Legislative Update 4.11.22


Devon Green, VP of Government Relations
This week, I am spotlighting an issue that hospitals and all of Vermont continues to struggle with—long wait times in emergency departments (ED's). We continue to see dozens of people regularly waiting days, sometimes even weeks, in emergency departments. Children, adults, families and health care providers are suffering. VAHHS will continue to advocate for and support all initiatives that address long wait times.
Mental Health: VAHHS and the Vermont Program for Quality in Health Care (VPQHC) testified in House Health Care on the adverse impacts of long wait times in emergency departments for patients, families and providers and updated the committee on recent initiatives to address the issue:
  • Trauma-informed care training
  • SMART medical clearance—guidance around the medical clearance process that will help get patients to the right level of care more efficiently
  • Healthworks ACT, a pilot in Windham County where the hospital, designated agency and housing organization clinical services to individuals who have housing insecurity, have a diagnosed serious mental illness and tend to be high utilizers of emergency care and service.
  • Suicide prevention quality initiative lead by VPQHC
  • Statewide emergency telepsychiatry lead by VPQHC
  • Comfort kits for children in emergency departments lead by VPQHC
Additionally, VAHHS advocated for the following initiatives:
  • Inpatient expansion
  • Highly coordinated 988 Suicide Prevention Lifeline
  • Mobile crisis units
  • Alternatives to EDs
  • Peer-run respite
  • DA initiatives—6 ED alternatives being considered
  • Psychiatric urgent care for kids
  • Intensive outpatient care
  • Peer support specialist certification
  • Further coordination with community providers and using wait times in EDs to measure effectiveness of initiatives
Financial Assistance Policies: The Office of the Health Care Advocate and VAHHS testified in Senate Health and Welfare on H.287, an initiative that would help standardize eligibility thresholds and the definition of household for financial assistance policies in Vermont. The bill would also allow all Vermont residents, including those experiencing housing insecurity or undocumented residents, to be eligible for financial assistance policies. The new standards would not take effect until 2024, giving hospitals time implement the changes and determine the financial impact, if any.
VAHHS pointed out to the committee that Vermont does not maximize the matching federal funds available in its allocation of the Disproportionate Share Hospital (DSH) payment, which goes towards reimbursing uncompensated costs. Vermont has about $49 million in potential funding, but only draws down $22 million.
Vermont has a 3% uninsured rate: The House Health Care Committee heard the latest results from 2021 Vermont Household Health Insurance Survey. Vermont continues to have a high rate or coverage with only 3% uninsured. Almost half of Vermonters are covered by private health insurance at 49%; 21% are enrolled in Medicare and 24% are enrolled in Medicaid.