[{"_1":2,"_87":-5,"_88":-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],{"_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",6260941,"mediaKeyId","3126565-c9bc4638a18924b9d72d629f2fc58d86","parentId",3126565,"title","VPQHC urges lawmakers to build quality measures into S126, outlines suicide-prevention and pediatric psychiatry supports","audioSeconds",2983,"startMs",69000,"endMs",3052000,"viewUrl","/Search/View?dp=1&key=3126565-c9bc4638a18924b9d72d629f2fc58d86&start=69&end=3052","thumbnailUrl","https://assets.pipeline.soar.com/3126565-c9bc4638a18924b9d72d629f2fc58d86/thumbnail_69000.jpg","articleUrl","/articles/6260941/Vermont/VPQHC-urges-lawmakers-to-build-quality-measures-into-S126-outlines-suicide-prevention-and-pediatric-psychiatry-supports","mediaUrl","https://secure.pipeline.soar.com/6260941-f3883779018935e5e70bb3e58dee0e94/orig.mp4?Expires=1771222781&Signature=Bw-6AfaSZ~ThfdAiEOOvbxJ997WGQn1bZzvvbhMsjiBCfhQfms29F34MzecOGVxJ~aHdjyuYEh-HM-c4g~MdwtbCikAFGWAs3nG0hcmGuVH3o47QebLQ6CebbCwXYYmiDfEQHymcf1xFhRmeK3bnSJDB0wg32DLqLYT4onf5ow421CRBYiF4eibyMPq8V8vfaP11OFCp0-4P6Nc8b9jYtyz97NDfFDvjvotDJNqvKhadzua8UETres8ggZilQ4pz8otOag-lYWGIOxYz2WxjyVv27PbQ05YGr5pCcStFQk3OA9h8pX0ZvEcsrS~AJQs5MYBPvpP8wULbYBW872YjrA__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-04-25T19:38:57.853Z","article","Hillary Wolfley, executive director of the Vermont Program for Quality in Health Care (VPQHC), told a legislative committee on April 25 that quality should be explicit in any statewide health‑care redesign and that VPQHC stands ready to help shape S126’s measurement and safety provisions.

VPQHC wants a formal role in the bill’s advisory structures and funding to participate. \"Picture this like a three‑legged stool,\" Wolfley said, urging legislators to weigh access, cost and quality together when evaluating reforms.

VPQHC, designated by the Vermont legislature as an independent, non‑regulatory peer‑review organization, described three programs it said are relevant to S126: a statutory patient‑safety surveillance and improvement system, an emergency‑department suicide‑prevention quality‑improvement initiative, and a pediatric/perinatal psychiatry consultation line that supports primary care.

The patient‑safety program, operated under contract with the Department of Health, collects adverse event data from hospitals and ambulatory surgery centers and helps facilities conduct causal analyses. \"Analyses of patient safety work product should not be admissible, for example, into the court of law,\" said Morgan Bedard, a quality improvement specialist at VPQHC, describing legal protections that encourage candid reporting and learning. VPQHC told the committee the program uses National Quality Forum definitions for serious reportable events and that the statewide view helps detect system‑level trends beyond any single institution.

On emergency‑department suicide prevention, VPQHC described a collaborative initiative launched in March 2022 that uses evidence‑based care pathways, training, lethal‑means counseling and workflow support. Presenters said the program has trained more than 400 ED staff and that all of Vermont’s emergency departments participating in the third year are implementing pathways that align with the project’s essential elements. VPQHC highlighted a Northwestern Medical Center example in which, during the first eight weeks after universal screening began, staff identified 251 patients with suicide‑related concerns; 53 were actively considering suicide and 11 disclosed suicidal thoughts although they had arrived for non‑mental‑health issues. VPQHC said the initiative informed Vermont’s model protocol for suicide prevention submitted by the Department of Mental Health and has been recognized by outside organizations including Pew Charitable Trusts and the Federal Office of Rural Health Policy.

Greta Spottswood, child psychiatrist and medical director of the Vermont Consultation and Psychiatry Access Program (now under the VPQHC umbrella), described the consultation line that provides immediate psychiatric consultation to primary‑care clinicians. VPQHC said the program has registered 100% of pediatric practices in Vermont and has supported more than 1,300 calls; it reported that 85% of primary‑care providers said the service improved their working life and that 60% of callers would otherwise have made immediate specialty referrals.

On funding and capacity, Wolfley said VPQHC receives $660,000 annually in bill‑back funding and that amount cannot exceed 75% of its operating budget; VPQHC reported that bill‑back funding currently accounts for 29% of its total operating budget and that the organization also relies on grants, contracts and philanthropy. VPQHC told the committee the Department of Health contract specifying bill‑back work is renewed every two years and said additional appropriation would be needed for the group to perform new duties created by S126.

VPQHC recommended that the S126 delivery plan explicitly call for the identification of opportunities to improve quality, enhance quality reporting and data collection, and share exemplars of high quality care. The organization also said it is already in discussion with state officials about joining the state health‑information exchange steering committee to support data access for quality work.

The presenters asked legislators to include VPQHC in the bill’s advisory committee or otherwise formalize the organization’s advisory role so it can help monitor and implement the delivery plan and related quality measures. They also cautioned that some statutory and federal protections — such as the patient‑safety work product protections described under federal law — should be preserved when data are used for system improvement.

VPQHC offered to provide the committee with its written comments on S126 and said staff would return to brief lawmakers on any section where the committee sought more detail.

Ending: The committee did not vote on language; committee members asked follow‑up questions on VPQHC’s budget and the sustainability of grant funding. VPQHC said it would provide requested budget figures and reiterated its offer to collaborate with the Green Mountain Care Board and other stakeholders on the bill’s quality, data and implementation elements.","mediaType","Video","parentTitle","House Healthcare 2025-04-25 1:10 PM","oneSentenceSummary","Hillary Wolfley, executive director of the Vermont Program for Quality in Health Care (VPQHC), told a legislative committee on April 25 that quality should be explicit in any statewide health‑care redesign and that VPQHC stands ready to help shape S126’s measurement and safety provisions.","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},6260936,"Primary‑care clinicians tell committee S126 must give them more authority, funding and data access to rein in costs",4138,3336000,7474000,"/Search/View?dp=1&key=3126565-c9bc4638a18924b9d72d629f2fc58d86&start=3336&end=7474","https://assets.pipeline.soar.com/3126565-c9bc4638a18924b9d72d629f2fc58d86/thumbnail_3336000.jpg","/articles/6260936/Vermont/Primarycare-clinicians-tell-committee-S126-must-give-them-more-authority-funding-and-data-access-to-rein-in-costs","https://secure.pipeline.soar.com/6260936-0d1c3322b2bc7de883426d2a8fa20f88/orig.mp4?Expires=1771222781&Signature=A45hiuig1CmgVRCcN0dHcq6X19uzs9qEsBptHugcbap5Awe-SeiakBhUgvg5DLJlpMLtqFxi2Tg37~~JIk79VljF0xHyxckw4wPKjmCkLGG00DBWBxPYcbWFFr6ZJO8v4dDKf-Fr5uFcIPofAUrBCMnokx45b2tDNjpjnJCayDWqxSMv-l28VApdlZGmcRzV1~ONVkDFlUJoekF11H-SNGEllzGBdTeQHlNTZFqWh30lx6GjDJbqvXprVN0NZIsxuWvZ1B0aspWNTdfsDOzpIaf3XOq-yT8GGFsxF27bH8TiKv8SXNukYguLzhhJi0NNLoj21JoyO4LiGXkxp6cxew__&Key-Pair-Id=KUT5TJCACFTXG","A group of primary‑care clinicians and advisory‑group members told a legislative committee on April 25 that S126 and related policy work should give primary care a stronger, better‑resourced voice and concrete authority to change system behavior.

A physician participating in the Green Mountain Care Board Primary Care Advisory Group (PCAG) told the committee the group represents clinicians from federally qualified health centers (FQHCs), hospital‑affiliated practices, private and direct‑primary‑care practices, nurse practitioners and physician assistants. The speaker said the advisory group has advised state officials since 2018 but lacks the ability to drive implementation: \"I don't think we have any teeth,\" said Faye Homan, a family physician who practices at an FQHC.

Clinicians urged several near‑term priorities: raise the primary‑care spend rate from historically low levels, expand residency training slots and pipeline supports for rural primary care, improve data‑sharing between electronic health records and the state health information exchange, and redesign payment so providers are rewarded for keeping care in primary care settings.

Testimony and discussion included these specifics and examples:

- Primary‑care spend rate: multiple speakers cited a rough long‑running primary‑care share of health spending of about 4–5%, a figure they said is low given primary care’s role in population health and cost containment.

- Panel sizes: clinicians said a full‑time primary‑care provider in rural Vermont typically manages a panel of roughly 1,500 patients and bears substantial unpaid panel‑management work (referrals, record follow‑up, medication authorizations and discharge‑summary reconciliation).

- Workforce and GME: clinicians said the state needs more residency slots and cited the Maple Mountain residency proposal as an example of an unopposed, community‑based program that would expose trainees to broad scope primary care; speakers said Medicare GME caps limit the number of residency slots available and that additional state support or incentives are needed.

- Data and interoperability: multiple clinicians described time‑consuming work to gather records across different hospital electronic‑health‑record systems and the state exchange (referred to in testimony as the health‑information exchange or \"Bridal\"). They said better, more automatic access to shared patient records would reduce redundant testing and administrative burden.

- Specialist follow‑up: clinicians urged payment or quality changes to discourage long‑term specialist follow‑up for stable conditions that primary care could manage, a practice that both fragments care and increases cost. Suggested fixes included clearer discharge instructions and an explicit specialist checkbox indicating whether a patient is stable to return to primary care.

Nurse practitioner Michelle Wade, president of the Vermont Nurse Practitioners Association and a PCAG member, pressed for payment and implementation language in the bill that recognize nurse practitioners’ role in primary care and asked that advisory language avoid physician‑centric phrasing.

Several speakers recommended greater, routine connection between PCAG and the Green Mountain Care Board (GMCB) or statute‑based authority so primary‑care voices are not only consultative but can help hold implementation bodies to account.

Ending: Committee members thanked clinicians for the testimony and indicated S126 markup would begin the following week. Clinicians asked lawmakers to consider modest increases in primary‑care spending, targeted investments in residency training, improved health‑information exchange integration and statutory mechanisms that give primary‑care advisory input practical effect in implementation.","Members of the Green Mountain Care Board’s Primary Care Advisory Group and practicing clinicians told legislators on April 25 that primary care needs a larger, better‑resourced role in S126. Speakers urged stronger involvement in policy decisions, improved data sharing, changes to payment and more residency slots to address workforce shortages.","actionData","errors"]

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VPQHC urges lawmakers to build quality measures into S126, outlines suicide-prevention and pediatric psychiatry supports

Primary‑care clinicians tell committee S126 must give them more authority, funding and data access to rein in costs