legislative Update
by Devon Green
Vice President of Government Relations

That collective itch in the air isn’t allergies—it is Vermonters dying to get outside into the warm temperatures and sunshine, and our legislators are not immune to it. Welcome to what could be the last week of the legislative session!
Last Week: Children waiting in EDs for mental health treatment: The House Health Care Committee sent a letter to the Agency of Human Services, the Department of Education, and VAHHS with a framework for addressing long wait times for children in emergency departments waiting for mental health treatment. The framework includes dates by which the Agency of Human Services will: provide ongoing weekly reports with data on children waiting in emergency departments; establish a target date by which the average length of stay will not exceed 24 hours; and provide an outline of ongoing and completed emergency action steps. The letter also asks hospitals to take immediate steps to address the crisis of children waiting in EDs, which could include:

  • ED or crisis staff providing more support to children and caregivers
  • Segregating children from adults or other ED stressors
  • Dimming lights, if possible
  • Expanding the use of telehealth

With Commissioner Sarah Squirrell leaving the Department of Mental Health, VAHHS sees the framework as a way to ensure continued focus and work on this important issue.
Forensic Care Working Group: The House passed an amended version of S.3 which provides $25,000 in funding towards a working group, including a representative of the Designated Hospitals, to examine gaps in the current mental health and criminal justice system to improve public safety and address treatment needs for those who are incompetent to stand trial or adjudicated not guilty by reason of insanity. The new language also provides more time for the group to come up with workable solutions. 
Health insurance market update: The Department of Vermont Health Access updated the House Health Care Committee on changes to health care coverage under the federal American Rescue Plan Act (ARPA), including:

  • More generous premium tax credits/subsidies for people who currently receive premium tax credits
  • Expanded premium tax credit/subsidy eligibility for Vermonters with higher incomes
  • Households with one week of unemployment are eligible for zero-premium plans
  • Holiday on tax credit reconciliation for 2020
  • Eligibility for COBRA without cost for April 1-Sept. 30 2021

Contact devon@vahhs.org if your hospital needs resources for discussing these changes with patients or would like to be connected with the Department of Vermont Health Access for Assister training.
This Week
Interstate Nurse Licensure Compact: The House provided initial approval to S.48, the bill that would allow Vermont to join the Interstate Nurse Licensure Compact. This week, we’re expecting to see final approval and hoping for a quick concurrence from the Senate.
In the News
Vaccine registration opens to children ages 12 to 15 across region

Vaccine registration for children ages 12 to 15 has opened in New York, Vermont and New Hampshire as of Thursday afternoon.
The expanded registration follows an endorsement from federal health advisors for use of the Pfizer-BioNTech COVID-19 vaccine with the age group. In New York, the expansion has also been approved by the state's advisory task force and state health commissioner.

Vermonters ages 12 to 15 can now get the Pfizer COVID-19 vaccine after U.S. health advisers endorsed its use for those ages.

Registration for vaccine appointments opened on Thursday morning.
Pfizer’s vaccine has been used for months in people 16 and older.

Earlier this week the Food and Drug Administration cleared its use for those as young as age 12.

Vermont is one step closer to kids 12-15 getting vaccinated against COVID-19.
Wednesday, a panel of CDC advisers signed off on the move. Now, only the CDC director needs to give the OK.

Vermont and New Hampshire are ready. Both states are opening registration on Thursday for 12-to-15-year-olds to get Pfizer shots. But some parents still have concerns.

“I can’t wait until for Vermont’s adolescents to start getting vaccinated,” said Dr. Benjamin Lee, an infectious disease specialist at the UVM Medical Center. “These vaccines are safe and effective.”

Despite doctors’ confidence, some parents are still hesitant. A recent national study shows only 3 in 10 parents of kids ages 12-15 plan to get the shot as soon as it’s available.

Gov. Phil Scott accelerates Vermont reopening plan; Phase 3 begins today
Saint Albans Messenger

On Friday, Gov. Phil Scott informed the state that Vermont has already hit its June 1 vaccination milestone for the Vermont Forward Plan and so will subsequently be moving into Phase 3 recommendations effective immediately.

Here are key takeaways from Friday’s press conference updating the public on the state’s response to the COVID-19 pandemic:

State moves to Stage 3

According to the current plan, by July 4 gatherings and events will have no restrictions and while masks and physical distancing are encouraged, universal guidance is advised for all sectors.
“I want to thank Vermonters for making this possible,” Scott said. “Because of you, stepping up for the greater good, doing your part and getting vaccinated, we are able to do this.”
Kids with severe allergies can get COVID vaccine with extra precautions
Burlington Free Press

Kids who are at risk for anaphylaxis due to food allergies, bee sting allergies and the like are able to receive the COVID vaccines.

"Severe allergies due to environmental or food allergies are neither a contraindication nor a precaution to mRNA vaccines," according to Benjamin Lee, a pediatric infectious disease expert at UVM Medical Center. 

"Personally, I carry an EpiPen due to a wasp venom allergy and had no hesitation getting vaccinated, and predictably, had no issues other than the common side effects of low-grade fever, headache, and fatigue the following day. Well worth it!" he wrote in an email.

The data behind Vermont's pandemic death toll

The Vermont Health Department says 252 Vermonters have lost their lives to the coronavirus over the course of the pandemic. But as Dom Amato reports, even though Vermont has the fewest deaths in the country, it has still taken a toll on families and the medical community.

It’s been a busy year for Rutland Regional Medical Center Dr. Rick Hildebrant.

Reporter Dom Amato: Do you have any estimation on how many patients you have seen that have been infected with COVID? Dr. Rick Hildebrant: A lot.

Hildebrant helped create the hospital’s COVID plan for treating patients and keeping staff safe. The emotional toll has been hard -- long days, few breaks, and seeing patients die in hospital beds without their families. “When someone’s dying of this illness -- and to not have their loved ones by their side, not holding their hand -- that is really hard on patients, and it’s emotionally taxing on clinicians too,” Hildebrant said.
10 States Where Hospitals are Best, Worst at Avoiding Overuse

Hospitals in the South are worse at avoiding unnecessary tests and procedures than those in the North, according to a ranking from the Lown Institute.

For the 2021 Lown Institute Hospital Index, released May 4, the institute analyzed service use measures at more than 3,100 hospitals.

Data in the ranking came from the Medicare claims database and spanned January 2016 to December 2018. Twelve low-value tests and services, such as coronary artery stenting for stable heart disease and head imaging for fainting, were measured.

Hospitals included in the list had to have the capacity to do four or more of the services used in the ranking. Overuse was scored based on the rate of overuse and volume of overuse. 
Hospitals in the News
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