Two health provider groups brought alarming anecdotes and statistics to the House Committee on Health Care this week, causing one new lawmaker to compare the state’s health care system to a village on fire. Unlike the evacuation of the Statehouse earlier in the week, this was not a drill.
“In the last couple years, we were hoping it was Covid. We were hoping it was the aftereffects of Covid. We were hoping we could dig our way out of it,” Devon Green of the Vermont Association of Hospitals and Health Systems said on Thursday morning.
But this week, systemwide, inpatient medical surgical beds in local hospitals are at 97% capacity, with UVM and Dartmouth Hitchcock medical centers both entirely full. As has become the norm, over one-third of those beds are being used by patients who could be transferred to lower-level care facilities that can’t accept them due to their own lack of staffing, Green said.
The cascading effects are extreme. There are 25 people statewide waiting in emergency departments to be transferred to inpatient beds. And those are the patients who can even be served in-state. “We have been having to send people with heart attacks as far away as Connecticut,” she said.
Meanwhile, five hospitals surveyed this week reported 500 open positions. And nine out of the state’s 14 hospitals are running an operating deficit, two-thirds of which is due to increased labor costs.
The situation outside hospital settings 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 physician assistants, said on Wednesday morning.
An annual survey of the society’s members shows that they are suffering. “Just the level of stress that health care providers are under right now is incredible and enormous, and frankly almost overwhelming,” Barnard said.
That stark reality was the backdrop to the news that millions of dollars legislators had allocated in 2022’s Act 183, an omnibus workforce bill signed in June, had yet to be disbursed.
One $2 million program to increase compensation for nursing school staff may yet get going, said Ena Backus, the director of health care reform for the state Agency of Human Services, to the committee on 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 use of state recovery funding from the American Rescue Plan Act, she said. Other initiatives have stalled because the state has been unable to fill funded positions.
Rep. Mari Cordes, D-Lincoln, who is a registered nurse at UVM Medical Center, expressed frustration. “The people that we need to help are not getting help yet, 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 the fire out. “I am wondering why isn’t the water getting into the hoses,” 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 Junction, the committee’s chair. “It’s frustrating. It’s very frustrating. Welcome to being a legislator.”
— Kristen Fountain
IN THE KNOW
Today was Homelessness Awareness Day, and advocates across the state held vigils to commemorate those who have died while living unhoused and to bring renewed attention to the state’s ongoing housing crisis. At the Statehouse, luminaries lined the steps and stuffed clothes, arranged to look like bundled, sleeping humans, dotted the icy walkway that cuts across the lawn.
If things are bad now, they are about to get much worse. On March 31, unprecedented federal funding is set to dry up on Vermont’s transitional housing program, the Covid-19 pandemic-era program that has housed the bulk of the state’s unhoused population in motels. About 1,300 households currently receive shelter through the program, and there appear to be no plans ready to fill the gap.
Inside the Statehouse, a less artful but nevertheless effective display greeted lawmakers and lobbyists as they made their way into the cafeteria: a cardboard map of Vermont. Paper notes taped to each region displayed the number of people experiencing homelessness recorded in the state’s database for the year, and below, the number of shelter beds. In Washington County, the ratio was 932 to 91.
Martin Hahn, the executive director of the Vermont Coalition to End Homelessness, said these numbers make clear what awaits vulnerable Vermonters when that motel program ends. (The coalition is asking lawmakers to find the cash to keep it going through 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 last resort that local service providers are preparing for their clients.
And then, scanning the Sorell boots, hand warmers, flashlight, two-person tent and sleeping bag tidily arranged before a reporter, he added this: “This is an overstatement of what many people are able to provide.”
— Lola Duffort
The Legislature has approved a two-year extension of pandemic-era options for how and when the state’s 247 cities and towns decide local leaders, spending and special articles.
H.42, adopted by the House 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 or around the first Tuesday in March — and gather governing boards solely online.
The bill, now awaiting the governor’s signature, will continue the options of switching from floor voting to ballots, rescheduling Town Meetings to a later date and holding public information sessions online until July 1, 2024.
— Kevin O’Connor
WHAT’S ON DECK
Not that you were going to forget: Gov. Phil Scott delivers his 2023 Budget Address on Friday at 1 p.m. to a joint assembly in the House chamber. Watch it live.
WHAT WE’RE READING
‘Contained fury’: Shaftsbury residents alarmed over 85-acre solar proposal (VTDigger)
Snowy forecast could signal change in Vermont’s unseasonably warm weather (VTDigger)
Mary Lake slaughters and shears sheep for a living. They’re ‘everything’ to her (Vermont Public)
Correction: An earlier version of this post misstated Rep. Lori Houghton’s city.