Current News

by Morgan True vtdigger.org
Home health companies in Vermont want the Agency of Human Services to pay for telemonitoring services for Medicaid beneficiaries.
Medicare and private insurers already pay for the service, which yields significant savings by reducing hospital admissions, said Peter Cobb, director of the Vermont Assembly of Home Health and Hospice agencies.
Telemonitoring in a home health context means placing devices in the patient’s home to take vital signs and relay the information back to the home health agency. When readings are outside parameters set by a physician, a nurse is sent to the patient’s home.
It is a distinct service from telehealth or telemedicine, which generally involves video conferencing with physicians in lieu of in-person appointments.

by Morgan True vtdigger.org
The Senate Health and Welfare Committee confirmed Al Gobeille as chair of the Green Mountain Care Board Friday after he delivered a status update on the board’s work in 2013.
Gobeille took over as chair in August when Anya Rader Wallack stepped down, taking a lucrative consulting position helping Vermont manage its $45 million federal State Innovation Model (SIM) grant.
Al Gobeille. File photo by Josh Larkin/VTDigger
Despite the Burlington restaurateur’s scant health policy background, his board colleague Dr. Allan Ramsay said he’s effectively balanced the economic imperatives of reform with its social mission to improve people’s health.
Gobeille discussed the board’s annual report, which was released earlier this month, with senators.
The board’s mandate is to reduce costs and improve the delivery of health care services in Vermont and guide the state’s transition to a universal health care system.

by Rob Roper A goal of Green Mountain Care ‘ the primary goal, according to Governor Peter Shumlin ‘ is to control the total amount of money that Vermonters pay for health care. Back in November, an’ independent report’ by Avalere Health concluded that the official estimate of $1.6 billion in new taxes necessary to replace premiums and pay for a single payer healthcare system was too low. The real number is more likely to be in the $1.9 billion to $2.2 billion range.
This is significant because, if the Avalere numbers are correct, adopting Green Mountain Care will not save Vermonters anything. The single payer system would end up costing us even more than the current system, as messed up as the current system is. There’s not a lot of room for error.

Publicity surrounding the implementation of patient decision support interventions (DESIs) traditionally focuses on two areas of improvement: helping patients make better decisions AND lowering health care spending. The use of patient decision support interventions as a means to generate health care savings has been widely advocated, but the extent and quality of evidence is unclear.
A systematic review found that the evidence for savings was not as broad or deep as suspected. In addition, an examination of the quality of the economic analyses in the studies was performed. Not surprisingly for a young field, the quality has room for improvement. An assessment of the risk of bias in each study found a moderate to high risk across the studies that found savings.

Dartmouth engineers and radiologists are developing new approaches for an emerging technique in diagnostic imaging for breast cancer’MRI with near-infrared spectroscopy (NIRS) as reported in the journal Academic Radiology, February 2014.’
Combined MRI/NIRS may benefit women whose mammogram showed an abnormality and requires further testing to rule out cancer. The test would be conducted before an invasive biopsy to look for tumors.’ For the new method to work successfully in routine patient care, MRI/NIRS must adapt to an individual’s body size as well as accommodate a range of cup sizes.’ The equipment must also mobilize and maintain contact with the breast.’

Vermont Attorney William H Sorrell is leading an effort to preserve federal, state and local control over tobacco products in a proposed Pacific-basin free trade agreement. In a letter released Monday through the National Association of Attorneys General and co-sponsored by Attorneys General Sorrell and Lawrence Wasden of Idaho, the chief law enforcement officers of 44 states and territories are calling upon the United States Trade Representative to exclude tobacco and tobacco products from the Trans-Pacific Partnership, which is currently under negotiation. This would preserve the ability of federal, state and local governments to regulate tobacco products to reduce their use and protect the public health.

Governor Peter Shumlin announced today that he will appoint Michael Sirotkin of South Burlington to replace his late wife, Senator Sally Fox, in the Vermont Senate. The appointment was expected. Fox passed away from cancer on January 10.
Sirotkin, who started his career at Vermont Legal Aid, asked to be considered for the seat held by Fox in the Chittenden County Democratic Committee nominating process. Sirotkin was chosen as one of three nominees sent to the Governor by a large majority of the 60 Committee members who voted in the process.’ ‘ ‘
‘There were several exceptional candidates interested in this Senate seat,’ Shumlin said in a statement. ‘But Sally wanted her husband to fill her seat after her death, and recognizing Sirotkin’s strong qualifications, I’m honoring that request. I’m confident that Michael will continue the great work Sally did for the district and the state.’’

by John Herrick vtdigger.org After weeks of debate centered on the rights of lakeside property owners and the urgency to protect Vermont’s shared resources, a committee of lawmakers approved legislation to regulate shoreland around the state’s lakes and ponds.
The Senate Natural Resources and Energy Committee unanimously approved a bill Friday to require a permit for certain development around lakes and ponds of greater than 10 acres.
The Senate’s version of H.526 requires a state permit to develop property within 250 feet of lakeshores under certain conditions. The bill also includes a list of exemptions for small projects, qualifying towns and urban and agricultural shorelands.
Sen. John Rodgers, D-Essex-Orleans, a member of the Natural Resources and Energy Committee. Photo by John Herrick/VTDigger

by Hilary Niles vtdigger.org A first-of-its-kind look at student-staff ratios across grade levels in Vermont offers some insights into education costs, and also raises plenty of questions. Namely: what to do with all the information.
The report from the Agency of Education recommends minimum course sizes across grade levels for four main learning categories: English, math, science and social studies. Up to eighth grade, the smallest class sizes should be 10 students at schools of 150 children or more; at schools with fewer students, classes should consist of no less than five children, the report says. The minimum class size would be 10 for schools with grades 5-8, or any school up to 12th grade.

Addison County Transit Resources (ACTR) was recently asked by the Vermont Agency of Transportation (VTrans) to provide management services for Stagecoach Transportation Services Inc, based in Randolph. Stagecoach is one of Vermont's several non-profit rural community transportation providers.
Stagecoach's longtime executive director recently stepped down from that role, which left it in need of new leadership. ACTR was asked to assume management responsibilities due to its strong history of operational success, as well as the many similarities between the two regions.
Stagecoach provides more than 100,000 rides annually to Orange and North Windsor County residents connecting people to jobs, medical appointments, school, shopping and other vital quality of life services. VTrans, Stagecoach and ACTR are currently working out a three-year agreement for ACTR to manage administrative and operational functions for Stagecoach.

by Anne Galloway vtdigger.org The Vermont House passed the Budget Adjustment Act on Friday. The vote, which was largely split along partisan lines, was 110 to 33. Most of the Republican caucus voted against the $12.6 million mid-year increase in spending for fiscal year 2014.
The Budget Adjustment Act, H.655, includes increased spending on winter road maintenance, methadone treatment, an increase in prison costs and a spike in emergency housing expenditures.
The House also put $9.5 million in a rainy day fund.
In a statement House Speaker Shap Smith said the bill ‘makes important adjustments to the 2013 budget with the health and wellbeing of Vermonters in mind.’

by Anne Galloway vtdigger.org Environmental issues will preoccupy both the Vermont House and Senate this week. The House takes up H.702, the so-called ‘net metering’ bill, which would raise the cap on how much power utilities can accept from household solar electric systems. Under the current law, utilities are required to take up to 4 percent of the utility’s power based on peak demand levels from net-metering systems. The bill would raise the cap from 4 percent to 15 percent. Utilities and customers want assurance that the program does not subsidize backyard renewable energy projects at the expense of ratepayers who do not participate in the program.
The Senate is expected to bring H.526, the shoreland protection bill, to the floor.