Devon Green: ER capacity limits also affected by post-treatment shortage

by Devon Green, VP of Government Relations, Vermont Association of Hospitals & Healthy Systems

For those that skim, I’m keeping the intro brief in the hope that you dedicate more brain space to the budget piece, below:

 FY’25 Budget: Last week, the policy committees heard from organizations making their cases for funding. VAHHS put a twist on this process by advocating not for themselves, but for strengthening our post-acute care system, including skilled nursing facilities and home health agencies. In our letter to the House Human Services, House Health Care, and House Appropriations Committees, 

VAHHS noted that as of February 6th there were 142 individuals waiting to be discharged from hospitals and 28 patients waiting for beds in emergency departments. 

Health Care providers are having to treat individuals in waiting rooms and at least one emergency department went on diversion as a result of patients having no place to go after their hospital stay. 

The Agency of Human Services has some good forward momentum in stabilizing skilled nursing facilities and home health agencies, but we hope the legislature can go even further to strengthen these organizations so Vermonters can get care in the right place at the right time.

FY’24 BAA: Now that it has passed both chambers, there will be a conference committee on the 2024 Budget Adjustment Act to iron out some differences between the House and the Senate, including:

  • $17 million in the Senate versus $14 million in the House for skilled nursing facilities
  • Increase in skilled home health reimbursement rates 

Occupational therapy compact: The House Appropriations Committee passed H.247, the Occupational Therapy Compact, but raised concerns about how the government loses needed licensure fees to administer licensure programs with the growing popularity of compacts.

Audio-only telehealth: The Department of Financial Regulation reported back House Health Care on audio-only telehealth impacts to quality of care, patient satisfaction, and costs. The Department found that audio-only represents a small portion of telehealth services at 4.4%. While more research is needed on quality of care, the Department concluded that reimbursing audio-only telehealth at parity would not have a big cost impact.

Alzheimer’s disease and dementia education bill: The Senate Health and Welfare Committee looked at S.302, a bill that promotes a public health effort to educate health care providers early detection and diagnosis of Alzheimer’s and dementia.

Medicaid coverage for doulas: The Senate Health and Welfare Committee passed S.109, which provides Medicaid coverage for doula services during pregnancy, labor, delivery, and the postpartum period.