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Legislative Update 4-1-19

March 30, 2019
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Last Week

Budget: The budget passed out of the House and is on to the Senate. It does not contain the Administration’s proposal of funding the Green Mountain Care Board by increasing the proportion billed back to hospitals and health insurers. However, the budget maintains the Administration’s cuts to supporting emergency departments for supervision of patients in mental health crisis who are in the “care and custody” of the Commissioner of Mental Health. VAHHS is currently working on a plan for how to administer that funding and partnering with representatives from the Department of Mental Health, State’s Attorneys, the Sheriff’s Association, community mental health providers, Vermont Care Partners, individuals with lived experience from Vermont Psychiatric Survivors and Licensing and Protection to craft a solution that will provide hospitals with the proper support to provide safe and effective care. 

Health Care Workforce:  VAHHS gave two presentations to the Senate Health and Welfare Committee on the alarming state of Vermont’s health care workforce shortages across fields and with an emphasis in nursing.  VAHHS acknowledged that Vermont has workforce needs in many different areas of the economy, but emphasized the importance of developing our health care workforce because we are seeing increased retirements at the same time that we are experiencing an increase in demand due to an aging population. Hospitals and other health care facilities must maintain staff because, unlike manufacturing or other industries, they are an industry of people caring for people. VAHHS highlighted some of the creative ways hospitals have recruited and retained staff, such as through J-1 visa waivers, but acknowledged that we need more help and suggested a tax credit program focused on recruiting people to work in health care. 

Health Care Provider on Green Mountain Care Board: The House Health Care Committee heard testimony from the Vermont Medical Society on S. 42, requiring that at least one member of the Green Mountain Care Board be a health care provider. The Health Care Advocate testified against this requirement, stating that such a requirement was considered, but not taken up, when creating the Green Mountain Care Board.

Health Insurance Bill: This bill, H.524, originally had a financial penalty for individuals who did not maintain adequate health care coverage similar to the Affordable Care Act’s penalty that was defunded last year.  The House Ways and Means committee members stripped the bill of the penalty because they felt that they did not have the time to look at the mechanics of the penalty.  The bill does include a provision that maintains small group insurance in the small group risk pool along with the individual risk pool, even in association health plans.  This will help maintain the cost of individual health insurance plans.

 

This Week

Capital Bill: The Capital Bill, H.543, will be up for final vote in the House this week.  The bill contains provisions for both a state-run secure residential mental health facility and a facility organized in partnership between Rutland Regional Medical Center and Rutland Mental Health Services. 

Health Care Workforce: The Senate Health and Welfare Committee will continue to look at health care workforce needs and will hear from the Vermont Talent Pipeline Management Project, the Office of Primary Care and AHEC Program and Bi-State Primary Care Association.

Social Service Integration with Vermont’s Health Care System: The House Health Care Committee will be hearing about S.7, which requires Vermont’s Accountable Care Organizations (ACOs) to report on the progress of integrating social services into health care with an emphasis on trauma and resilience-building and primary and pediatric care.

Study on Primary Care Spend: The House Health Care Committee will also hear about S. 53, which has the Green Mountain Care Board studying the current state of primary care spending in Vermont and an analysis of the impact to access and health care quality if spending on primary care were to increase.