Legislative Update
Devon Green, VP of Government Relations
While the policy committees keep up their quick pace, the appropriations committees received further detail on the budget last week. It’s easy to assume that the Administration’s budget process is hush hush until the floodgates of knowledge open with the Governor’s speech, but the truth is, there’s usually some gaps in understanding until agencies and departments come in to testify and elaborate on the proposals. Read on for more, and feel free to visit our bill tracker.
Post-acute and long-term care budget: VAHHS is keeping a close eye on the budget for skilled nursing facilities, because they have a direct impact on our hospitals’ ability to discharge patients. The FY’25 budget proposes the following base funding:
$9.9M in rate stabilization funds for skilled nursing facilities along
$2.3M anticipated rate for the Bennington Health and Rehab including iCare costs
$2.5M in special rate incentives for complex patients for the upcoming iCare facility
At this point, the iCare facility should have 40 beds available out of a potential 90 beds once it opens. Much of those beds will be taken up by a 120-person waitlist.
While skilled nursing facilities see increases in the FY’25 budget for post-acute and long-term care, the House cut extraordinary relief for skilled nursing facilities by $3M in the Budget Adjustment Act for FY’24. The Senate Appropriations Committee will be looking at this cut further.
Mental Health Budget: The proposed budget has base funding for the Brattleboro Retreat at about $6M and one-time funding for the psychiatric youth inpatient facility at Southwestern Vermont Medical Center at about $1M.
Health Care Reform Budget: There is one-time funding of $9.3M in the proposed budget to cover 5 hospitals as they get on a prospective Medicaid payment system pilot program.
Expanding health care workforce through graduates of international medical schools: The Senate Health and Welfare Committee heard Sen. Harrison’s testimony on S.263. The bill proposes a working group led by the Board of Medical Practice to examine a Tennessee law that allows issuance of temporary medical licenses to international medical school graduates and consider other opportunities to expedite the licensure process for health care professionals from other countries.
Medicaid expansion: After comprehensive testimony on H.721, the House Health Care Committee agreed to have the Department of Vermont Health Access conduct an analysis of the impact of expanding Dr. Dynasaur up to age 21 and to pregnant individuals of any age as well as a range of reimbursement rates for providers and whether Medicare is the appropriate benchmark.
Restoration of competency: The Senate Health and Welfare Committee heard from the Department of Mental Health on its restoration of competency report. At 796 pages, it’s not for the faint of heart. The high-level recommendations are:
competency restoration for those cases where there exists a compelling interest so that the criminal case proceeds;
conduct restoration program at the most appropriate site, which includes a health care setting, Department of Corrections, or the community.
The committee agreed that there was not enough time in the session to set up a comprehensive framework, but they will come back with legislation next session.
Step therapy: The House Health Care Committee heard testimony from providers and health insurers on step therapy protocols and potential changes in H.766. Providers pointed out how step therapy protocols can be unduly burdensome for providers and patients while insurers noted that they are a useful tool for keeping down costs and ensuring providers are staying current with the latest prescription protocols.
Data Privacy: We have not one, but two bills on data privacy. Bill H.121 is a blanket data privacy bill from last year backed by the Attorney General. The committee worked on it during the summer and unveiled the latest version last week. Another bill, S.173, specifically targets consumer health data.