The legislature was hard at work leading up to the Labor Day weekend with the House Appropriations Committee scheduled to vote out the remainder of the FY ’21 budget on Tuesday and the House expected to vote soon after. The budget contains no significant cuts to health care programs. Other issues the legislature is working on include:

ACO Contracts: On Friday afternoon, the Senate Appropriations Committee and Senate Health and Welfare Committee met and discussed legislation that would prevent the Green Mountain Care Board from certifying an ACO during 2021 if the ACO reduces payments to primary care practices. This will move fast. The Senate Health and Welfare Committee is taking testimony and finalizing the proposal this week. 

Hazard Pay Program: The legislature is using two bills, S.352 and S.353 to clarify and expand the Hazard Pay Program. Under S.352, contracted housekeeping and dietary staff of a covered employer and individuals who clean or sanitize the premises of a covered employer working for a covered employer are eligible for the program. Additionally, an employer may provide contact information of a former employee to AHS for program eligibility and the employee can individually apply for the program.

With S.353, the legislature allocated an additional $19.5 million in funding to expand the Hazard Pay Program to include grocery stores, retail stores, pharmacies, wholesale distributors, vocational rehabilitation providers, waste management services, funeral services, child care facilities that provided services to essential workers and security services provided to covered employers.

Office of Professional REgulation (OPR) Bill: VAHHS testified in favor of S.220, the OPR bill, last week. The legislation expands the scope of practice of pharmacists and gives them limiting prescribing authority, including for a possible COVID-19 vaccine. The bill also allows pharmacists to administer tests for COVID-19 and SARS associated viruses. Finally, the bill contains provisions to eliminate the requirement that clinical nurse educators have a

master’s degree.

After an infection in his heel required that Bill Blodgett have his leg amputated last December, he couldn’t go back to where he was living in Hartland because it wouldn’t accommodate a wheelchair.

Having one leg also meant the 61-year-old who’s cooked in restaurants “all over the Upper Valley” couldn’t find a place in an assisted living facility despite sending out about 40 applications, he said in a Thursday phone interview from his room at Mt. Ascutney Hospital and Health Center in Windsor, where he’s now been living for 8½ months.

“If it wasn’t for the nurses here, I’d have lost it a long time ago,” Blodgett said.

Before the Covid-19 pandemic, Mt. Ascutney sometimes had trouble moving patients like Blodgett on to other settings once they were no longer in need of hospital-level care. But that problem has worsened in recent months so that six to eight of the Windsor hospital’s 25 beds now are regularly taken up by people who don’t need to be there, according to Mt. Ascutney CFO David Sanville.

As a result, Sanville estimates the hospital has lost $700,000 providing that care because Medicaid only covers a portion of the hospital’s cost related to such patients.

Nursing home giant Genesis HealthCare is selling five of its Vermont nursing homes.

The financially troubled Pennsylvania-based company told the state in a letter Aug. 21 that it would offload St. Johnsbury Health & Rehab, Berlin Health & Rehab, Bennington Health & Rehab, and Springfield Health & Rehab.

Genesis, which has been the subject of past state investigations for patient neglect, owns nine facilities in Vermont. One of them, Burlington Health & Rehab, was ravaged by the coronavirus this spring.

Genesis spokesperson Lori Mayer confirmed that the company planned to sell a fifth nursing home as well, but she declined to identify the last facility, citing ongoing negotiations. She also refused to identify the buyer, whose name was not included in information provided to the state.

“A definitive agreement has not yet been reached,” Mayer said in an emailed statement. Genesis had already notified patients, residents and staff, she added.

We are all in the middle of an unprecedented event in our lives, and it has certainly been a difficult experience individually and collectively, to say the least. As with most challenging situations, there is a silver lining of opportunity to the COVID-19 experience. We now have a chance to see what we otherwise were too busy to notice and to appreciate the simple truths connected to this. COVID-19 offers us the chance to remember how important it is to take care of ourselves and each other, and there is no difference between the two, if done well.

One way we can take care of ourselves is to practice lifestyle as medicine. Lifestyle medicine is a topic that is gaining attention in health care. The official definition of lifestyle medicine is “the evidence-based practice of helping individuals and families adopt and sustain healthy behaviors that affect health and quality of life. Examples of target patient behaviors include, but are not limited to, eliminating tobacco use, improving diet, increasing physical activity and moderating alcohol consumption.” (www.lifestylemedicine.org) The basic idea is that the way we live has very real impact on how healthy we are mentally, physically and socially. Much of the information connected to lifestyle medicine is based on common sense. Many old adages that are considered clichés but, in fact, have born the test of time, have been forgotten. The saying you are what you eat is something we hear frequently, but the practice of eating well to stay healthy often gets overshadowed in our busy lives. Now is a great time for us to slow down and pay attention to the choices we are making and to make changes in our lifestyles to be healthier overall.

Vermont’s health commissioner is pushing back against the CDC’s updated testing guidance.

The CDC this week changed its recommendations for testing people who may have been in close contact with someone who has COVID-19, saying they may not need to get tested, a controversial change of course that some say was politically motivated.

Vermont Health Commissioner Dr. Mark Levine says in the six months Vermont has been dealing with the virus, they’ve learned people who are in close contact are at risk for getting sick. So the state’s testing recommendations will not be changing.

“The whole strategy of containment-- testing, isolating, contact tracing and quarantining-- has been fundamental to our success in Vermont and needs to continue. And underpinning its success is testing,” Levine said.

Levine also said the CDC’s decision to leave travel quarantine guidance-- both within the U.S. and internationally-- up to individual states is short-sighted.

He says Vermont’s travel quarantine policies have served us well and will not be changing.