Final Reading: Vermont’s health care system is a ‘village on fire’

Rep. Joseph Andriano, D-Orwell, left, talks with Rep. Leslie Goldman, D-Bellows Falls, during a break between House Health Care Committee meetings at the state House in Montpelier on Thursday, Jan. 19. Photo by Glenn Russell/VTDigger

Two groups of health care providers brought alarming anecdotes and statistics to the House Committee on Health Care this week, prompting a young lawmaker to compare the state’s health care system to a village on fire. Unlike the State House evacuation earlier in the week, this was not a drill.

“In the last two years, we were hoping it was Covid. We were hoping it was the effects of Covid. We were hoping we could get out of it,” Devon Green of the Vermont Association of Hospitals and Health Systems said Thursday morning.

But this week, system-wide medical surgical beds at local hospitals are at 97% capacity, with UVM and Dartmouth Hitchcock Medical Centers both completely full. As has become the norm, more than a third of those beds are being used by patients who could be transferred to lower-level care facilities that cannot accept them because of their understaffing, Green said.

The cascading effects are extreme. There are 25 people nationwide waiting in emergency departments to be transferred to hospital beds. And these are the patients who can be served within the state. “We’ve had to send people with heart attacks all the way to Connecticut,” she said.

Meanwhile, five hospitals surveyed this week reported 500 open positions. And nine of the state’s 14 hospitals run an operating deficit, two-thirds of which is due to rising labor costs.

The situation outside the hospital premises is no better. “All clinicians are struggling, but primary care practices right now are really on the brink of financial survival,” Jessa Barnard, executive director of the Vermont Medical Society, which represents 2,600 physicians and assistants, said Wednesday morning.

An annual survey of society members shows that they are suffering. “Just the level of stress that health care providers are under right now is unbelievable and enormous, and frankly almost overwhelming,” Barnard said.

That grim reality was the backdrop to news that lawmakers had appropriated millions of dollars in Act 183 of 2022, an omnibus workforce bill signed into law in June, that had yet to be paid out.

A $2 million program to increase compensation for nursing school staff could still begin, Ena Backus, director of health care reform for the state Human Services Agency, told the committee Thursday. But another $2.5 million to support on-the-job nursing training of existing lower-skilled health care staff did not fit federal guidelines for using state recovery funding from the American Rescue Plan Act, she said. Other initiatives have stalled because the state has not been able to fill funded positions.

Rep. Mari Cordes, D-Lincoln, who is a registered nurse at UVM Medical Center, expressed disappointment. “The people we should be helping are still not getting help, and it’s nine months later,” she said.

First-term Rep. Joseph Andriano, D-Orwell, compared the state of the health care system to a village on fire, describing the federal funds allocated last year as the water needed to put out the fire. “I’m wondering why the water isn’t getting into the guts,” he said.

“We all understand the urgency. We all know the village is on fire and we are working as fast as we can,” said Rep. Lori Houghton, D-Essex City, the committee chairwoman. “It’s frustrating. It’s very frustrating. Welcome to being a legislator.”

– Kristen fountain

WE KNOW

For Homeless Awareness Day, luminaries lined the steps of the State House and stuffed clothes arranged to look like people sleeping in bundles dotted the icy walkway that runs through the lawn. Photo by Sarah Mearhoff/VTDigger

It was today Homelessness Awareness Day, and advocates across the state held vigils to commemorate those who have died while living homeless and to bring renewed attention to the state’s ongoing housing crisis. At the State House, luminaries lined the steps and stuffed clothes, arranged to look like people sleeping in groups, dotted the icy walkway that runs through the lawn.

If things are bad now, they will get much worse. On March 31, unprecedented federal funding is set to dry up for Vermont’s transitional housing program, the Covid-19 pandemic-era program that has housed much of the state’s homeless population in motels. About 1,300 families currently receive housing through the program, and there appear to be no plans in place to fill the gap.

Inside the State House, lawmakers and lobbyists were greeted by a less artistic but still effective display as they entered the cafeteria: a cardboard map of Vermont. Sticky notes in each region displayed the number of people experiencing homelessness registered in the state’s database for the year, and below that, the number of shelter beds. In Washington County, the ratio was 932 to 91.

Martin Hahn, executive director of the Vermont Coalition to End Homelessness, said the numbers make it clear what awaits vulnerable Vermonters when that motel program ends. (The coalition is asking lawmakers to find the money to keep it in place until the end of June.)

“The solution, at this point, is for people to sleep outside,” Hahn said, pointing to a “survival kit” also on display, meant to illustrate the latest tool that local service providers are preparing for their customers.

And then, scanning the Sorrell boots, hand warmers, flashlight, two-person tent and neatly arranged sleeping bag in front of a reporter, he added this: “This is an overestimation of what many people are able to provide .”

– Lola Duffort

The Legislature has approved a two-year expanding pandemic-era options how and when the state’s 247 cities and towns decide on local leaders, spending and special items.

H.42passed by the House of Representatives last week and the Senate on Thursday, mirrors legislation passed in 2021 and 2022 that allowed municipalities to make short-term, Covid-safe changes to Town Meeting — traditionally held on the first Tuesday in March or about it – and board meetings only online.

The bill, now awaiting the governor’s signature, would continue the options of moving from a floor vote to a ballot, rescheduling town meetings to a later date and holding online public information sessions until July 1, 2024.

Read more here.

– Kevin O’Connor