Legislative Wrap-Up 2021 Session

VAHHS 2021 Legislative Session Summary

Back in January, as I worked with hospitals on setting up vaccine clinics, procuring testing supplies, and other COVID-related responses, I hoped against hope that the legislature would limit their activity to COVID issues.

Of course, not even Zoom squares can contain our legislators. Now, I’m relieved that they expanded their scope because we made a lot of progress in important areas like workforce, mental health, and health equity. I thank all of our legislators for their support on these initiatives and of their local hospitals.

Below is a summary of the legislative initiatives tracked by VAHHS that passed this year.

COVID-19 State Regulatory Flexibilities

  • Regulatory flexibility extension: Under Act 6, many regulatory flexibilities will be extended to end of March 2022. For a summary, go here.
  • Audio-only reimbursement: Act 6 also requires the Department of Financial Regulation (DFR) to determine the appropriate codes in the billing and payment of audio only by July 1, 2021 and requires all health care providers and health insurers to use those codes by January 1, 2022.  It also requires DFR to determine reimbursement amounts for audio only for health plan years 2022-2024.

Workforce Initiatives

  • Interstate Nurse Licensure Compact: S.48 passed, allowing Vermont to enter into the interstate Nurse Licensure Compact and takes effect on February 1, 2022.
  • Scholarships for physicians and nurses: $2.27 million in the budget
  • Higher Ed Tuition-Free Year: the budget includes funding for one year of free tuition for critical occupations, including allied health programs at CCV and undergraduate studies at Vermont State Colleges for dental hygiene, radiologic science, respiratory therapy, and paramedic/EMS programs.  Funding at Vermont State Colleges is also available for practical nursing, nursing, and mental health counseling.
  • Working Group on Interstate Practice Using Telehealth: Act 21 creates a working group to make recommendations on facilitating the interstate practice of health care professionals using telehealth.

Mental Health

  • Changes to notice of rights and consent: Act 30 goes into effect on July 1, 2021 and requires all inpatient psychiatric units to inform patients:
    • Notice of rights: that the patient may apply to have his or her status changes from involuntary to voluntary
    • Consent: voluntary patients understand that they may be placed on a locked unit

Act 30 also requires continued reporting of emergency room wait times for patients seeing mental health care in hospital settings until 2023.

  • Secure residential recovery facility: The capital bill provided funding for the design and construction of a 16-bed secure residential recovery facility to replace the temporary Middlesex Therapeutic Community Residence.
  • Mobile crisis pilot in Rutland: Funding in the budget for a pilot mobile crisis intervention program in Rutland.
  • Children waiting in emergency departments: The House Health Care Committee sent a letter to the Department of Mental Health, the Agency of Human Services, and VAHHS setting out timelines and a framework for addressing the issue of children in mental health crisis waiting in emergency departments.

Addressing Disparities and Promoting Equity in Health Care

  • Act 33 creates a Health Equity Advisory Commission advise the Office of Health Equity, make recommendations to the Office of Health Equity, once it is established, and identify issues with existing policies related to the health status of individuals who are Black, Indigenous, Persons of Color; individuals with disabilities, and individuals who are LGBTQ.
    • The commission will also provide recommendations by October 1, 2022 to the legislature for improving cultural competency in Vermont’s health care system as well as recommendations for using funds under the American Rescue Plan Act to promote health equity.
  • The law also requires all state entities collecting health-related individual data to disaggregate health equity data by race, ethnicity, gender orientation, age, primary language, socioeconomic status, disability, and sexual orientation.

Health Care Reform

  • Delivery System Reform Investments: The budget included $3.9 million to support health information technology projects and Delivery System Reform efforts to implement the All-Payer Accountable Care Organization Model including health information technology projects and the continuation of the Longitudinal Care Home Health Program.
  • Coverage for eligible children and pregnant individuals regardless of immigration status: Act 48 created Dr. Dynasaur-like health care coverage for Vermonters who are pregnant or under 18 and otherwise financially eligible for Dr. Dynasaur but do not qualify due to their immigration status.
  • Report on including coverage of hearing aids and DMEs and more: The budget requires the Department of Financial Regulation to determine the potential impacts of including coverage for hearing aids, dentures, vision care, DMEs, fertility services, and at least two primary care visits in Vermont’s benchmark plan.
  • Task Force on Affordable, Accessible Health Care: The budget created a legislative task force to provide recommendations to the legislature by January 15, 2022 on the most cost-effective ways to expand access to affordable health care for Vermonters.


  • Prohibitions on PBM reporting and network requirements: The budget includes a prohibition on pharmacy benefit managers from requiring pharmacies to do certain reporting on 340B drugs or restrict access to a pharmacy network due to participation in the 340B program.
  • Report on State responses to prescription drug manufacturer and PBM actions affecting 340B: Also in the budget, by January 15, 2022, the Department of Financial Regulation, in consultation with the Office of the Attorney General, will report on the latest national activity affecting the 340B Drug Pricing Program and possible State responses.