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Monday, March 27, 2017

Burlington Man Upbeat After Injuring His Spine on Ski Slope

Posted By on Mon, Mar 27, 2017 at 7:47 PM

Ryan McLaren, left, and fiancée Adrienne Shea - COURTESY PHOTO
  • Courtesy photo
  • Ryan McLaren, left, and fiancée Adrienne Shea
Newly elected Burlington school board member Ryan McLaren is unsure whether he will walk again in the wake of a March 17 ski accident that damaged his spinal cord.

Despite a tough prognosis, 30-year-old McLaren was upbeat Monday in a telephone interview from the Spaulding Rehabilitation Center in Boston where he is undergoing physical therapy.

 “I am OK. I am as good as I possibly could be," McLaren said in an interview with Seven Days.

He expressed gratitude for all the love and support he has received from family, friends and his fiancée, Burlington lawyer Adrienne Shea.

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Friday, March 24, 2017

Walters: Scott, Senate Close to Mental Health Pay Fix

Posted By on Fri, Mar 24, 2017 at 8:52 PM

  • File: Jeb Wallace-Brodeur
  • Sen. Claire Ayer
The chairs of two key Vermont Senate committees say they are working out a plan to give workers in the mental health system a long-overdue bump in pay, and that Gov. Phil Scott is — at least in principle — on board.

“We have a plan, we’ve got a bill, we’re closing in on exactly how much money we need to do what we want,” said Sen. Claire Ayer (D-Addison), chair of the Senate Health and Welfare Committee, after emerging from a closed-door meeting with Scott Friday morning.

“We agree that there’s urgency to act,” she added. “We’re not in total agreement, but we’re pretty close.”

There’s broad awareness that the entire system is in shambles, with inpatient bed shortages, patients lingering for days or weeks in emergency rooms and low pay for mental health workers.

Ayer’s committee has approved a bill calling for a variety of studies, with an eye toward identifying longer-term fixes in 2018. In the meantime, the bill would establish a minimum $15-an-hour pay rate for all designated agency staffers. Earlier this week, Senate President Pro Tempore Tim Ashe (D/P-Chittenden) vowed that the pay issue would be addressed.

The price tag was originally thought to be $30 million, but that’s been pared down to less than $15 million because at least half the money would come from federal matching funds. That reduced figure was presented to Scott Friday morning.

“We’re having constructive discussions,” Scott said in a written statement. “There is consensus to try to improve the delivery of mental health services to Vermonters.”

His statement closed with a call to make the fix “budget-neutral.”

The legislation is now before the Senate Appropriations Committee. The crossover deadline for money bills was Friday; committee chair Jane Kitchel (D-Caledonia) said she would insert language “that would basically articulate our intent to address this funding need. It gives us time to really refine those numbers.”

Kitchel was loath to give a precise figure, but estimated that $16 million would be federal — making the state responsible for roughly $14 million. Her committee will look for ways to further reduce the figure, make it as “manageable” as possible, “and make sure we’re putting the money where the acute need is,” she said.

Possible options for reducing the cost of the wage fix include phasing in wage increases over time and trimming budgets in other areas of the system in anticipation of lower expenses if the staffing crisis eases on the front lines of mental health care.

Postscript: Friday morning’s meeting with Scott was supposed to include all five members of the Senate Health and Welfare Committee, and was listed on the panel’s official agenda. But when the five senators gathered outside Scott’s Statehouse office and saw Your Correspondent waiting outside, they went into a brief huddle with Ashe’s chief of staff, Peter Sterling.

Ayer then entered the governor’s office. A few minutes later, she came out and announced that the meeting would include only her and committee vice chair Ginny Lyons (D-Chittenden). The other three members were sent away.

“We just want to have a discussion with the governor, okay?” Ayer said.

“So did I cause this?” I asked.

“Yes, you did,” she said in a cheery voice.

“So it’s not a quorum,” I said.

“It’s not a quorum,” Sterling echoed.

I feel so accomplished. If they can’t think of anything else to put on my tombstone, they can always use “Once Caused a Quorum Kerfuffle.”

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Senate Revives Effort to Raise Smoking Age, But Future Uncertain

Posted By on Fri, Mar 24, 2017 at 4:14 PM

Sen. Debbie Ingram (D-Chittenden) speaks in favor of raising the legal smoking age to 21. - TERRI HALLENBECK
  • Sen. Debbie Ingram (D-Chittenden) speaks in favor of raising the legal smoking age to 21.
Lt. Gov. David Zuckerman broke his first tie Friday on a vote to rescue a bill that would raise the smoking age to 21.

The bill’s prospects remain in limbo, however, as senators later put the bill, S.88, on hold. Supporters indicated that while they had just enough votes to keep the bill alive, they lack sufficient backing to pass it.

“We wanted to give senators more time to be educated on the bill and address some of the concerns,” said Sen. Debbie Ingram (D-Chittenden), a leading supporter of raising the smoking age.

One of those concerns is money the state would lose by collecting less in cigarette taxes. Under the bill as written, the state would lose an estimated $1.4 million next year from cigarettes not sold to consumers under age 21.

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Friday, March 10, 2017

Officials: Vermont Would Take $200 Million Hit Under New Health Plan

Posted By on Fri, Mar 10, 2017 at 6:01 PM

Mary Kate Mohlman, state director of health care reform, and Al Gobeille, secretary of the Agency of Human Services, talk to reporters Friday. - TERRI HALLENBECK
  • Mary Kate Mohlman, state director of health care reform, and Al Gobeille, secretary of the Agency of Human Services, talk to reporters Friday.
If Congress’ plan to replace the Affordable Care Act goes through as proposed, Vermont would lose just shy of $200 million a year in federal Medicaid funding starting in 2020, state leaders said Friday.

“We think Vermonters should know this,” Al Gobeille, secretary of the Agency of Human Services, said at a media briefing in Montpelier. “You cannot tell from the coverage of these bills what impact this will have on Vermonters and we think that’s important.”

The Republican House majority’s proposal passed two key committees in Washington on Thursday and could reach the House floor by the end of March, according to news reports. The plan would replace federal insurance subsidies with individual tax credits and grants. President Donald Trump has endorsed the plan.

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Wednesday, March 8, 2017

Walters: Welch Pleased After Meeting With Trump

Posted By on Wed, Mar 8, 2017 at 10:26 PM

Congressman Peter Welch - JOHN WALTERS
  • John Walters
  • Congressman Peter Welch

When approaching the self-proclaimed Master of the Deal, it’s best to offer him a chance to play dealmaker.

That’s what Congressman Peter Welch (D-Vt.) took away from a Wednesday meeting with President Donald Trump. The subject: a bill championed by Welch and Congressman Elijah Cummings (D-Md.) that would allow the federal government to negotiate lower drug prices for the Medicare program, which is currently forbidden by federal law.

“President Trump was knowledgeable and enthusiastic about this,” Welch reported. “He was not having staff whispering in his ear telling him what was going on. This was him totally in control and vividly aware of how expensive these prescription drugs are.”

The Oval Office sit-down included Welch, Cummings, and Dr. Redonda Miller, president of the Johns Hopkins Hospital, as well as Health and Human Services Secretary Tom Price, a former Georgia congressman.

Welch and Cummings have introduced the same legislation for eight years, and always run into what Welch called a “stone wall of resistance” from House Republicans.

When Price was serving in Congress, he was one of those devout stonewallers. He has also faced ethical questions about some very profitable trades in health care stocks he made when he had access to inside information as a member of a key House subcommittee.

It must have made Price a bit uncomfortable to hear his boss praising the idea. And Welch didn’t shy away from pointing out the discrepancy.

“I mentioned that Secretary Price had always been resistant to this when he was my colleague in the House,” Welch said, “so the president asked Price about that, and he said he’s against price fixing, price setting. And the president seemed undeterred by that, because I pointed out that price negotiation is what you do between a willing buyer and a willing seller.”

Welch called it “surprising” that Republicans oppose free-market dealmaking in the case of drug prices. “And the president said it’s probably because Big Pharma is very powerful in lobbying and campaign contributions,” Welch concluded. “So he gets that.”

Welch left the session optimistic, but with eyes wide open. “The proof will be, do we get a bill passed?” he said. “But bottom line, our only chance to succeed is to have his support.”

At the end of the meeting, Trump handed Welch’s and Cummings’ bill to Secretary Price with instructions to provide an official response. One hopes that Price didn’t find a convenient shredder on his way out of the Oval Office.

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Friday, February 24, 2017

Vermont Senate Approves Bill to Limit ‘Duty to Warn’

Posted By on Fri, Feb 24, 2017 at 3:17 PM

Sen. Jeanette White and Sen. Brian Collamore - FILE: PAUL HEINTZ
  • File: Paul Heintz
  • Sen. Jeanette White and Sen. Brian Collamore
The Vermont Senate swiftly passed a bill Friday that limits health professionals’ obligation to warn people about potentially dangerous patients.

Mental health providers panicked after a Vermont Supreme Court ruling last May, which, in their interpretation, drastically expanded their “duty to warn” when releasing patients from their care.

Before the so-called Kuligoski case, providers had to warn people when there was an imminent threat to an identifiable victim. The court ruling expanded the obligation to also apply to “foreseeable victims or to those whose membership in a particular class ... places them within a zone of danger.”

The Senate voted to restore the previous standard — essentially voiding the court’s ruling. According to Sen. Jeanette White (D-Windham), who presented the bill, an “identifiable victim” doesn’t have to be a particular person. She noted that it could extend “to a situation where a patient says, ‘I hate barbers. I’ve got a gun. And I’m going to go kill a barber.’”

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Wednesday, February 22, 2017

Walters: Vermont Senate Panel Orders Up a Fistful of Studies

Posted By on Wed, Feb 22, 2017 at 12:02 PM

  • File: Jeb Wallace-Brodeur
  • Sen. Claire Ayer
A Vermont Senate panel is addressing widespread problems in the state's mental health care system in traditional fashion: by calling for a total of nine separate studies, analyses, and explorations.

On Thursday morning, the Senate Health and Welfare Committee took a first look at a draft bill aiming to identify solutions for the system's intractable problems. The bill has yet to be formally introduced, but is poised for quick approval. Committee chair Claire Ayer (D-Addison) expects to move the bill out of committee by the end of next week.

"The rationale behind the bill is to take a look at a system that should work, that was designed to work, but that isn't working," Ayer explained.

The bill's scope takes in the entire system, but focuses on a few known trouble spots: chronic underfunding and understaffing at community-based agencies, a rising tide of geriatric and forensic psychiatric patients, and improving the coordination between different parts of the system.

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Wednesday, February 15, 2017

Vermont Nonprofit Is a Semifinalist for a $100 Million Grant

Posted By on Wed, Feb 15, 2017 at 1:51 PM

Doctors Sanduk Ruit and Geoff Tabin examining a cataract patient in Nepal - COURTESY OF MICHAEL AMENDOLIA
  • Doctors Sanduk Ruit and Geoff Tabin examining a cataract patient in Nepal
A Waterbury nonprofit has been named a semifinalist for a $100 million grant award in an international competition.

The Himalayan Cataract Project announced Wednesday that the organization is one of eight from around the world to make it to the final round of the 100&Change grant competition sponsored by the MacArthur Foundation.

When Job Heintz, chief executive officer for the organization, heard the news about two weeks ago, "I sat down," he said. "It's exciting beyond compare."

The Himalayan Cataract Project, which has a budget of just under $10 million, performs low-cost, en masse cataract surgeries in remote locations around the world. The grant money would be used to eliminate needless cataract blindness in three countries — Ghana, Ethiopia, and Nepal.

The Chicago-based MacArthur Foundation launched the 100&Change grant competition last year to "solve critical problems of our time," according to a press release. The funds can be used for up to six years.

HCP was selected from 1,904 proposals from around the world, according to the press release. About 800 went on to the second round, and the final selection was made by MacArthur's board of directors. The proposals were judged on four criteria: verifiability, durability, meaningfulness and feasibility.

Over the next six months, HCP will receive training and technical assistance from the MacArthur Foundation to refine its proposal. Next September, the foundation will select five finalists who will present at a live event in December.

HCP was founded in 1994 as the result of a partnership between Dr. Geoff Tabin, who lived in Vermont at the time, and Dr. Sanduk Ruit of Nepal. Since then, they have performed 6.6 million cataract surgeries in a dozen countries at a cost of $25 per surgery.

The grant money would create "an adaptable 'train the trainer' model that can be replicated and scaled around the world," according to the MacArthur Foundation website. The money would be used to train more health professionals, provide equipment and "increase the innovation," Heintz said. HCP also plans to partner with IBM Watson Health to create a platform to log surgeries and track their data more comprehensively.

HCP will pursue the work regardless of whether they win the competition, Heintz said. "Boy, 100 million would help," he added.

Other semifinalists include the Internet Archive's project to provide free digital access to books for libraries and students, the Carter Center's effort to cure river blindness in Africa, and the Human Diagnosis Project's proposal to offer underserved American patients "virtual access to specialist medical care."

After being selected from 1,900 applicants, the odds are "a heck of a lot better," Heintz said. "We're very confident in what we proposed to do. We're also very aware and humbled by the other semifinalists."

Heintz highlighted the benefits for Vermont as well. "It'll bring a ray of hope to the state, to the NGO community here," he said. "We started here, stayed here, and are growing here."

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Wednesday, February 8, 2017

Vermont Tests All-Payer Health Care on 30,000 Medicaid Patients

Posted By on Wed, Feb 8, 2017 at 4:02 PM

OneCare CEO Todd Moore addresses reporters Wednesday with Gov. Phil Scott to his right. - TERRI HALLENBECK
  • Terri Hallenbeck
  • OneCare CEO Todd Moore addresses reporters Wednesday with Gov. Phil Scott to his right.
Vermont has started a one-year program to pay a network of health care providers a lump sum to care for 30,000 Medicaid patients.

The pilot program could determine whether the state adopts an all-payer system, in which health care providers are paid based on the quality of care they provide rather than the quantity of services.

“At the end of this pilot, if it’s effective, we’ll expand it,” Gov. Phil Scott said at a press conference Wednesday. “If it’s not meeting these goals and we cannot address operational concerns, we will not move forward.”

Scott’s predecessor, Peter Shumlin, received permission from the federal government last year to implement an all-payer model, and selected OneCare last June to try out the model with Medicaid patients.

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Thursday, January 5, 2017

Walters: Rambur Leaves Green Mountain Care Board

Posted By on Thu, Jan 5, 2017 at 2:03 PM

Vermont Statehouse - FILE: JEB WALLACE-BRODEUR
  • File: Jeb Wallace-Brodeur
  • Vermont Statehouse
Governor Phil Scott will get the chance to make an immediate impact on health care regulation in Vermont, as two of the five members of the Green Mountain Care Board are stepping down.

GMCB chair Al Gobeille is leaving the board to become Agency of Human Services secretary. Board member Betty Rambur is resigning effective January 15 to move out of state. “This is a completely personal decision,” she told Seven Days. “My husband-to-be lives in Rhode Island, and I have an opportunity for a position there. The stars just lined up.”

Indeed, she’d thought about resigning in September, but “we wouldn’t have had a quorum” because Dr. Allan Ramsay had just resigned and Con Hogan was on medical leave. “A lot of health care decisions are made in September, and the board would have been unable to do its work,” she said.

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