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Vermont lawmakers look to make building health care facilities easier – VTDigger

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Vermont lawmakers look to make building health care facilities easier – VTDigger


The women’s and children’s unit at Rutland Regional Medical Center. Administrators are planning to combine this unit with the hospital’s birthing center, which is separated from it by a hallway. Courtesy of Rutland Regional Medical Center

At Rutland Regional Medical Center, administrators have long wanted to combine two different parts of the hospital: the birthing center and the Women’s and Children’s Unit. 

The two units are separated by a hallway, meaning that patients are moved to a new unit shortly after giving birth — “a setup for poor patient experience,” Jonathan Reynolds, the hospital’s vice president for clinical operations, told a Vermont House committee last month. 

And, because having two separate units means that the hospital must maintain two different pools of practitioners with overlapping skill sets, combining them would save an estimated $1 million in labor costs annually. 

But consolidating the two units will incur an additional expense: that of obtaining a certificate of need.

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Under state statute, Vermont health care institutions are required to get a certificate of need — effectively, a legal permission slip — anytime they want to build, renovate or buy facilities or obtain medical equipment that are more expensive than certain threshold amounts. 

But as prices for construction and medical equipment rise, more and more projects — including the consolidation of Rutland Regional’s two units — require such certificates, tying up health care facilities and state regulators in lengthy and expensive bureaucratic processes. 

“Rutland Regional is handcuffed, and we are unable to take the initiative right now to decrease the cost of health care because of the CON process,” Reynolds told lawmakers.

Now, lawmakers are seeking to relax those requirements. Last week, Vermont’s House passed a bill, H.96, that would increase the monetary thresholds needed for a certificate of need — a move that supporters say will lower health care costs and make care more accessible to state residents. 

“The dollar amounts that trigger the CON process are causing extraordinary burdens to hospitals, independent providers and other essential health care entities,” Rep. Mari Cordes, D-Lincoln, the bill’s lead sponsor, said on the House floor March 11. 

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Certificate of need regulations, which exist in most states, are intended to reduce unnecessary health care spending and avoid duplicative medical services. 

The process “is intended to protect the public, and it does so by ensuring that projects that are built have sufficient need and are appropriately priced,” Owen Foster, the chair of the Green Mountain Care Board, said in an interview. 

In Vermont, certificates of need are required when a hospital or health care facility seeks to build a new facility, renovate an existing one, or purchase an expensive piece of equipment. If a project hits a certain dollar threshold, hospitals or other health facilities must apply to the Green Mountain Care Board for permission. 

Currently, for hospital construction or renovation, a certificate of need is required for all projects that cost more than about $3.8 million. Approval is also needed for non-hospital construction or renovation over $1.9 million.  

And certificates are also required for purchases or leases of single pieces of medical equipment that cost more than roughly $1.9 million for hospitals, or $1.3 million for non-hospitals.

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Those limits increase annually by an inflationary factor. But the cost of construction and medical equipment has far outpaced those inflationary increases — something that the bill would address.

If passed, the proposed legislation would significantly raise those cost thresholds. Construction and renovation projects, both for hospitals and non-hospitals, would require a certificate of need only if costs run over $10 million. And the acquisition of new medical equipment, both by hospitals and non-hospitals, would only require certificates of need if the cost exceeded $5 million.

With little opposition, the bill has drawn support from health care entities that are often at odds with each other: advocates, regulators, and hospitals. 

The certificate of need process eats up “resources, both in money and time, both for the Green Mountain Care Board and for hospitals,” Devon Green, a lobbyist for the Vermont Association of Hospitals and Health Systems, said in an interview. 

Reforming the process, as envisioned by H.96, would “reduce cost and burden for the board and for health care providers,” Foster, of the Green Mountain Care Board, said. “And it would increase competition, while still providing oversight” over more complex projects.

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Getting a certificate of need can take months, or even, in the case of one recent construction project, over a year. And the process requires applicants to provide reams of documentation about their project’s benefits, costs, projected utilization and more. Other people, organizations or health care entities can weigh in too, and board members can pose multiple rounds of questions and attach conditions to their approval of an applicant’s project.  

“In terms of the current certificate of need process right now, I think there’s a general feeling of, it can be administratively burdensome,” Green said. 

That’s the case at Rutland Regional Medical Center. The consolidation of the birthing unit with the women’s and children’s unit is projected to cost between $5.5 million and $6 million — enough to require a certificate of need under current law, but not under the proposed reforms.  

As it currently exists, “I would wager that the CON process would delay our start of this consolidation of two units by at least a year, if not longer,” Reynolds, the hospital vice president, said last month. 

But if signed into law, he said, H. 96 “gives us the breathing room to perform these types of projects.”

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Resources for families as Vermont National Guard prepares for deployment

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Resources for families as Vermont National Guard prepares for deployment


MONTPELIER, Vt. (ABC22/FOX44) – Earlier this month, ABC22/FOX44 reported that members of Vermont’s Air National Guard would be sent to the Caribbean to take part in Operation Southern Spear.

Legislators from all three major political parties in Vermont wrote Tuesday about resources available for the families of the members sent out in the field. They said that Maj. Gen. Gregory Knight, Adjutant General of the Vermont National Guard, had officially confirmed the mobilization Monday.

“The uncertainty of a deployment is a stressful time for families, especially during the holiday. We thank our Vermont Guard Members and their families for their service to Vermont and our country. During this time, we encourage Vermonters to check in on their friends and neighbors impacted by this deployment.”

The “central hub” for family support the Vermont National Guard Family Programs Office. Its support line, (888) 607-8773, is available Monday through Friday from 7:30 a.m. to 4:30 p.m., with more available at its website at ngfamily.vt.gov.

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Families can ask at the support line to be connected with a local volunteer support group as well (include link).

There are also six regional centers across the state in Montpelier, White River Junction, Rutland, South Burlington, Jericho, and St. Albans. The National Guard describes these as “resource and referral experts” that can help families connect with any services they may need.

Information on these is available at their own webpage. https://www.ngfamily.vt.gov/Programs-Services/Military-and-Family-Readiness-Centers/

Other resources include:

The Vermont National Guard Charitable Foundation: (802) 338-3076 or https://vtngcharitable.org/VTNGCF to apply.

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Military OneSource, a federal referral program offered nationwide and 24/7: (800) 342-9647, www.militaryonesource.mil

Child and Youth Program Deployment Resources, with tools for children’s resilience during deployments: https://www.ngfamily.vt.gov/Resources/Youth-Deployment-Resources/

Yellow Ribbon Reintegration Program, events held mid-deployment for children and families: contact Staff Sgt. Jessica Smith at jessica.m.smith308.mil@army.mil

Vermont 211: https://vermont211.org/

ChildCare Aware: https://www.childcareaware.org/state/vermont/

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Hunger Free Vermont: https://www.hungerfreevt.org/



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Commentary | Molly Gray: Standing with Afghan allies in Vermont and beyond

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Commentary | Molly Gray: Standing with Afghan allies in Vermont and beyond


I was a senior in high school when 9/11 happened. I will never forget where I was or how the day unfolded. I wasn’t yet 18, but my entire adult life would be shaped by that event. Soon after, the U.S. invaded Afghanistan, and then Iraq. U.S. involvement in Afghanistan would last 21 years, and at one point Vermont would have the highest per-capita population of servicemembers serving in Afghanistan and Iraq in the nation.

Over the last three years as the Executive Director of the Vermont Afghan Alliance, I’ve met countless veterans, former aid workers, lawyers, contractors, and others who worked in Afghanistan. U.S. efforts focused on everything from counterterrorism and the rule of law to education and agriculture.

During the chaotic withdrawal from Afghanistan in August 2021, the U.S. evacuated an estimated 125,000 Afghan allies. That was only a fraction of those who had worked with the U.S. government over two decades. An estimated 145,000 Afghans eligible for Special Immigrant Visas (SIVs) were left behind, along with countless wives and children. Many men evacuated in 2021 were told to leave their families behind with the promise of reunification within a year, yet separation continues.

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The Vermont Afghan Alliance began in 2022 as a scrappy, GoFundMe-funded, volunteer-led effort to help newly arriving Afghans learn to drive and obtain a license. In Vermont, we all know that without a car, employment options shrink quickly. Today, Afghan allies live in more than a dozen towns—from St. Albans to Bennington and Rutland to Hartford—well beyond traditional resettlement hubs like Burlington.

In 2023, I joined the Alliance as an “interim” executive director to help grow and professionalize the organization. While I never worked in Afghanistan, I spent much of my twenties with the International Committee of the Red Cross, promoting U.S. compliance with the Geneva Conventions in Afghanistan, Iraq, and at Guantánamo. My brother served in Iraq, and like so many of my generation, my adult life has been shaped by the so-called “Global War on Terror.”

I felt a deep responsibility to a community that had risked so much in support of U.S. missions abroad. I also felt a strong sense of Vermont’s hospitality—that if you welcome someone into your home, at a minimum you provide food, shelter, and safety. Finally, as someone long concerned about our demographics, the truth is simple: we are not going to birth our way out of our workforce crisis. The solution lies in welcoming people—and their talents—from across the country and the world.

Since 2023, the Alliance, together with community partners, has welcomed and served an estimated 650 Afghan allies statewide with employment, driving lessons, housing assistance, immigration legal services, civic education, health programming, and more. We’ve partnered with dozens of employers across northern Vermont eager to hire Afghan allies and willing to make small workplace adjustments. Through our driving program alone, more than 60 individuals have passed the Vermont road test. From manufacturing to healthcare, education to commercial truck driving, Afghan allies are filling high-demand jobs, strengthening our rural economy, and enriching our communities.

A recent USCRI policy report found that Afghan allies nationwide have contributed an estimated $1.79 billion in local, state, and federal taxes, including contributions to Medicare and Social Security. Contrary to harmful rhetoric, Afghan allies are not a “drain” on the system—their contributions far outweigh the short-term support provided during resettlement.

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A damaging narrative suggesting Afghan allies are “unvetted” or pose a security risk to this country is circulating from Washington. In reality, those fleeing the Taliban are among the most thoroughly vetted individuals in this country—they were screened during employment with the U.S. government, during immigration processing, and again with every status adjustment.

Afghan allies are our neighbors, friends, and colleagues. At the Alliance, the majority of staff and board members are Afghan allies themselves—thoughtful, courageous, emerging leaders raised in an Afghanistan backed by the U.S. They understand, as deeply as we do, the hope and possibility that come with a free and democratic society. I’ve been inspired daily by what these young leaders have achieved for Vermont and the talents they’ve already contributed to our state.

I’ll soon step back from the Alliance to make space for new leadership and a new chapter for the organization. What began as an interim role became far more meaningful than I ever expected. As for what’s next, I hope to bring what I’ve learned back into state government, where I can have a broader impact as we continue to address our demographic crisis and the policies coming from Washington.

To the state and local leaders, community partners, and volunteers I’ve had the opportunity to work alongside over the last few years—thank you. I’m inspired and amazed by what we can accomplish when we pool our resources and talents around a common purpose. I’m excited for the Alliance’s next chapter and for all we can continue to achieve for our newest neighbors and Vermont.

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Vt. man with lengthy criminal history sentenced for domestic assault

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Vt. man with lengthy criminal history sentenced for domestic assault


BENNINGTON, Vt. (WCAX) – A Bennington man with a lengthy criminal history was sentenced on Monday on aggravated domestic assault charges.

Max Misch, the once self-described white nationalist who has made headlines before for hate crime and gun charges, will spend six months in jail with credit for time served and two years on probation for domestic assault.

He pleaded guilty to the charge last month after authorities said he admitted to hitting a woman he knew.

His conditions of probation include avoiding contact with his victim and not possessing any deadly weapons.

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