Message from the CEO
The word “hope” commonly appears in tag lines of hospitals and health systems. There is a reason for this. Hope is what we have in the face of tough diagnoses and challenging recoveries. It is also what we have when the bad news keeps coming and it seems that our world is on fire.

A global pandemic is still taking many lives and changing all others. The economy has left people unemployed and vulnerable. And tension is appearing in cities nationwide as protests unfold and issues of race resurface. 

In the face of these seemingly massive and intractable problems, what can we do in the health care field to offer hope? What can we do to make our state more equitable and unified?

First we must acknowledge that racial disparities exist in health care. As much as health care providers want to see themselves grounded in objectivity, study after study shows that African Americans experience poorer health outcomes—even after controlling for other factors.

As one current example, we know already that minorities are suffering from COVID-19 infection and death at a disproportionally high rate. “If they had died of COVID-19 at the same rate as White Americans, about 13,000 Black Americans, 1,300 Latino Americans and 300 Asian Americans would still be alive” ( APM Research Lab ).
Vermont is not immune—African American Vermonters are testing positive for COVID-19 at the highest rate of any racial group.

The health care field, together with government and other partners, can help change this reality. Last week, Gov. Scott took a solid step when he announced formation of a Racial Equity Task Force charged with reducing racial disparities in health outcomes.

This is important work VAHHS supports. As Gov. Scott acknowledged, a task force is not a “cure-all.” We, as institutions and individuals, must lead with daily action. Even simple steps:
  • listen to a perspective you haven’t considered before,
  • invite a new person to join a social group or public service organization,
  • sponsor or join a community dialogue (on any important issue),
  • donate time, money and brain power to groups and efforts that bring people together

Health disparities were with us long before COVID-19 and demand our attention now more than ever. As Martin Luther King said at a medical convention in 1966, “of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

To address health disparities, we should avail ourselves of knowledge and resources already available, just one example of which  is here , and keep building that body of work. As individuals and groups, we should make efforts to hear and trust one another. And always remember the way we experience the world is not how others do.

To close on a hopeful note, I share this  tribute video  VAHHS developed. Just as Vermonters have counteracted the pandemic with compassion, dedication, and ingenuity, so too can we together counteract racism and health care disparities.

The work ahead is not easy or simple. Worthwhile efforts rarely are. I believe we are up to the challenge, which begins with treating each other respectfully and kindly every day. 
Jeff Tieman, VAHHS President and CEO
Legislative Update
by Devon Green
Vice President of Government Relations

June has turned into all the ups and downs of an entire session as legislators craft an enormous appropriation from the $1.25 billion Coronavirus Relief Fund within the span of one month.

Last Week
Coronavirus Relief Fund (CRF): VAHHS and the coalition of health care provider associations advocated for a simple, needs-based distribution of CRF funding, noting the current financial position of providers and the potential for rapidly evolving circumstances in the form of further outbreaks or federal funding.

Secretary Mike Smith presented a proposal for providing $333 million to providers through a needs-based assessment focused on impacts of business disruption, increased expenses, and state and federal funding already received.
In a memo to the House Health Care Committee, Speaker Mitzi Johnson allocated $225 million towards health care using a tiered approach-- $150 million for immediate allocation towards committee priorities and $75 million to be determined later.

Hospital Disciplinary Reporting: The Senate passed H.438, a bill on the Board of Medical Practice and the licensure of physicians and podiatrists that clarifies requirements for hospital disciplinary reporting. It will now go to the governor’s desk.

This Week
Coronavirus Relief Fund: The House will continue to develop a spending proposal for the CRF funding.
In the News
It's in the Building: How COVID-19 Overwhelmed a Burlington Nursing Home 
Seven Days

he order came over the intercom: Managers, meet now in the lobby.

Social worker Tiffany Smith knew what it meant. If the latest test for the coronavirus at Birchwood Terrace Rehab and Healthcare had been negative, she would have heard through a text message, the same way she had previously learned that residents with a cough or fever didn't have the disease.

The 16 managers gathered near the recently locked double-door entryway so the nursing home's executive director, Alecia DiMario, could deliver the news.

It was Monday morning, March 30, and Birchwood Terrace had just become the second eldercare facility in Vermont with a confirmed case of COVID-19.

Across the Queen City at Burlington Health & Rehabilitation Center, the virus had already infected dozens and killed eight elderly residents in just two weeks. Birchwood's caregivers and other staff understood — they thought they understood — how one case could become two, then four, then 16, and keep multiplying until the virus alone would decide who inside the building would live and who would not.

Still, they had reason to hope.
Winooski outbreak prompts questions about outreach to immigrant residents

As the Covid-19 outbreak in Winooski continues to spread, state and city officials are facing questions about whether they have done enough to educate the city’s New American residents about the virus.

“We feel that we are not supported enough,” Bidur Dahal, a Winooski resident who works at the University of Vermont and as an interpreter for the Association of Africans Living in Vermont. “We feel that the state hasn’t been able to do much, or at least they could have done more.”

Dahal and other advocates and interpreters expressed frustration at a press conference Friday that non-English speakers in Vermont’s most diverse city don’t have adequate information about the virus. They don’t know why they have to self-quarantine for two weeks, and a task force created to address the issue has inadequate funding, they said.

As of Friday morning, 34 people in Winooski had tested positive for the virus, the largest single day increase in cases since April 9. The state Department of Health has tested 436 residents since the beginning of the week, and Health Commissioner Mark Levine announced that the state would keep the pop-up testing site open through the end of next week.
Local woman provides telehealth tools
Times Argus

Lia Rubel, of Barre, is on a mission: Provide smartphones and other WiFi capable devices to seniors who can’t afford them but need them now during the COVID-19 pandemic to meet with their doctors.

Rubel has collected 30 devices and is hoping to secure at least 70 more.

Rubel, a 2019 graduate of Spaulding High School and a sophomore at Emory University in Atlanta, Georgia, is the Vermont representative to the nonprofit group TeleHealth Access for Seniors which began in March with the goal of collecting smart devices and cash donations to provide elderly patients and veterans with access to healthcare services via video chat and to sustain the patient-doctor relationship during the pandemic.

“Given COVID-19, most medical practices have switched to a telehealth model where doctors connect with patients via video chat. However, many elderly patients lack the camera-enabled devices necessary to attend these appointments. Essentially, what we do is collect old smartphones, tablets and laptops and we donate them to elderly patients so they can remotely connect with their doctors. What this does is allow elderly patients to stay at home and avoid the risk of COVID-19 infection,” she said.
SVMC creates virtual waiting room to encourage distancing
The Bennington Banner

Starting Monday, many people who need in-person appointments at Southwestern Vermont Health Care's hospital and clinics will no longer need to use traditional waiting rooms, the hospital has announced. A virtual system created by the hospital allows patients to call 802-447-5000 when they arrive in the parking lot and receive a text message when their provider is ready to see them.

SVMC's outpatient and inpatient surgeries and diagnostic services, like those for imaging and laboratory work, have resumed with enhanced safety protocols per the directive of Gov. Phil Scott. The health system's emergency department, ExpressCare, emergency surgical services, and most of its primary and specialty practices remained open during the pandemic.

"SVHC has provided safe, high-quality care throughout the pandemic," Thomas A. Dee, Southwestern Vermont Health Care's president and CEO, said in a media release. "Innovation has been an important part of providing care during these extraordinary times and this new program decreases the number of people in our waiting rooms and allows them to stay the recommended 6 feet apart or more."

In order to use the virtual waiting room, patients must be able to wait in their vehicle and have a charged cell phone with them. They will receive the virtual waiting room telephone number during their appointment-reminder telephone call. Signs outside the building and at the respiratory check-in stations inside the main hospital and medical office building entrances will also include the number to call.
Vermont Dept. of Health pushing for required childhood immunizations

It's been a quiet few months at Timber Lane Pediatrics in South Burlington, which is seeing far fewer patients than it normally does because of the COVID-19 pandemic.

"Not only are patients more nervous to come in, but we as physicians and as private offices who are small businesses are also worried about how do we protect both our patients, ourselves and our staff," said Leah Costello, MD, with Timber Lane Pediatrics.

Fewer appointments mean fewer kids are being vaccinated.

According to Vermont's Dept. of Health, when comparing numbers to 2019, there was a dramatic decrease in immunizations between April and May.

Data shows that in children between ages 11 and 12, there were 1,529 immunizations in April 2019 compared to 264 in April 2020, and 1,708 in May 2019 compared to 696 in May 2020.

Scott administration pitches $375M hospital stabilization plan

Vermont hospitals were struggling before the pandemic but now their budgets are being stretched even tighter.

Now, Gov. Phil Scott is pitching a $375 million plan to stabilize the industry.

The hospital system estimates at least $300 million is needed to offset business disruption and increased expenses between March and December.

The Agency of Human Services has already paid out $42 million for needs including retainer payments for Medicaid providers, hazard pay, payments to hospitals and financial relief to nursing homes, among others.

An estimated $333 million has yet to allocated.

Resuming Outpatient Services: 3 things you need to know
Brattleboro Reformer

On Monday May 18, Brattleboro Memorial Hospital began reintroducing and rescheduling some of the elective surgeries, procedures, and tests that were temporarily delayed the past two months due to COVID-19. Beginning Monday, June 1, BMH resumed additional services, including outpatient practices, radiology, physical therapy, and wound care. If you were originally scheduled for an appointment with these services, the staff will be contacting you to reschedule a new appointment time in the coming weeks.

On Friday, May 22, Gov. Phil Scott announced that inpatient procedures/surgeries may now be performed at our state hospitals. BMH says it is working with its Surgical Clinician Leadership to initiate these services before the middle of June.

"We are taking every precaution to ensure all services are restarted responsibly and in accordance to state and federal guidelines, and our priority remains to protect the well-being of our patients and staff members," the hospital said in a statement.