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Ensuring care for Vermonters with OUD in skilled nursing facilities

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Ensuring care for Vermonters with OUD in skilled nursing facilities


BURLINGTON, Vt. (WCAX) – Skilled nursing facilities in Vermont are key for inpatient rehab and medical treatment for people with a wide range of needs. That includes care for patients following an accident, illness, or surgery. It can also include treatment for opioid use disorder.

But are those struggling with addiction being turned away for care?

U.S. Attorney for Vermont Nikolas Kerest says there have not been any reports of skilled nursing facilities turning away patients for substance use disorder but it is a topic of conversation in neighboring states.

“Facilities need to do an individualized assessment of each potential patient.” Vermont’s U.S. Attorney Nikolas Kerest sent out a reminder to each of Vermont’s 30 skilled nursing facilities as a precaution as the state’s opioid crisis continues to get worse.

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“They can’t have blanket policies against admitting people who use medication, medication-assisted treatment or substance use disorder,” said Kerest.

“We do admit those types of applicants.” Woodbridge Rehabilitation and Nursing in Berlin is one of the nursing facilities that have a dedicated unit for patients with substance use disorder.

William Kowaleski of Woodbridge says there are anywhere from three to ten of these specific patients in the facility at any time.

“Our providers, we have one physician and three nurse practitioners are all skilled in prescribing suboxone relief and support to people with OUD,” said Kowaleski.

Not every skilled nursing facility in the state has a dedicated unit like this but Kowaleski says the limiting factor for patients of any kind to be admitted is that the facility is almost always full. They get 50 or 60 referrals a month statewide with the ability to admit five or six a week. He says 2/3 of the population are long-term care patients.

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“We look at the code and also the skill set of our staff. We want to make sure that we have staff that have the skills to handle the applicants that we admit,” said Kowaleski.

“We know and are working hard on the problem that many folks are turned away for admission simply because the services to match the treatment plan are not available.” Helen Labaum of the Vermont Health Care Association says she too hasn’t heard of any skilled nursing facilities turning patients away because of substance use disorder but says it indirectly highlights the staffing and capacity challenge many facilities face.

Vermont is currently ranked last in the country for stability of the workforce and services in skilled nursing facilities, according to federal data. In a broader healthcare context, Vermont’s nursing turnover is 61% the second highest in the country.

“We’ve got a shortage of mental health workers, counselors, the folks who can provide those services that often go along with the medications prescribed that are the focus of this particular memo,” said Labaum.

Despite people Channel Three spoke with saying skilled nursing facilities are not turning away patients with Substance Use Disorder Vermont’s U.S. Attorney says if they do, there are violation fines up to around $111,000 that increase as the violations do.

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Vermont

Thousands more people are moving into Vermont than moving away

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Thousands more people are moving into Vermont than moving away


A new study shows Vermont has become a popular place to move to since the COVID-19 pandemic.

The state treasurer’s office analyzed recent census data and found that on a per capita basis, Vermont had the highest net in-migration of any New England state, and the third highest rate in the U.S. last year.

Vermont had a net gain of 7,592 new residents in 2023, with the greatest number coming from Massachusetts.

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Treasurer Mike Pieciak says remote work flexibility and outdoor recreation opportunities are the key reasons people are flocking to the Green Mountain State.

“It’s clear that the people who are moving to Vermont are higher-income earners and what that says to me is that they are bringing their remote jobs with them to Vermont,” Pieciak says.

But he says the report also highlights Vermont’s affordable housing challenges.

As for out-migration, the report says the two most popular states for Vermonters to move to last year were New York and New Hampshire. On a net basis, after accounting for all migration, Vermont lost the most people to Illinois and Utah.

Have questions, comments, or tips? Send us a message.

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Vermont Cannabis Control Board sued for ‘unconstitutional’ ad regulations (print)

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Vermont Cannabis Control Board sued for ‘unconstitutional’ ad regulations (print)


PITTSFIELD — On behalf of a coalition of businesses, Flora Cannabis is suing the Vermont Cannabis Control Board over what they deem to be “unreasonable” and “unconstitutional” advertising regulations. 

The Middlebury-based retailer said it’s trying to block the state’s “unprecedented and unconstitutional restrictions on the protected free speech rights of the state’s 500-plus licensed cannabis cultivators, manufacturers, distributors and retailers.” The lawsuit was filed Monday in Addison Superior Court, Civil Division. 

Having a health warning on all cannabis ads and demonstrating that no more than 15 percent of those potentially exposed to an ad are under the age of 21 are considered “unreasonable” burdens, according to the complaint. Also cited in the suit are “unreasonable” prohibitions on “common promotional offers” and “depicting or describing particular cannabis products on social media websites.”

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Flora said the litigation is supported by a broad coalition of licensed cultivators, manufacturers, distributors and retailers across Vermont. Scott Sparks, owner of Vermont Bud Barn in Brattleboro, said he’s involved in the suit. 

Dave Silberman, co-founder of Flora, described having attorney A.J. Ruben file the complaint “reluctantly, and only after years of failed attempts to reason with legislature and regulators to find a workable compromise, and to treat us in the same manner as the state treats other ‘regulated vice’ industries such as sports wagering and alcohol.”

“Vermont’s licensed cannabis industry supports reasonable advertising regulations, including targeted regulations to prevent advertising that is especially appealing to underage consumers, or making false or misleading statements,” Silberman said in a statement, calling the regulations “the nation’s most wide-ranging and onerous prohibition on protected speech.”

Current regulations are “illegally muzzling the cannabis industry and preventing us from being able to effectively communicate with adult customers,” Silberman added. 

CCB Chairman James Pepper said he received a copy of the complaint Tuesday night and knew it was coming. 

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“The industry has come out strongly asking for advertising reforms,” he said. 

Pepper expects the court will be looking at some of the principles related to the freedom of commercial speech. 

“How they come down on this will be interesting is all I can say,” he said. 

Pepper noted the CCB’s job is to enforce law as it’s written. He plans to ask the Attorney General’s Office to defend the CCB. 

“We really are, as regulators, not in a position to say the advertising laws are good or bad,” he said. “We’ll keep [enforcing] until we’re told otherwise.”

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In an interview Monday about goals and projects in the new year, Pepper mentioned the possibility of being sued over the ad regulations. 

“We may need another attorney position especially if the advertising law was struck down,” he said. 

Cannabis companies don’t like needing pre-approval before publishing ads as the process “slows things down for the businesses by about seven days,” Pepper said. With the CCB rejecting a “fair number” of submissions regularly, he anticipates enforcement actions with fines attached will require more resources for his agency. 

“It will be a lot more work for something that could have been dealt with through the advertising review process,” he said. 

CCB data released in October showed nine out of 29 advertising submissions were denied in a month. Six were missing or had illegible health warnings, one appealed to children, another missed audience requirements and one had not been classified. 

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Data in July showed 16 advertising submissions were approved and nine were denied in a month. Seven had missing or illegible health warnings. One was missing audience information, and another involved a cannabis product giveaway.

A hearing on a motion for preliminary injunction is set for late January, Ruben said.



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Flooding expected in Vermont on Wednesday night. Here’s what you need to know. – VTDigger

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Flooding expected in Vermont on Wednesday night. Here’s what you need to know. – VTDigger


The air traffic control tower is seen as rain falls at the Leahy Burlington International Airport in South Burlington on Wednesday, December 11, 2024. Photo by Glenn Russell/VTDigger

The National Weather Service has issued a flood watch for almost the entire state of Vermont from Wednesday afternoon through Thursday morning. 

Forecasters were expecting 1 to 2.5 inches of rain, with localized amounts up to 3 inches possible in southern Vermont, according to Abbey Gant, a meteorologist in the weather service’s Albany office. But it’s the combination of rain and rising temperatures, leading to snowmelt, that was expected to cause flooding.

Several rivers statewide were expected to come close to or surpass flood stage. The Otter Creek in Rutland and the Walloomsac River in North Bennington were anticipated to see moderate flooding, according to the weather service’s river forecast. 

As of 9 a.m. Wednesday, five other rivers in central and northern Vermont were expected to reach minor flood stage by Thursday morning. Those included the Connecticut River in Wells River, the Mad River near Moretown, the Winooski River at Waterbury and Essex Junction, the Lamoille River at Johnson and the Missisquoi River at North Troy.

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The weather service also warned of flash flooding in smaller bodies of water. Maureen Hastings, a meteorologist at the weather service’s Burlington office, said that flooding in poor drainage areas in urban environments could begin later Wednesday afternoon or into the evening hours. 

A FedEx cargo plane on a wet runway at an airport during nighttime, with headlights on and trees in the background.
A cargo plane lands as rain falls at the Leahy Burlington International Airport in South Burlington on Wednesday morning , December 11, 2024. Photo by Glenn Russell/VTDigger

Main-stem rivers such as the Winooski were expected to reach flood stage at night and crest early in the morning on Thursday, Hastings said. 

Because of the late hours of the flood’s peak, Mark Bosma, a spokesperson for Vermont Emergency Management, cautioned Vermonters near waterways to have their phones near them overnight in case they needed to be evacuated. In that event, emergency responders could do a “reverse 911” call to a specific area. 

He also advised Vermonters to sign up for VT-Alert for more notifications about road closures, local flooding and other emergencies. 

And he emphasized the weather service’s common refrain for dealing with floodwaters on roadways: “Turn around, don’t drown.” 

“Even if it doesn’t look like there’s a lot of water on the road, that can be difficult to really tell, and looks can be deceiving,” said Gant, the meteorologist. 

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Dozens of local schools closed, opted for a delayed start or announced an early dismissal as of Wednesday morning, particularly in Windsor County, central Vermont and the Northeast Kingdom, Vermont Public and WCAX reported. 

Bosma said that state officials were in the midst of preparing for flooding. They were still figuring out the best place to potentially set up swiftwater rescue teams. 





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