From the President and CEO
Hospital Sustainability Requires a Careful Planning Process with Oversight

By Jeff Tieman, President and Chief Executive Officer and Devon Green, Vice President of Government Relations

For the entirety of the legislative session, VAHHS has been engaged in an important health reform discussion. Vermont has long been committed to innovative health reform and has made real progress in this space, often adopting policies other states later replicate. Unfortunately, this is not the case now, as legislators insist on passing a “hospital sustainability” bill that is extremely expensive without offering clear value to Vermonters.
Last week, the Senate Health and Welfare Committee proposed allocating $4.1 million to the Green Mountain Care Board for an engagement process around hospital sustainability. The GMCB said it would use $3 million of this funding for data gathering and analysis, community engagement and technical assistance for transformation. This is a continuation of their consultant-driven work on the type of health care services they believe individual hospitals should provide. 
The GMCB has had numerous and worrisome discussions around cutting hospital units and health care services in rural communities. Their deliberations often fail to acknowledge the need for resources that would be needed for any kind of meaningful transformation. And the regulator’s planning effort could easily lead to health care providers leaving and patients being unable to access care close to home.
The GMCB has testified about having difficult conversations with communities, but it is unclear how the conversations will be structured beyond hiring a consultant and including relevant stakeholders. The bill passed by the House had GMCB coming back with a plan for community engagement that would address workforce and resources needed. The latest version does not have this critical oversight.
It is unfortunate that this legislature is unwilling to bolster our health care workforce without a concrete plan, but is willing to contribute millions of dollars to a vague effort that could endanger our rural health care workforce.
Sustainability is important, and VAHHS has said so early and often. Hospitals are participating in the All-Payer model, our current reform path, and continue their commitment to moving to a value-based system. What we need right now is some predictability and staying on the path we are already on, not a costly new planning effort to move in a whole new direction that could imperil access.

In the News
VAHHS CEO Jeff Tieman leaving for Colorado Hospital Association
Vermont Business Magazine

“I have absolutely cherished my time in Vermont, working so closely with our hospitals and will continue to be a champion for their cause,” shared Tieman. “I have always been impressed by and proud of how Vermont’s hospitals work together to ensure high quality, respond to major crises, contain cost growth and protect access where it would otherwise be lost. My hope is that state leaders and regulators continue to realize how awesome and important that is and will support our hospitals as they fight to recover from the pandemic and keep Vermont healthy and thriving.”
Vermont sees new wave of COVID infections, hospitalizations

“Since Vermont is leading the nation in the percentage of its citizens who are vaccinated, that means that the people who can get infected with COVID and can get sick from it are mostly vaccinated,” said Dr. Tim Lahey, an infectious disease expert at the UVM Medical Center.

All of this is to confirm Vermont is in the midst of another surge, the last being between November and January. It’s a trend Lahey says experts have been expecting.

“Peak and a valley, and a peak and a valley, over and over again for the coming months. The hope is that each wave is a little bit smaller and a little bit less dangerous than the previous one, and so far that’s the pattern we’re seeing,” he said.
Dartmouth Health partners with Grace Cottage to provide telemedicine neurology care
Brattleboro Reformer

Dartmouth Health Connected Care is partnering with Grace Cottage Family Health & Hospital, an independent, nonprofit critical access hospital and family health clinic in Townshend, Vt., to provide acute care TeleNeurology services to Grace Cottage patients. Through this partnership, Dartmouth Health TeleNeurology can quickly bring a neurologist to the patient’s bedside to assist the local clinical team with prompt assessment and treatment recommendations via telemedicine. The service began on Monday, April 11.

“Using the latest technology to bring TeleNeurology services to Grace Cottage will ensure the very best care for our patients who experience neurological issues,” said Douglas DiVello, president and CEO of Grace Cottage Family Health & Hospital. “This partnership allows us to provide world-class care from one of the nation’s leading academic medical centers to our patients and allows our medical staff to consult with Dartmouth Health neurology specialists, right here in rural southern Vermont.”
Hundreds of Suicidal Teens Sleep in Emergency Rooms. Every Night.
New York Times

On a rainy Thursday evening last spring, a 15-year-old girl was rushed by her parents to the emergency department at Boston Children’s Hospital. She had marks on both wrists from self-harm and a recent suicide attempt, and earlier that day she confided to her pediatrician that she planned to try again.

At the E.R., a doctor examined her and explained to her parents that she was not safe to go home.

“But I need to be honest with you about what’s likely to unfold,” the doctor added. The best place for adolescents in distress was not a hospital but an inpatient treatment center, where individual and group therapy would be provided in a calmer, communal setting, to stabilize the teens and ease them back to real life. But there were no openings in any of the treatment centers in the region, the doctor said.
Hospitals in the News
From Our Hospitals
America is Facing a Shortage of Healthcare Workers
Copley is Solving the Problem in a Unique Way:
We’re "Growing Our Own!"

by Trish Rick
VP, Development & Marketing
Copley Hospital

Across the country, hospitals and medical centers are struggling with a shortage of qualified nurses, lab technicians, and other medical staff. Take a quick glance through the medical help-wanted ads at nearly every hospital in America and you’ll find scores of open —and unfilled—positions. Some organizations have seen reductions in nursing and medical staff due to the stress and fatigue caused by the now two-year old COVID pandemic; others have simply been unable to locate, attract and retain qualified workers.
“It’s a problem on a national level,” said Copley CEO Joe Woodin, “but it’s especially hard in rural areas. We’re fortunate to be situated in one of the most beautiful areas of the country—not to mention Vermont—but it still takes a special kind of person to want to settle here.

Recruiting and attracting the kind of high quality practitioners we need is a full time endeavor. It never stops.” Fortunately, Woodin said, Copley is finding success in addressing the problem, and it’s doing so in typically Vermont fashion.

“Our Nursing Assistant Training Program (NATP) gained final approval by the State of Vermont this past spring with our first cohort of students entering the program during the first week of May 2021,” he said, “and through a partnership with Utah-based Weber University, we have just about solved our shortage of lab technicians.”
Health care sustainability is why the UVM Health Network exists

by John Brumstead
President and CEO of the UVM Health Network

Rural health care is in peril. It simply is not sustainable in its current form due to financial, demographic and workforce pressures. 

So it’s a good time for the health care sustainability discussions now happening in the Vermont Legislature and the Green Mountain Care Board. We at the UVM Health Network have some important lessons to share — examples of how achieving sustainability leads to better health care for the future and for right now. 

But we need support to keep this critical work going.

Building a sustainable health care system has been my focus for more than a decade. In many parts of this country, people living in rural areas do not have adequate access to important services, from primary care to the complex and specialized services provided at an academic medical center. Since 2010, 138 rural hospitals have closed nationwide, and today, many more are on the brink of financial collapse. 
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