[W]ith Vermont’s hospitals struggling to make ends meet, the House Health Care Committee wants to take a closer look at the future of rural health care.
The committee has approved H.528, which seeks to establish a Rural Health Services Task Force. That would bring together state officials, medical practitioners, mental health professionals and others to “identify ways to sustain the system and to ensure it provides access to affordable, high-quality health care services.”
The bill comes in the wake of major financial problems at Springfield Hospital. But lawmakers said they’re also interested in a larger examination of a system that’s tasked with delivering modern health care in sparsely populated areas.
“I think it’s a response to a much bigger issue,” said Rep. Lucy Rogers, D-Waterville and a member of the Health Care Committee. “At the same time, Springfield is on our minds, clearly, right now.”
Springfield Hospital’s issues have led to job cuts and a state bailout. But Springfield is not the only Vermont hospital that’s struggling: A recent analysis by the Green Mountain Care Board found that a majority of the state’s hospitals lost money on operations in fiscal year 2018.
The care board’s report also found that the growth in hospital expenses is outpacing revenues statewide, and operating margins are eroding.
Rep. Ben Jickling, I-Randolph and a member of the Health Care Committee, said the state was “completely caught off guard” by the Springfield Hospital situation. He doesn’t want to see that happen again, and he also wants to know how the state can better support its small hospitals.
“We as a state have to be in a better position to react to these situations, and to be more proactive,” Jickling said.
Jickling had introduced H.446, which created a new Rural Health Commission and imposed a tax on the revenues of “walk-in” health care facilities like independent urgent care centers. Proceeds from that tax would have been used partly to fund rural health care pilot projects and partly to compensate hospitals that treat large numbers of Medicaid and uninsured patients.
Jickling’s bill didn’t advance. But in the days before the legislative “crossover” deadline for this year’s session, the Health Care Committee took the idea of studying rural health care and placed it in a new bill – H.528 – that the committee approved on Friday.
The legislation’s Rural Health Services Task Force would include representation from the Agency of Human Services and the Green Mountain Care Board, as well as from the Office of the Health Care Advocate at Vermont Legal Aid.
There also would be two task force members from rural hospitals “that are located in different regions of the state and that face different levels of financial stability.”
Additionally, the task force would include an independent, rural doctor and a licensed mental health professional along with representatives from federally qualified health centers, designated mental health agencies, home health agencies and long-term care facilities.
The task force would examine the rural health care system in Vermont and determining how to “ensure the sustainability” of that system, “including identifying the major financial, administrative and workforce barriers.” The group is supposed to come up with ways to overcome those barriers and analyze “the potential consequences of the failure of one or more rural Vermont hospitals.”
Vermont has not seen any closings, though Springfield came close. Nationwide, there have been more than 100 rural hospital closures in less than a decade.
“Is there a way we can go forward and support our hospitals so that we’re not a part of that trend?” Rogers asked.
At the same time, she noted that “hospitals don’t work in a vacuum – they work as part of a whole system.”
“The end goal is that everyone has access to high quality and affordable health care in rural places. Hospitals are a piece of that system, but we don’t want to be narrow in our view of that,” Rogers said. “We really wanted to bring together stakeholders from all the different parts of the rural health care system, not just hospitals, to talk about these issues.”
The task force’s report is due by Dec. 31. After that, the group would dissolve.
Rogers said the committee wanted to allow the task force room to set its own agenda for discussion while also giving lawmakers a prompt report on which to base legislation in 2020.
“Next year, it will be the same group of people (on House Health Care), which is really important to us, because there clearly is momentum surrounding rural health care in this committee,” she said.
