[{"_1":2,"_98":-5,"_99":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6270806,"mediaKeyId","3031930-fa1117154535eeca593a065ffdd39f89","parentId",3031930,"title","Department of Mental Health proposes folding public inebriate beds into crisis‑bed system, cites 988 and staffing considerations","audioSeconds",1825,"startMs",4921000,"endMs",6746000,"viewUrl","/Search/View?dp=1&key=3031930-fa1117154535eeca593a065ffdd39f89&start=4921&end=6746","thumbnailUrl","https://assets.pipeline.soar.com/3031930-fa1117154535eeca593a065ffdd39f89/thumbnail_4921000.jpg","articleUrl","/articles/6270806/Vermont/Department-of-Mental-Health-proposes-folding-public-inebriate-beds-into-crisisbed-system-cites-988-and-staffing-considerations","mediaUrl","https://secure.pipeline.soar.com/6270806-aade690c9773ccac3e2b04dc0221ebd7/orig.mp4?Expires=1771177656&Signature=USEiagLQ3q9JfG3kKzwBNtb9ZJgnRvFsrIkjU4LZEIAxzz6hjedpEngRYo~-QXJCD42iKvXBmSS7F6VcmSE83DS61NMREghd9Iiovv4bKIEzBM70WOM8eQ~-WW-CEQT-P4E5kARWiP~ktkMubNu4n159t3ue5PATNI3dOR~1HB4cr7JYTq2cQ9iOiuAHL83a516WCw71bRaoZOX6g39-fVq~5fpenC7qRdNva5SFGiD59ypJ0KnvYS2wrwe3wA1VpWmCXNMveGbWSyQ13btIyG3ldUFKNSvkOVCjFloWEJZUAPvTlnSaUgLFLp~EjFGKKsgq-~mCsOxWRGhHLJZwZA__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-04-17T03:49:54.867Z","article","Emily Haas, commissioner for the Department of Mental Health, told the committee that state agencies are proposing a phased effort to combine the public inebriate program (PIP) with the mental‑health crisis‑bed system to create a more efficient co‑occurring crisis response.

Haas said the PIP sites historically were not staffed for a 24/7 clinical response, while the crisis‑bed network is staffed continuously. With expansion of 988 and enhanced mobile crisis services — both intended to provide co‑occurring responses for substance use and mental‑health crises — the agencies see an opportunity to align and repurpose existing beds and staff. She said that the change is designed to increase the number of appropriate, non‑emergency settings for people in public intoxication or co‑occurring crisis situations.

Nut graf: The department plans to braid public‑inebriate grant dollars with existing crisis‑bed case‑rate funding rather than request new funds in the current fiscal year, pursue a phased rollout that addresses staff training and workplace readiness, and continue to evaluate geographic access because PIP utilization concentrates in some counties.

Key details from testimony

- Locations and capacity: Haas summarized current PIP locations cited in Department of Substance Use materials: Washington County (Claire Martin Center — does assessments and refers), a bed in St. Johnsbury through Northeast Kingdom Human Services, five beds with Recovery House in Wallingford, and a single bed through United Counseling Services. She noted utilization patterns vary by region with Chittenden County accounting for a substantial share of PIP traffic.

- Rationale for combining beds: Crisis beds are staffed 24/7 with trained personnel; PIP sites have historically struggled to provide a continuous clinical response. The department’s position is that co‑occurring crises are increasingly common and consolidating beds into a co‑occurring crisis‑bed system should make better use of resources and reduce inappropriate emergency‑department use.

- Implementation and funding: Haas said the plan would braide current PIP grant dollars with the crisis‑bed case rate and that no new budget ask is planned this year; the department will first attempt to use existing funds to support a phased transition. She also noted opportunities to draw on training and technical‑assistance funding available through federal grants (SAMHSA, CCBHC‑related supports) to expand workforce competencies for co‑occurring disorders.

- Service‑continuity concern: Committee members and witnesses raised concerns that combining populations could be inappropriate in certain local contexts; Haas acknowledged the need for a careful phased approach and local planning, noting the Chittenden County configuration arose from crisis‑era responses and that geographic differences require tailored solutions.

Quotes and attribution

- “The public inebriate program has struggled over the years, mostly because it's not necessarily staffed for a 24/7 response,” Haas said.
- “Our hope is to really look at what our current resources are and put into play a more efficient use of the delivery of those services,” she said, describing the phased plan.

Ending

Haas asked for continued committee support for a staged, evidence‑driven transition that preserves safe placements for people in crisis, minimizes emergency‑department boarding, and leverages existing grant and case‑rate funding to avoid a large current‑year budget ask. The department also offered to supply utilization data and further operational detail to the committee and stakeholders as planning proceeds.

","mediaType","Video","parentTitle","House Healthcare - 2025-04-16 - 2:05 PM","oneSentenceSummary","Emily Haas, commissioner for the Department of Mental Health, told the committee that agencies plan a phased effort to combine the public inebriate program with the mental‑health crisis‑bed system to create a more efficient co‑occurring crisis response.","taxTitle","Health Care, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont","taxId",30956,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6270811,"Rutland Regional CEO backs reference‑based pricing, urges caution on S126 reporting expansions",1307,2997000,4304000,"/Search/View?dp=1&key=3031930-fa1117154535eeca593a065ffdd39f89&start=2997&end=4304","https://assets.pipeline.soar.com/3031930-fa1117154535eeca593a065ffdd39f89/thumbnail_2997000.jpg","/articles/6270811/Vermont/Rutland-Regional-CEO-backs-referencebased-pricing-urges-caution-on-S126-reporting-expansions","https://secure.pipeline.soar.com/6270811-7d512f0d0ecbc638b25ef1ae414cad5d/orig.mp4?Expires=1771177656&Signature=O3pl0rShAKgpkgkAIl2PmG~3VBYrWwnQ1BJLW5KN4pbLfCV-OmiEk9ObZuHI9PbVnt2sXOYj2UE53tZQiDHL1Wum5w5OpQMLlUXLAV~4tJ1s7PJN-OyCFyRbg5OweFKbE8VljoFVQDSDx7FsutMbAhXt1pcmcP9GkKWPBkJoBXnvS91X-IeoJL9tjAH91EGYWf7958J7M38vdz~1R2BcMOKItyg-YQeAzwZDdc9SzlXSgLGnIzs0B0F71zat1vYkOyMubX-JGAO1S~Crijcuoy8eqQLOygy64r1erXu546LnuXrF0-H2WplyRFug1WyeUNhjvgdoqC3OF8u7NhdNaQ__&Key-Pair-Id=KUT5TJCACFTXG","Judy Fox, president and CEO of Rutland Regional Medical Center, told a legislative panel that while her hospital supports many aims in S126, portions of the bill are redundant with reporting the hospital already submits to the Green Mountain Care Board and could create administrative burdens that raise costs.

Fox briefed lawmakers on Rutland Regional’s scale: about 60,000 community members served, roughly 6,500 inpatients annually, more than 100,000 clinic visits, about 300,000 testing encounters, and roughly 1,800 employees including 140 physicians and advanced practice providers. “Rutland, we're the second largest hospital in the state, but we're the largest employer in Rutland County,” she said.

Nut graf: Fox recommended using the Green Mountain Care Board’s existing budget‑reporting processes rather than adding parallel reporting requirements in S126; she also supported carefully staged payment reform — including reference‑based pricing pilots — warning that Vermont’s Medicare reimbursement baseline differs from other states and that immediate, large rate changes could destabilize local services.

Key testimony points

- Redundancy and confidentiality concerns: Fox said S126 asks hospitals to provide data on administrative vs. patient‑care classifications, base and variable compensation, and other details that Rutland already reports to the Green Mountain Care Board as part of its budget guidance and 990 filings. She cautioned that detailed public disclosure of salaries could create recruitment and competitiveness problems.

- Excluding primary care/behavioral health revenue: Fox supported excluding primary care, mental‑health and substance‑use disorder revenue from certain reporting calculations — but asked that expenses tied to those services also be waived in parallel so the measures don’t create under‑funded obligations.

- Global budgets and payment reform: Fox said Rutland supports global budgets in principle but reminded lawmakers the state’s Medicare reimbursement levels are lower in aggregate than many states. “When we looked at the services provided in Vermont and the services provided in other states, Vermont was about $350,000,000 below in reimbursement,” she told the committee, referencing AHS and Green Mountain Care Board evaluations.

- Reference‑based pricing and pacing: Fox endorsed reference‑based pricing as an objective and recommended a phased approach with pilot groups rather than a single large shift. She said Rutland would face a roughly $50 million impact if commercial payments were universally set to 200% of Medicare in a single year and urged gradual implementation instead.

Context and supporting detail

Fox noted Rutland’s existing reporting obligations to the Green Mountain Care Board (budget narrative and other operations sections) and recommended relying on that “single source of truth” rather than creating parallel statutory reporting. She also warned that service closures do not automatically save money statewide because patients typically shift to other hospitals; she cited Central Vermont’s inpatient psychiatric unit closure and said about 40 patients from that service area subsequently received inpatient psychiatric care at Rutland.

Quotes and attribution

- “Rutland, we're the second largest hospital in the state, but we're the largest employer in Rutland County,” Fox said.
- “If Rutland were to do [200% of Medicare] holistically, we would lose about $50,000,000 of reimbursement,” she said, urging a stepped approach.
- “This information should not be overly public; it needs to be held tightly because it will create competitiveness issues and recruitment issues,” Fox said about granular salary reporting.

Ending

Fox offered Rutland’s assistance in designing pilots and a staged pathway toward more transparent, benchmarked payments, while urging lawmakers to avoid redundant reporting requirements and to account for Vermont’s distinctive Medicare reimbursement baseline when setting targets and timelines.

","Judy Fox, president and CEO of Rutland Regional Medical Center, told the committee that sections of S126 overlap with existing Green Mountain Care Board reporting, flagged a $350 million aggregate Medicare reimbursement shortfall for Vermont, and urged a phased approach to payment reform including pilots for reference‑based pricing.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":91,"_47":92,"_49":93,"_51":94,"_53":95,"_55":56,"_57":58,"_59":96,"_61":62,"_63":64,"_65":97,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6270816,"Copley Hospital CEO urges clearer price transparency, warns of fragile hospital finances",0,3535000,"/Search/View?dp=1&key=3031930-fa1117154535eeca593a065ffdd39f89&start=3535&end=3535","https://assets.pipeline.soar.com/3031930-fa1117154535eeca593a065ffdd39f89/thumbnail_3535000.jpg","/articles/6270816/Vermont/Copley-Hospital-CEO-urges-clearer-price-transparency-warns-of-fragile-hospital-finances","https://secure.pipeline.soar.com/6270816-2fb6386d07b9dbed584b138eed9daefa/orig.mp4?Expires=1771177656&Signature=d~6pgQgZFYHOZUHR0ChrjF~5DkiA-nLU~dAHRVmftcJJ~vCNlvOlpR3BRXHlXXID3Dw3tfG3Q36LMjkU6spKDqaBsDwtjHo6AOZJVbIcoM9uTC3rIK8OyTC3BrumXG9YM2gFmrSmmenbpF9tj2l1MmQNILPEtgar8kD3UJMYmFkyUC9HPj0JJSSTRleqPvg1a7GhGgLSqB3OaduobcrvGnvwVUOv72NCsj4CozYhrcpjzkZJV3hRhXDmtnqnQymIUd3YLPQSCXcbWNMA3l-lVOFp-P~y2MA9hPp1j4cJMdfFVac0c7i7OwPZu3NUiAMtuYvDjhUiVyUyGtnqzan3Yw__&Key-Pair-Id=KUT5TJCACFTXG","Copley Hospital CEO Joseph \"Joe\" Wooden told a legislative hearing in April that his critical-access hospital is financially fragile, that published hospital charges vary wildly across Vermont, and that current price-disclosure rules are not accessible to patients.

Wooden said the hospital’s finances have been “very fragile” for years and that federal COVID relief was the reason Copley showed a positive operating margin in 2020–21. “Anytime somebody chooses shows you budget information as a hospital, they should delineate the COVID money,” Wooden said. “That wasn't a small amount of money that the feds gave all the hospitals to the states.”

Wooden framed his testimony around three priorities for Copley in 2025: finance and sustainability, quality, and keeping care local. He told committee members Copley is one of eight critical access hospitals in the state and described a longstanding pattern of under‑requesting rate increases that has left the hospital with lower-than-average published prices.

The nut graf: Wooden argued patients and policymakers cannot make informed choices because hospital price lists are published in machine-readable formats that are hard for the public to use, and because contractual reimbursements (what insurers actually pay) differ greatly from list prices. He recommended targeted policy steps such as reference‑based pricing, incremental rate adjustments, and simplifying reporting so the public and payers can compare like with like.

Most important facts and supporting details

- Hospital finances and margins: Wooden said Copley lost money for multiple years and that federal COVID relief produced an anomalous positive operating margin in 2020. He described operating margins as the basis for reinvestment and said a sustainable margin is modest: “a healthy operating margin across the board for hospitals should be between … 2 to 3%,” he said. Wooden also noted Copley’s first positive margin since COVID was 1.4% in the most recent year reported.

- Published charges versus reimbursement: Wooden walked committee members through examples from the published price files and insurer reimbursement data, showing large differences. He used a specific example — an abdomen/pelvis CT without contrast — where Copley’s list charge was $1,224 vs. a state average around $3,300 and a high of about $5,153 on one dataset he displayed. He said some published prices vary several hundred percent or more from other hospitals.

- Machine‑readable disclosure is not customer‑friendly: Wooden said federal and state efforts to publish price data produce machine‑readable data that the public cannot readily interpret. “I'm not a machine. I don't even know what it means,” he said, urging simpler public summaries in addition to raw files.

- Contractual collections differ from charges: Wooden also presented insurer‑level net reimbursement tables (Blue Cross, Cigna, MVP) showing that what hospitals actually collect varies by payer and by hospital. He urged policymakers to look at collected reimbursement and not only list prices to assess how revenue flows through the system.

- Reference‑based pricing as a step: While not endorsing a single national solution, Wooden described reference‑based pricing — tying commercial payments to a standard multiple of Medicare or a transparent benchmark — as an incremental step toward fairness and simpler pricing. “Reference based pricing is a step towards Medicare for all, toward something that's understandable,” he said.

Context and background

Wooden referenced state studies and reporting requirements including Act 167 and Act 53 and the Oliver Wyman work that prompted statewide hospital-service reviews. He said the state has been “on the cutting edge” of asking hospitals to publish prices but that the implementation has been difficult for the public to use. He also noted that Medicare cost reports, which are retroactive, complicate near‑term budgeting because hospitals reconcile payments with delayed federal settlements.

Quotes and attribution

- “We’re more like an old fashioned hospital,” Wooden said, describing Copley’s service mix.
- “Anytime somebody chooses shows you budget information as a hospital, they should delineate the COVID money,” Wooden said.
- “You can’t, as a member of the public, just go out there and get this. You can't easily say, hey, I'm gonna have hernia surgery. I wonder how much it's gonna be,” he said, describing the difficulty patients face in using price files.

Ending

Wooden urged lawmakers to prioritize small, practical fixes — improved public summaries of price data, clearer reporting on reimbursements, and incremental adoption of reference‑based pricing — rather than expect a single large reform to be a quick fix for long‑standing pricing and financial‑sustainability issues.

","Joseph \"Joe\" Wooden, CEO of Copley Hospital, told a legislative hearing that rural hospitals in Vermont face fragile finances, wide variation in published charges and reimbursements, and barriers to meaningful price transparency; he recommended incremental steps including reference-based pricing and better data use.","actionData","errors"]

Article not found

Department of Mental Health proposes folding public inebriate beds into crisis‑bed system, cites 988 and staffing considerations

Rutland Regional CEO backs reference‑based pricing, urges caution on S126 reporting expansions

Copley Hospital CEO urges clearer price transparency, warns of fragile hospital finances