Updated at 1:14 p.m.
UVM Health plans to eliminate approximately 199 positions in late October, the latest round of workforce reductions as Vermont’s largest health care provider confronts mounting financial pressure.
Employees affected by the cuts are being notified Tuesday and Wednesday, according to an email that UVM Health chief executive officer Dr. Stephen Leffler sent to staff Tuesday morning. The reductions span the health system and include both managers and other employees.
“I want you to know that none of these decisions are made lightly,” Leffler wrote. “I did not take on the role of CEO to cut staff. I took the role for the same reason that I became an emergency medicine doctor: to take care of people. But I also know in my heart that if we don’t make tough decisions right now, we will not be able to care for our patients and communities for the long run.”
Roughly 55 of the positions will be replaced with newly structured jobs that will be posted at a later date, Leffler wrote. Some clinical employees whose positions are eliminated may also be able to find other jobs within the health system. Those who leave UVM Health will be offered severance based on their length of service.
The announcement did not clarify where the positions were based across the health network. But at Central Vermont Medical Center, the cuts include mental health technicians and patient safety attendants, according to Christina Searles, vice president of the hospital’s support staff union and a licensed nursing assistant and mental health technician in the emergency department. Searles said she and another licensed nursing assistant learned this morning they would be reassigned, but she estimated that 16 to 18 other mental health technicians at the Berlin medical center could lose their jobs.
She worried that eliminating workers who monitor and assist patients, including those experiencing mental health crises, could leave the emergency department with fewer people to respond to potentially dangerous situations. Searles added that layoffs this fall will leave employees without income to pay car loans and mortgages as they head into the holiday season.
“It breaks my heart that it’s always the small guy that pays the price,” she said.
The cuts were planned before state regulators approved hospital budgets on Monday, according to a UVM Health spokesperson. The Green Mountain Care Board voted to require UVM Health’s three Vermont hospitals to cut the prices they charge commercial insurers in the coming fiscal year, which begins October 1. UVM Medical Center was ordered to make the steepest reduction of any hospital — a 4.4 percent cut to commercial reimbursement rates. Regulators also ordered the medical center to reduce its commercial revenue by 1.3 percent, to roughly $1.05 billion.
Central Vermont Medical Center in Berlin received a somewhat smaller cut of 1.7 percent to commercial reimbursement rates, in part because some board members were concerned about the steep losses expected at the network’s flagship hospital. The board ordered Porter Medical Center in Middlebury to reduce its commercial reimbursement rates by 1 percent, in line with the regulator’s statewide guidance.
The workforce cuts are the latest in a series of staff reductions at UVM Health as the system tries to rein in spending amid pressure from state regulators to make health care more affordable.
In June, UVM Health announced changes affecting 142 positions. Of those, 76 jobs were eliminated outright, while 66 positions were eliminated and reconfigured into new jobs. The network said at the time that the changes would save roughly $9.5 million a year.
That followed cuts in July 2025, when UVM Health laid off 77 employees and eliminated 69 vacant positions as it aimed to reduce spending by at least $185 million.
In Tuesday’s email, Leffler said the health system is confronting a significant budget deficit and has been using its reserves to cover expenses. He also said UVM Health has cut the number of executive positions by 17 percent over the past year, done away with incentive compensation for leaders and decided against raises for its highest-ranking executives this year.
“The reality is that we can’t meet our expense-reduction mandates without reducing our workforce,” Leffler wrote.
He warned more changes are coming.
“This is not the first or the last step we’ll need to take to make our health system more sustainable,” he wrote.
The full email announcement from Leffler is below.
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