NMC Commentary

With the New Governor, What is NMC Expecting to Change?

It is too early to tell. While some level of change is natural with the introduction of any newly elected official, we are too early in the process of Phil Scott becoming Vermont’s Governor to know exactly what changes will be made and how those changes will impact the direction of current initiatives in Vermont. I am encouraged by early signs of a willingness to listen to the needs of communities and an interest in improving the health of Vermonters.  It is now up to all of us to work together to find the best share path forward.

Governor-elect Scott recently met with the Board of the Vermont Association of Hospitals and Health Systems.  He came to listen and heard Mental Health as the number one issue across the state.  Governor-elect Scott is very focused on strengthening Vermont’s economy and ensuring a healthy workforce.  Addressing mental health, addiction, and social determinants are key components of the effort it will take, so there is a strong opportunity to work together for the common good on shared goals.

In his campaign, Governor-elect Scott presented a plan to address addiction issues that focuses on “education/prevention, enforcement, and treatment.”  It calls for efforts to be “community based” as “one size does not fit all” and speaks of “building strong neighborhoods” as “every Vermonter has a role to play.”  It speaks to specifics around leadership structures to facilitate efforts, updated Federal drug disposal rules, flexibility for law enforcement, expansion of treatment options, and support for long term treatment.  It is worth reading and available online at: http://www.philscott.org/position-papers/phil-scott-vermont-addressing-vermonts-opiate-epidemic/  We look forward to collaborating with the administration on improvements.

Mental Health concerns are truly pressing and need a top level of focus. With shortages of available inpatient mental health beds in the state (due to both infrastructure and staffing), patients in severe mental health crisis sometimes have to be held in hospital emergency departments for days or weeks or months awaiting proper placement where they can get the level of treatment they need.  Community hospitals like NMC do not have the proper facilities or the specially-trained staff to provide exceptional care for these patients, so it creates a tremendous challenge for our team and for our dedicated partners at Northwestern Counseling and in local law enforcement to keep these patients safe as we work to get them to the care they need.  This must be addressed as a top priority. Vermont needs a long-term strategy for both inpatient and outpatient mental health care to prevent long, costly, and inappropriate stays in Emergency Departments.  We need a sense of urgency and a solution – not more distracting legislation.

Investment in primary prevention is also vital to improving Vermont’s future.  Research shows that every $1 invested in prevention returns $5 after five years and yet, the US and Vermont healthcare systems are not designed to fund primary prevention. NMC invests more than $2 million a year in unreimbursed secondary and primary prevention efforts, including serving as the primary funder of RiseVT, the local community campaign to embrace healthier lifestyles, improve the quality of life, and reduce healthcare costs where we live, work, play, and learn. This investment is challenged by state restrictions on hospital revenues, which is troubling as the State praises NMC for our efficiency and lower-cost status.  We must work with the administration and private partners to establish sustainable funding for a long term emphasis on preventing the chronic conditions which are driving the majority of Vermont’s healthcare spend.

To address issues of this nature, Governor-elect Scott has selected current chairman of the Green Mountain Care Board Al Gobeille to be the new Secretary of the Agency of Human Services (AHS).  This is a crucial role, as AHS’s mission is “to improve the health and well-being of Vermonters today and tomorrow and to protect those among us who are unable to protect themselves.”  AHS includes: the Department of Health; the Department of Mental Health; Vermont Health Access; the Department of Independent Living; the Department of Corrections; and the Department of Children and Families.  We know and respect Al Gobeille and welcome him to this new role.  His ability to listen to concerns, to bring the right people together, to analyze data, to identify opportunities for improvement, and to use good business practices will serve Vermonters well as he leads the Agency of Human Services.  I just hope with all the priorities real change can happen to restructure the system to allow for focus on the long term outcomes produced by focusing today on investing in primary prevention to reduce high cost chronic conditions.

Gobeille’s appointment means additional change for the GMCB – so the changes in this turbulent healthcare environment continue! As we work with the new administration and continue to navigate all of changes at hand, our focus on a healthier future for all will be unwavering. We will be at the table.

— Jill Berry Bowen, NMC’s Chief Executive Officer