Week 5 Legislative Update

Action continues in the committee rooms with little time spent on the House floor. The Governor’s veto of the paid family leave bill was sustained on a vote of 99-51. In order to override a veto each chamber needs a two-thirds majority vote. I am deeply disappointed in this vote but will continue to find ways to support Vermont families.

The Health Care Committee continues to focus on workforce, affordability and accessibility. All three being intimately linked together. We are experiencing shortages in all professions from unlicensed personal care attendants and direct support professionals, to physicians - across all care units. A 2018 study found there will be 3,900 nursing vacancies in Vermont by spring 2020 – just around the corner.  The situation in Vermont is not unique, these same issues are happening across the country.  In Vermont the workforce crisis is driven by several factors: tight national and local labor markets, aging workforce, provider burnout, rising higher education costs, limited educational capacity, insufficient Medicaid rates and broader economic development challenges. The health care committee is taking testimony on how we license medical professionals, what background educators need, programs for student loan repayment and an expansion of telehealth, just to name a few focus areas, in an effort to turn the tide.

I attended a meeting where Dr. Joshua Sharfstein, Professor of the Practice of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, provided a national perspective on Vermont’s health reform. He spoke of the widening gap between U.S. health spending and that of other countries and the decline in U.S. life expectancy. He discussed the limits of fee for service reimbursement, the current U.S. model, and how that model incentivizes expensive procedures, creates a tug of war between insurers and clinicians and rewards the healthcare system when our population is sicker. This is at the crux of Vermont’s efforts with the move to value based payments through our All Payer Reform. We have a statewide goal of improving quality of care and population health while limiting cost growth.  At the center of our reform efforts is OneCare, Vermont’s accountable care organization. An ACO is a group of healthcare providers, including hospitals and doctors, who work together to provide high quality, coordinated care. One of the key known success factors for an ACO is the involvement of multiple payers - in Vermont’s model we are bringing together Medicare, Medicaid and commercial insurers. Early results show our efforts are working with patients reporting timely care, good communication and coordination. The Milbank Quarterly reviewed the reform efforts of four states and found that Vermont has “the most promising results” with fewer hospitalizations and monthly savings per person versus their comparison groups. The committees of jurisdiction will continue oversight of our reform efforts and I’m happy to provide more information to anyone interested. 

On a completely different note I co-sponsored a bill this year asking for a $500,000 increase to the Vermont Department of Tourism and Marketing promotional budget focused on encouraging out-of-state visitors to Vermont. This department unifies messaging from the various parts of the state and across the tourism sector into one cohesive message and shares that message to potential visitors across the country and around the world. There are many ways that tourism is economic development – it generates tax revenues, creates jobs and unlocks economic activity in rural communities. After manufacturing, tourism is the second largest contributor of out-of-state dollars to the state.  Tax revenue generated from tourism equates to a savings of over $1450 for every Vermont household – any investment we make in tourism will benefit all Vermonters by bringing in more revenue. We are asking for this increase now because Vermont has decreased its investment in tourism promotion by 6% over the last 5 years – we need to reverse that trend and invest in Vermont. 

There are a few upcoming events that might interest residents: 

House Speaker Mitzi Johnson will be holding a community conversation at ArtHound Gallery Monday February 10th from 6pm to 7:30pm.  The ArtHound Gallery is located at 21 Essex Way (across from the Essex Cinemas). 

Voices for Inclusion in Essex and Westford will present The Hate U Give on Wednesday February 12th at Essex High School from 6pm to 9pm.  A dialogue will be held after the free screening.

The next Essex Delegation Community Conversation is Saturday February 15th from 9am to 10:30am at Sweet Alchemy.  This is a relaxed environment where we answer questions and have discussion on the topics important to residents.
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Hope to see you at one or all of these events.  As always, don’t hesitate to reach out with questions or comments – Houghton.lori@gmail.com