Legislative Update
Devon Green, VP of Government Relations
A huge thank you to the House Health Care and House Human Services Committees and their chairs, Rep. Lori Houghton and Rep. Theresa Wood, for holding a joint hearing last week on the systemwide impact of patients who cannot get to the appropriate level of care due to a fragile post-acute and long term care system. Dr. Stephen Leffler, President and COO of the UVM Medical Center, underscored how the inability to discharge patients to a skilled nursing facility reverberates throughout the health care system with smaller hospitals unable to transfer their sickest patients to the UVM Medical Center and emergency departments filling up with long-stay patients. The message from hospitals, skilled nursing, and home health was unified: invest in post-acute and long-term care.
Emergency Medical Services: The House Government Operations took testimony on H.622, a bill to improve Vermont’s emergency medical services (EMS) system. The bill:
Increase Medicaid reimbursement rates for EMS treatment without transportation to a facility.
Turn the current EMS advisory committee into a Board and develop its duties including drafting and maintaining a 5-year statewide emergency services plan.
Create an EMS taskforce to oversee implementation of a coordinated EMS system in VT.
Appropriate funding for EMS training.
The House Health Care Committee will finalize recommendations on funding treatment without transportation and EMS training this week.
Peer Support Provider and Recovery Support Specialist Bill: The House Appropriations Committee advanced H.847, a bill that creates a certification for mental health peer support providers and recovery support specialists. The committee approved lowering the initial certification fees.
Expanding Medicare Savings Program: The House Health Care Committee heard from the Department of Vermont Health Access on the costs of expanding eligibility for the Medicare Savings Program. The Health Care Advocate discussed how an $18M investment in the program would put $40M in the pockets of vulnerable Vermonters through premium savings alone. VAHHS testified that expansion could help hospitals with uncompensated care and improve patient placement and capacity issues by making traditional Medicare more affordable for more Vermonters and reducing the need for Medicare Advantage plans that delay or deny authorizations for post-acute and long term care.
Expanding Medicaid Eligibility: The House Health Care Committee viewed the latest draft of H.721, which appropriates $350,000 for a robust technical analysis on the impacts of increasing Medicaid eligibility for Vermonters and increasing reimbursement for providers. The Committee also discussed the cost of proposals that would more immediately expand Medicaid up to 21 years of age and to pregnant individual up to 317% of the federal poverty level. VAHHS noted that birthing units are financially struggling and increasing Medicaid eligibility without reimbursement could have a negative impact, while the committee noted that some reimbursement would be better than no reimbursement.
Forensic Facility: The Senate Health and Welfare Committee passed S.192, admission criteria and processes for a forensic facility. In addition to establishing the Human Services Community Safety Panel and procedures for admission, the bill allows for residents to receive involuntary treatment in a forensic facility rather than a more restrictive environment, such as a hospital inpatient unit.