State regulators expect to wrap up their investigation into specialist visit wait times before the next legislative session, Mike Smith, secretary of the Vermont Agency of Human Services, said on Tuesday.
The state probe follows a Seven Days investigation revealing that some patients of the Burlington-based University of Vermont Medical Center, the largest hospital in the state, have been waiting for outpatient specialist appointments for weeks or months. After the newspaper published its report this month, the agency launched its investigation, saying it would focus on wait times for medical appointments statewide.
Speaking during Gov. Phil Scott’s weekly Covid-19 press conference, Smith said Vermont officials will use the data they collect to introduce legislation at the upcoming session in January.
“We’re trying to work as expeditiously as possible,” he said.
John Brumsted, CEO of UVM Health Network and UVM Medical Center, has previously said that he welcomes the state’s investigation, calling the status quo “unacceptable.” But in a Sept. 7 letter to state regulators, Brumsted took a more defensive tone.
“We are seeing the effects of multiple years of lean budgets for [UVM Health Network],” Brumsted wrote in the letter addressed to Smith; Mike Pieciak, commissioner of the Vermont Department of Financial Regulation; and Kevin Mullin, chair of the Green Mountain Care Board.
“We are efficient and low-cost, and will remain so, but we need to have enough revenue to invest in our people and our facilities. Without that, now and in the future, we will not be able to recruit and retain the talent we need in inpatient, outpatient and long-term care settings…”
Smith said he was disappointed by the letter because it focused on actions that Brumsted believes the state should be taking, rather than outlining steps the network would take to address inefficiencies and staffing vacancies that exacerbate wait times.
In his letter, Brumsted said the health system would need additional money to hire personnel. He also asked the state to invest in inpatient psychiatric beds and for the state to expedite its approval process for renovation projects such as expanding UVM Medical Center’s ER and surgical rooms and for purchasing an additional MRI machine.
The state, Smith said, has supported the medical center through a total of $73 million in stabilization grants in fiscal years 2020 and 2021, as well as other support. The agency has also increased the rates Medicaid pays for services, with an additional increase slated for this year, he said.
“The governor and the administration and myself fought for keeping and stabilizing the health care system and with the help of the Legislature, we’ve provided a lot of financial assistance,” Smith said on Tuesday. “We do have some expectations, and that is people that are running these institutions to find ways in conjunction with us to fix the problem instead of sending memos that just lays it on one side.”
UVM Health Network spokesperson Annie Mackin said Tuesday afternoon that Brumsted’s letter outlined some of the steps the system has taken to address the wait time issue. But the UVM Medical Center has a number of patients with nowhere else to go, Mackin said, including 46 hospitalized patients awaiting beds at long-term care facilities and 15 psychiatric patients — three of them children — at the Emergency Department for lack of inpatient beds.
“That doesn’t change the fact that we need our regulator and the state to be partners with us,” she said.
Pieciak, whose Department of Financial Regulation is also involved in the inquiry along with the Green Mountain Care Board, said that state regulations say Vermonters with commercial insurance are entitled to seek out-of-network care at no extra charge if they aren’t seen by a doctor in their own network within a reasonable time.
“Obviously it’s not the solution to this problem. It’s just something that Vermonters should be aware of and take advantage of, while we look into it further,” he said.
Correction: Due to an editing error, an earlier version of this story misspelled an instance of John Brumsted’s name.
