Tieman: The way through the storm

by Jeff Tieman, VAHHS President and CEO However long it may seem, it was only 10 months ago that our state went into a state of emergency to protect Vermonters from a new, scary and highly contagious virus. At the onset of COVID-19, it felt like we were driving through a furious snowstorm and our windshield wipers failed. Visibility was limited and the road was winding, unknown and potentially very dangerous.

Every week since has been a challenge, and this one will be no exception. The difference is now our windshield wipers are working and we can see both the road and the destination, which is a vaccinated Vermont. In fact, according to a leading COVID-19 data scientist, Youyang Gu, Vermont is the first state to vaccinate more people against COVID-19 (6%) than were infected with the virus (4.4%).

We are clearly headed in the right direction.

On Wednesday, Vermonters aged 75 and older will begin to receive COVID-19 vaccines throughout our state. By expanding vaccinations to those 75 and over, we take a few important steps:

1) protect those who are most vulnerable to COVID,

2) move beyond health care workers to include the first segment of the general public, and

3) prevent our hospitals and health system from becoming overwhelmed.

In short, this is great progress! It is an exciting week for Vermont and a victory in the war against COVID-19. Hospitals are proud to have helped get the state to this point and will continue to be part of vaccinating Vermonters both this week and beyond. And, that’s not all our hospitals continue to do. We are testing, treating and caring for Vermonters with COVID-19 and, at the same time, delivering the routine and necessary quality care we depend on.

As we look to the road ahead, here are ways to keep us moving in positive direction:

• Advise relatives and friends 75 and older to use the state’s online enrollment system, beginning later today, to sign up for their vaccine appointments.

• Assist parents, grandparents and others in using the website to keep the phone lines open for those who need it.

• Keep scheduled appointments; the likelihood of wasting vaccine increases if appointments are missed or canceled.

• Limit signup attempts to those over 75 years old. More age groups will be added in time, but it will only slow the pace of vaccinations if others try to jump the line.

• Be patient – with the website, with health care providers, with call takers, and with each other. There is still a long road ahead.

And on that note, vaccines are welcome and wonderful news, but our blizzard rages on. Even though visibility is improved, COVID-19 is still present, with a significant case count—so we have to continue the critical safety measures: masks on faces, six-foot spaces, uncrowded places.

We will not need these practices forever, but we do now. The best way through the storm is twofold: broad-base vaccination as quickly, effectively and fairly as possible, and following the guidance that has made Vermont a leader in responding to the pandemic. To see this metaphor through to the end: know the snow will subside, the clouds will part, the sun will shine and we will see blue skies together again.

Have a good week, stay safe.

Jeff Tieman

VAHHS President and CEO

by Devon Green VAHHS Vice Preident of Governmental Relations As testimony was winding down on Wednesday morning, I could not appreciate one senator more when she abruptly announced she needed to leave. I assumed she had another meeting, but she proclaimed that the first female Vice President was being sworn in, and she was not going to miss this piece of history! As historic as the inauguration was, it also marked a return to normalcy during these extraordinary times. Similarly, the legislature started diving into issues in a way that feels both familiar and normal despite the pandemic—mainly focusing on COVID-19, but also looking at some broader areas. Last week COVID-19 regulatory flexibilities: The House Health Care Committee revisited the regulatory flexibilities afforded to health care providers at the start of the state of emergency (incredible summary by legislative council can be found here). Over the summer, VAHHS and other health care providers advocated extending the flexibilities to the end of June 2021 to give health care providers flexibility. The resulting legislation created a patchwork of dates for when the flexibilities end, with some ending on March 31, 2021, some ending on June 30, 2021 and some ending at the end of the state of emergency (or even six months afterwards). The House and Senate health care committees will examine these provisions and determine if further extensions are required. COVID-19 federal funding: The health care committees heard testimony on federal funding related to COVID. The federal government extended the timeframe for using Vermont’s remaining $10 to $30 million in coronavirus relief funds from December 30, 2020 through December 2021. The legislature will evaluate how these remaining funds will be spent. In addition, Vermont is receiving the following federal funding: A Federal Medical Assistance Percentages (FMAP) bump of 6.2 percent, which will be in effect as long as the public health emergency is in effect (and that has been extended until the end of June 2021) $5.6 million for vaccination administration from the Centers for Disease Control and Prevention (CDC) $35.9 million for testing and contact tracing, COVID 19 mitigation from the CDC Green Mountain Care Board introduction: The Green Mountain Care Board provided an overview and discussed their 2021 priorities with the Senate Health and Welfare Committee, including the following: Implementation of the all-payer model (APM) and APM 2.0 planning—includes robust oversight of the ACO and ensuring the ACO adds more value to the system than cost Regulatory integration Transparency through data & VHCURES 3.0—Board Chair Kevin Mullin noted a priority is to update rules to require data reporting on race and ethnicity, so GMCB is looking for funding that initiative in the budget. Update of the Health Resource Allocation Plan (HRAP) Health care workforce Hospital sustainability This week Budget address: The governor will be giving his budget address at 2 p.m. on Tuesday. VAHHS will be following any health care-related proposals carefully. Audio-only telehealth: House health care will hear about a Department of Financial Regulation working group's recommendations on audio-only telehealth. VAHHS supports extending reimbursement for audio-only telehealth until 2024 to ensure greater access to care in rural areas and to encourage providers to expand their telehealth practice in preparation for value-based payment. Prohibition of guns in hospitals: VAHHS will be testifying in support of S. 30, legislation, which prohibits possession of a gun inside a hospital. If you work in a hospital and have thoughts on this issue, please e-mail me at [email protected].