Happy Town Meeting Week!

Devon Green, VP of Government Relations
Happy Town Meeting Week! The legislators are home this week to get input from their constituents and take a well-deserved break before the big crossover push. Here is where they left things:
Workforce: Thank you to all the Chief Nursing Officers who responded to our request for information on doubling the number of clinical educational opportunities. We will continue to work on this throughout Town Meeting Week.
The conference committee came to agreement on the Budget Adjustment Act—the final bill includes:
  • $25 million in continued COVID financial support, such as funding for contracted workers, to prevent closures and disruptions at facilities.
  • $60 million for health care worker recruitment and retention with grants of $2,000 per FTE. The first $45 million is allocated to long-term care facilities, home health agencies, designated agencies, adult day providers, substance use treatment providers and other human service providers. Hospitals with an identified need for funding may be eligible for $15 million if the needs of the above employers are met with the first $45 million.
Mental Health: In its recommendations to the House Appropriations Committee, the House Health Care Committee supported Governor Scott’s proposal of $500,000 in funding for a daily rate to emergency departments for patients in mental health crisis waiting for treatment.
Health Care Reform: It’s a tale of two health care reform efforts! Over on the House side, the Health Care Committee included $5 million in its budget recommendations for the Green Mountain Care Board to (1) engage a consultant to redesign Vermont’s health care system after community engagement; and (2) develop a methodology of fixed payments for hospitals, but only after engaging providers, payers and communities. The board cannot implement a new methodology before reporting back to both health care committees. 
On the Senate side, the Health and Welfare Committee took testimony on S.285, which also allocates $5 million to the Green Mountain Care Board to engage in health care system redesign with a process that is only “community inclusive” and asks the Board to develop global payments to hospitals without requiring provider or community input. VAHHS has requested to testify and is concerned about moving forward on delivery system and payment reform without the on-the-ground perspective of hospitals and other health care providers at a time when our system is fragile.
Regulatory Flexibilities: The Senate passed the House version of H.654 without changes. This bill extends many of the current COVID licensing and telehealth flexibilities from March 31, 2022 until March 31, 2023. The bill also resurrects Green Mountain Care Board flexibilities and requires the Green Mountain Care Board to consider labor costs. A comprehensive summary of the bill appears here.
Alzheimer’s and Dementia: The Senate Health and Welfare Committee passed S.206. The bill originally required all hospitals to develop an operational plan for the recognition and management of patients with dementia. VAHHS advocated for coordinating and supporting current Alzheimer’s disease and dementia efforts. The latest version of the bill asks the Department of Disabilities, Aging and Independent Living (DAIL) to address the following in its State Plan on Aging:
  • Transitions to and from care in home, hospital and long-term care settings
  • Support and education for families and caregivers
  • Strategies to promote affordable and accessible long-term care
The bill also requires DAIL and the Department of Health to propose a permanent Alzheimer’s Disease Coordinator position to be shared between both departments. DAIL must also develop accessible educational resources on Alzheimer’s disease and related disorders for patients, families, and health care providers.
Prohibition of Firearms in Hospitals: As Jeff mentioned in his column, the governor vetoed S.30, but provided a path forward. A huge thank you to all the health care providers who reached out to the governor’s office.
Freestanding Birth Centers: The Senate Health and Welfare Committee took up S.204 this week, which would allow licensure of freestanding birth centers and would exempt freestanding birth centers from the Certificate of Need process. Dr. Kathleen McGraw, Chief Medical Officer at Brattleboro Memorial Hospital, testified that the Certificate of Need process is needed because hospitals are already struggling to maintain their birth units due to Vermont having the lowest birthrate in the nation and low reimbursement through Medicaid. The committee acknowledged both the value of free-standing birth centers and the potential impact on hospitals and will take up the bill again after Town Meeting Week.Happy Town Meeting Week!