A checkup of Vermont’s health care system as regulators consider community needs

RUTLAND, Vt. (WCAX) - Experts got together in Rutland on Monday to chip away at some of the community’s most pressing problems inside and outside the hospital.

The pandemic may be in the rearview for many Vermonters but providers in Rutland staff say it has fundamentally changed the way our health care system works.

It’s a challenging time to be in health care.

“More patients who are much sicker than we had in the past and that’s difficult,” said Dr. Todd Gregory, the chief medical officer at the Rutland Regional Medical Center.

Leaders at the Rutland Regional Medical Center say many Vermonters are coming to the emergency room with chronic conditions and mental health challenges. The hospital is filled to the brim, partly because patients well enough to need less care have nowhere to go.

“So it’s hard to get those patients the care that they need,” Gregory said.

But the human service needs transcend the walls of the state’s second-largest hospital. Vermont’s Community Needs Assessment says housing, child care, elder care and mental health rise to the top.

“Lots of other factors that influence how healthy people can be,” said Jamie Bentley, the community impact coordinator at RRMC.

According to the report, 36% of kids under 6 in Rutland County live below the poverty line, half of Rutland renters pay more than 30% of their income on housing, and officials report a 115% increase in young people going to the ER for mental health crises in the last year.

Experts say the needs of the community have a direct impact on the health of Vermonters.

“That’s looking at where we live, where we grow, where we play, where we work: all of those factors have an impact on how healthy we are or how healthy we can be,” Bentley said.

To improve communication and get a better sense of the challenges, the Green Mountain Care Board toured places they don’t regulate, like community health centers and transitional housing.

“It’s important to understand how our budgetary decisions flow through to the community and how they impact and relate to everything else in the treatment world,” said Owen Foster, the chair of the GMCB.

Leaders with RRMC say bringing regulators to town helps them understand the ripple effect of their decisions.

“There are far better places to deliver a lot of this care than in the ER but more places are not set up to do it. But as we try to be creative to deliver care in a place that’s better for patients, they need to recognize that that’s going to take some investment,” Gregory said.

The GMCB’s visit comes at an active time for Vermont’s interconnected health care ecosystem. Leaders are puzzling over how to keep rural hospitals solvent. Providers are grappling with staffing shortages and long wait times. And the Scott administration is moving forward with reforming how health care is paid for.

A handful of Vermont lawmakers were also in the room taking notes for this coming session, where many of the issues of housing, child care and mental health staffing will take center stage in about a month.

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