Legislative Update
by Devon Green
Vice President of Government Relations

The Scott Administration and the legislature remain busy as Vermont extends its state of emergency to June 15 while slowly reopening.

Last Week

Resuming Outpatient Care:  To follow up on its May 4 announcement, the Vermont Department of Health released  official guidance  on resuming outpatient care.  

Federal Funding:  The Joint Fiscal Office presented an  update  on the federal funding coming into Vermont due to COVID-19 to the health care committees. 
Telehealth Expansion:  draft bill  on maintaining the current telehealth expansion was presented to the health care committees. The bill would close the gap in the store and forward expansion by commercial insurers by moving up the effective date from January 1, 2021 to May 1, 2020. It would also create a working group to develop recommendations for health care coverage of services provided by audio-only telephone. 

Mental Health Spending:  The Department of Mental Health provided its  FY 2020 budget adjustment request  to the health care committees. Included in the presentation was information on DMH’s $1 million COVID-19 Emergency SAMHSA grant, with priority
areas in:
  • Expansion of emergency services and outreach for the serious mental illness population, including 24/7 telehealth
  • Renovations to existing crisis programs to ensure social distancing
  • Mobile crisis van
  • Peer support services, such as virtual peer support groups

Next Week

Budget Adjustment Act:  The House will pass a second FY 2020 budget adjustment this week. The proposed bill addresses a projected $143 million deficit for the final quarter of FY 2020. The proposal closes the projected deficit with a combination of borrowing from the $1.25 billion Coronavirus Relief Fund (CRF) and newly available funds, including $45 million in Medicaid dollars. Other spending includes spending for the legislature to stay in session until June 19 and financial assistance for Vermont State College and University of Vermont students. Once the bill passes in the House, the Senate Appropriations Committee will take it up. Once the Budget Adjustment Act is passed, the legislature will work on a “skinny” budget for the first quarter of FY 2021.
In the News
Vt COVID growth rate lowest in nation
Brattleboro Reformer

Saying the last two months have felt more like a year, Gov. Phil Scott expressed how grateful he is to the Vermonters who have followed the state's safety guidelines in response to the COVID-19 pandemic.

"Your efforts have saved hundreds and hundreds of lives," said Scott during his daily press briefing on Friday. "Your sacrifices have made a real difference."

Proof of that, said the governor, is that Vermont has the lowest three-day and seven-day COVID-19 viral growth rates in the country. On Thursday the growth rate was .11 percent; the average for the rest of the country is 2 percent.

Mike Piecek, the commissioner of the Vermont Department of Financial Regulation is in charge of Vermont's COVID-19 modeling efforts. He said as of Friday, there is only one infected patient in an ICU in Vermont. He also said that last Friday, the state's modeling showed a doubling of infections in 12 weeks. With new data, they have extended that to 40 weeks.
How the coronavirus test will change in coming months
My NBC 5

When you drive through the COVID-19 test site at the Champlain Valley Exposition Center, it's almost completely contact free.

You hold up your photo ID to a closed car window, confirming your test appointment from a safe distance. There are signs instructing you to turn your air conditioning on, keeping the air flow circulating around you.

The only time the barrier is broken is when a health professional sticks swab so far up your nose, it can feel as if they're scratching at your brain.

"You're wondering why they need to biopsy your brain," said Dr. Debra Leonard who works in the University of Vermont Health Network. "It’s not -- it’s only going all the way back of your nose, to the back of your throat."

Leonard is the chair of the Department of Pathology and Laboratory Medicine. She's been working closely with the state health officials to keep up with testing needs.

"We will be doing more collections," she said. "The goal is to get to 1,000 tests a day."

Covid-19 survivor: ‘When you can’t breathe, it’s all you think about’

Back when Jessie Fisch started coughing in March, it was still early in Vermont’s Covid-19 crisis. As a health care provider, Fisch knew the symptoms of the virus were poorly defined and highly variable. She had had a cold for a couple of weeks, which didn’t fit what she had heard.

At the health center where she works as a physician assistant, the guidelines were still unclear.

"At that point, we didn’t have enough masks or PPE, and the recommendations were still very mercurial,” said Fisch. “They were changing all the time. At that point, it was ‘You should mask people who are coughing, but don’t need a mask yourself.’”

But Fisch’s sore throat was getting worse. And when she woke up one day with pink eye, Fisch — who puts her age at “almost 70,” knew she had Covid-19. Pink eye is one of many little-known side effects of the virus. A Covid-19 test came back negative, but a short time later, Fisch was in the ICU at Central Vermont Medical Center in Berlin, struggling to breathe.

In the weeks after she was hospitalized April 2, Fisch’s family and her large, tight-knit group of friends kept in close touch with Fisch’s daughter and each other on a large group text, sharing their hope and fear. Fisch has lupus, and her age puts her in the high-risk category anyway. Fisch herself thought she might die.

“It feels like you are drowning,” she said. A month later, she is still on oxygen at home. “You are constantly struggling to breathe and to stay calm. When you can’t breathe, it’s all you think about.”

A Porter doctor sees action in NYC hospital
Addison County Independent

I am an anesthesiologist at Porter Hospital in Middlebury, but I lived in New York City for over 20 years. When it became clear that the excellent work of Vermonters was turning our state into something of a COVID-19 success story, I volunteered late last month to go down and work in my old hometown. I was deployed for almost two weeks to a hospital in Queens, a very hard-hit part of the city.

The minute I arrived, I could feel the difference. At Employee Health, several people (sometimes with their masks off) approached the desk to talk about their positive tests or their worrisome symptoms. Alarmingly often, stretchers with masked or intubated patients were waiting at the elevators; even with my face covered, I was nervous walking by them. In late March, at the crest of the “wave,” whole departments were closed so that 85-90% of the hospital could be turned over to COVID patients, and four refrigerated trucks were brought in as makeshift morgues. “Everyone who lives nearby has lost someone,” a staff doctor told me.

The hospital sent me to work in Labor and Delivery, where an anesthesiologist is always needed but work is sporadic. This freed up one of their staff for more regular jobs. Of course, it also made it easier for me to avoid or manage any COVID exposure, since there are relatively few total emergencies in L&D, and all the pregnant women are tested for the virus. I breathed a little easier.
The knowns and unknowns of an experimental COVID-19 drug coming to Vermont
My Champlain Valley

An experimental drug said to speed the recovery of patients is in short supply. The Department of Human Services said the U.S. has enough Remdesivir for about 78,000 hospitalized patients. Local 22's Devon Bates has more on how it might be used in Vermont now and down the road.

Artists Paint A Portrait Of A Pandemic

It's an image of a nurse with her hands pressed together in prayer. In bold letters below her hands, it says "bless the healers."

The illustration, designed by the artist Marvin Madariaga, has been shared across social media. Some people have posted it in the window of their home. And it's been projected on the side of a building in the heart of New York City.

In health crises, people have long turned to the arts to inform and inspire. During the 1980s AIDS epidemic, the words "silence = death" were printed on posters, pins and patches. And during the 2014 Ebola crisis, murals with the slogan "Ebola is real" were painted across West Africa.

The coronavirus pandemic is no different. Two organizations, the United Nations and Amplifier, an arts group, launched independent campaigns in March inviting artists to submit artwork around the coronavirus. Tens of thousands of submissions later, the groups are now showcasing a selection of these works to the public.

Madariaga's artwork was submitted to Amplifier, which coordinated some of the iconic poster designs around the Women's March on Washington in 2016.