Access to Health Care

The COVID pandemic has been devastating to our health care system, creating staffing shortages, financial challenges, and access difficulties for patients. As Vice Chair of the Health and Welfare Committee, one of my priorities has been working to stabilize this fragile system, while expanding access for patients and moving forward with health care reform.

Mental Health Care. We are in the midst of a mental health crisis exacerbated by the isolation and anxiety of the pandemic. My first budget priority was ensuring that our local designated mental health agencies, like the Counseling Service of Addison County, received an increase in state funding. We were able to provide an 8%, or $26.6 million, increase in funding to these crucial mental health care providers, as well as disability service and home health care providers statewide. This funding has enabled these agencies to increase salaries and shore-up services for Vermonters. The Senate led efforts to improve mental health services for students and teachers by expanding or creating evidence-based, trauma-informed programs and strategies in partnership with the Agency of Education, Department of Mental Health, local designated mental health agencies, schools, and after-school programs. This legislation, S.197, will ensure greater access to mental health and well-being services to youth throughout Vermont.

Substance Use Prevention and Recovery. In 2021, 210 people died from opioid overdoses in Vermont, an increase of 33% over 2020. The FY23 budget includes significant funding for statewide recovery centers, a new Jenna’s House treatment program, substance misuse prevention coalitions statewide, recovery services for people transitioning from incarceration, prevention & needle exchange programs, and employment services for people in recovery. In addition, we expanded the type of organizations that can operate needle exchange programs, further decriminalized possession of certain harm reduction supplies, and expanded coverage of medication-assisted treatment. While I supported opening an overdose prevention site (also known as a safe-injection site) that did not pass, we did create an action-oriented working group to come back to the Legislature next session with a concrete proposal for opening such a site. (Unfortunately, after I wrote this summary, Governor Scott vetoed H.728, which included the provisions related to decriminalization, needle exchange, and the study of overdose prevention sites, drastically setting back progress in the the fight against the opioid epidemic.) Finally, we created an Opioid Settlement Advisory Committee to advise on the use of the Opioid Abatement Fund that has been established with opioid lawsuit settlement funds. Much more needs to be done to address the opioid crisis, but this work builds on a solid of system of recovery services and health care in Vermont.

Hearing Aid Coverage. Access to hearing aids is essential for people with hearing loss, but Vermont is one of the few states in the region that does not include coverage of hearing aids in its essential health benefits plan. This session we passed H.266/Act 108 that will now require coverage of hearing aids in most health insurance plans in Vermont.

Telehealth Licensure. Telehealth services have, literally, been live-saving during the pandemic, as many people have been unable to access health care in person. In order to ensure access to providers during the public health crisis, we have temporarily relaxed licensure requirements for out-of-state physicians and other health care providers who see patients in Vermont via telehealth platforms. This session, we created a three-tiered telehealth registration and licensure system for 26 different professions — from alcohol & drug abuse counselors to veterinarians — with reduced licensure fees, to enable continued services from out-of-state practitioners, while also meeting Vermont professional standards. This system will allow greater access for patients, while also protecting the safety of patients and quality of providers.

Prescription Drug Access. The cost of prescription drugs makes up a significant proportion of overall health care costs in the United States and the industry is increasingly dominated by large pharmacy chains and corporations. We passed legislation intended to make prescription drugs more affordable and accessible by increasing State regulation of pharmacy benefit managers and stabilize and safeguard against the loss of more independent and community pharmacies. The bill is quite complex and includes several measures to better regulate the industry, improve transparency, enhance access and safety, and support community pharmacies.

Care and Support for People with Alzheimer’s Disease. In 2020, an estimated 13,000 Vermonters aged 65 and older were living with Alzheimer’s Disease and Related Dementia, a figure that’s expected to grow by 30% by 2025. In addition, in 2020, 25,000 Vermonters were caring for people living with Alzheimer’s, most of them unpaid family members, totaling about 36 million unpaid hours of care with a value of $717 million. This session, I championed S.206/Act 113 that expands support, planning, and services for people with this devastating disease and those who care for them.

Health Care System Oversight. Over the past two decades, Vermont has engaged in several major health care reform efforts, with varying success. Reforming a system stressed by a global pandemic is extremely challenging, yet crucial to ensuring sustainability for health care providers and affordability for patients. Two important deadlines are on the horizon — the renegotiation of Vermont’s agreement with the federal government for support and participation in the state’s all-payer health care model, and the renegotiation of the state’s contract with the OneCare Accountable Care Organization. These renegotiation processes create an opportunity to make changes in our health care system with the goal of lowering costs, expanding access, and improving quality for all Vermonters. The Senate lead the way in passing legislation that will require the Agency of Human Services and Green Mountain Care Board to partner in these efforts and engage the public in the process.