The Green Mountain Care Board — a powerful player in Vermont’s health care sector — is about to gain some fresh new faces.
The board regulates the health care sector, which accounts for about a fifth of Vermont’s economy. Its members set hospital and insurance rates, regulate large purchases and construction projects and oversee OneCare Vermont, an organization that has become almost synonymous with health care reform in Vermont.
In May, board member Tom Pelham announced he will step down in September. That followed board chair Kevin Mullin’s April announcement that he’ll retire in July.
The nomination process to replace them has already begun.
The process is similar to how Vermont judicial appointments are made. A nine-member nominating committee for the board assembles a short list of possible members, but the governor has final authority over appointments.
Mullin’s successor could be a sitting board member or newly appointed one. The new chair will take the helm as Vermont’s health care system contends with the impacts of inflation and rising salaries. The state is also at a crossroads with the direction of health reform through the all-payer model.
Here’s a rundown of the process.
Who is on the committee?
According to state law, the governor’s office picks two members of the nominating committee. The House and Senate each appoint two lawmakers. Legislative leaders and the governor's office each pick one non-legislative committee member who has knowledge of health care policy, financing and health care delivery.
The governor-appointed members are Betsy Bishop, president of the Vermont Chamber of Commerce, who also chairs the nominating committee; Grace Branon, a dentist from St. Albans; and Tom Huebner, former chief executive of Rutland Regional Medical Center and now a member of the board of managers at OneCare Vermont, the state’s only accountable care organization.
OneCare funnels millions of health care dollars from the government and insurers to providers as part of the state’s ongoing effort to shift to paying for quality, rather than quantity, of care for Vermonters.
The legislators on the nominating committee are Sen. Ginny Lyons, D-Chittenden, Sen. Chris Pearson, P/D-Chittenden, Rep. Lori Houghton, D-Essex, and Rep. Anne Donahue, R-Northfield, according to Bishop.
Maria Mercedes Avila, a University of Vermont pediatrics and nursing professor, and Ellen Starr, executive director of Grounds for Health in Williston, also serve on the committee.
The nine members assemble candidates, and the governor picks from their list.
How will they choose the contenders?
Lyons, who has already been through a couple of nomination cycles, said the selection process begins with applications from interested candidates. The deadline for applications was May 27. This year’s pool includes at least 12 applicants, many of them physicians, according to Lyons. Sitting board members can also apply for the chair position.
Next, committee members choose applicants who are qualified enough to move to the next stage: an interview with the entire committee. Acing the interview is an essential component of the process, Lyons said.
The interview process is necessarily stressful for candidates, according to the senator, as it helps the committee weed out people who wouldn’t make it as board members.
“They are going to be very visible in the community,” she said. “And they're going to have to have the competence to be able to participate in a very transparent regulatory process.”
Candidates must also have some knowledge of Vermont’s health care system, finance and the duties of the Green Mountain Care Board, Lyons said.
The committee makes decisions by consensus, but Lyons said she’ll be looking for candidates with ideas about creating “a consistent, comprehensive system of care that links between our medical and community services.” Mental health knowledge is also high on Lyons’ list. “We’re in the middle of a mental health crisis, and so having folks who understand that whole relationship would be incredibly important,” she said. Lyons said the committee hopes to deliver its picks to Gov. Phil Scott’s office as early as later this month.
This year, a third board member, Robin Lunge, will finish her current term. She has asked to be reappointed, according to the board’s executive director, Susan Barrett. Such requests are usually accepted, Lyons noted.
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