Legislative Update 1.23.23


Devon Green, VP of Government Relations
VAHHS Update
With all the new legislators, I worried about endless introductory presentations and a slow start before delving into the issues. I’m happy to report that I was wrong. Whether it’s the joy of being back in person, or the infusion of new members, or the sheer amount of work that needs to be done, there’s a new energy in the building. Legislators get that the “village is on fire” and they’re getting down to work.
Health Care System Priorities: VAHHS testified on the access and financial issues facing our hospitals and laid out the need for workforce development, mental health resources, long term care support, regulatory flexibility and action on workplace violence. The Vermont Medical Society testified about provider stress and the financial risk facing primary care, particularly with the potential loss of $20 million due to Blue Cross Blue Shield pulling out of OneCare Vermont. 
FY 2024 Budget
Governor Scott presented the FY 2024 budget on Friday afternoon. We’ll have to wait for further details, but we appreciate that the governor wants to build Vermont’s workforce, acknowledged the need for housing, and signaled support for the health care continuum, including mental health, long term care, and dental.
Budget Adjustment Act
Before we fully turn towards the FY 2024 budget, the legislature is looking to tie up loose ends in the FY 2023 budget with the Budget Adjustment Act (BAA). Included in the proposed bill are:
  • $9.3 million for inpatient psychiatric beds for children and adolescents: thank you to Matthew Dove from Brattleboro Memorial Hospital and Dr. Maya Strange from the University of Vermont Health Network for their testimony describing the conditions of children waiting days or weeks for care and outlining the immediate need for resources to go towards the entire continuum of mental health care.
  • Graduate Medical Education program: the Department of Vermont Health Access is proposing increasing the total funding of the Graduate Medical Education program at the University of Vermont Medical Center from $30 to $51 million. This would be achieved through federal dollars and would require no additional state funds. 
  • Workforce: Due to federal restrictions and staffing issues, the Administration has been unable to administer the $400k towards preceptor grants for Critical Access Hospitals and $2.5 million in grants for pipeline programs at health care facilities. VAHHS will be testifying next week on a proposal in the BAA to expand the preceptor funding beyond Critical Access Hospitals and to create flexibility in the pipeline funding for wraparound services.
All Payer Model: Ena Backus, the Director of Health Care reform, in her final week before leaving to work for Sen. Peter Welch, testified on the extension of Vermont’s current All Payer Model and discussed the federal government’s priorities for a multi-state model starting in 2025, including:
  • Hospital global budgets
  • Total cost of care target
  • Inclusion of government and commercial payers
  • Investment in primary care
  • Inclusion of safety net providers
  • Addressing mental health, substance use disorder and social determinants of health
  • Addressing health equity