Legislative Update 2.7.22
Last week, Vermont officially implemented the Nurse Licensure Compact. This licensure compact came after years of advocacy from VAHHS and other health care provider associations, as well as extensive work from the Office of Professional Regulation. It is all too easy to jump to the next emerging policy issue without taking a beat to properly acknowledge this type of accomplishment. I want to thank all those in the legislature and at the Office of Professional Regulation who made this happen!
Workforce: And, because the Nurse Licensure Compact will not solve all of our workforce problems, the House Health Care Committee heard testimony from Vermont’s higher education system on ways to support and expand nurse education. Current proposals include $1.5 million to expand K-12 education pipeline programs and Governor Scott’s FY ’23 budget proposal, adding $2 million to the nurse loan repayment program. The Vermont State Colleges system hopes to obtain $7 million to reduce its $7,000-per-semester tuition to more closely match the national average of $4,500 per semester. All of the representatives from higher education coalesced around increasing salaries for faculty and creating more opportunities for clinical placement.
Mental Health: The House Health Care and Senate Health and Welfare Committees heard from UVMMC mental health professionals about the need for more mental health services, including:
- Intensive out-patient programs to fill the current gap in care between in-patient services and community services
- Replicating the Psychiatric Urgent Care for Kids (PUCK) program throughout the state to lower emergency department utilization
- Increasing respite and mobile crisis capacity
Regulatory Flexibilities and Telehealth: This week, the Senate Health and Welfare Committee will take up H.654, which extends many current COVID regulatory flexibilities until next year. We appreciate their action on this as the current March 31st deadline looms large.
In telehealth news, the House Health Care Committee sent H.655, which creates a tiered approach to telehealth licensure, for a vote in the House. We really appreciate their quick action on this bill.
Blue Cross Blue Shield of Vermont testified that it currently reimburses audio-only mental health and substance use counseling services at 100 percent of the current in-person amount and all other audio health services at 75 percent the in-person amount. MVP Health Care will move to the same reimbursement model starting March 1. We appreciate Rep. Mari Cordes pointing out that audio-only health care services are not just phone calls, but actual health care services, and VAHHS supports 100 percent reimbursement of all audio-only services.
Health Care Reform: In its FY ’23 budget testimony, the Green Mountain Care Board urged the committee to appropriate $2-$5 million to study and implement global budgets for hospitals, as opposed to global budgets according to ACO-attributed lives and to optimize the health care system by reducing inefficiencies.
Alzheimer’s and Dementia: VAHHS advocated for coordinating and supporting current Alzheimer and dementia efforts as the Senate Health and Welfare Committee took up S.206. VAHHS asked for:
- One-stop website with community resources for patients, families and providers
- Continued support for current educational efforts to support diagnosis of Alzheimer’s Disease by primary care providers
- Support for the long-term care workforce to get patients to the right level of care and decompress capacity issues at hospitals
No Surprises Act: The House passed H.489, which allows the Department of Financial Regulation to enforce the provisions of the No Surprises Act federal legislation.
Prohibition of Firearms in Hospitals: The Senate passed a version of S.30, which prohibits firearms in hospitals and closes the “Charleston Loophole” with removal of a reference to 30 days. Due to this language tweak, the bill will now head back to the House before going to the governor’s desk.
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When I think of sustainability, the first thing that comes to mind is partnership. Whether it is a marriage or a mission, a policy or a plan, making it sustainable requires collaboration. Rarely does major progress occur because someone acted alone.