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Vermont health commissioner outlines priorities on vaccines, substance use, EMS and reproductive care
Summary
New Health Commissioner Raquel Debrant told the House Appropriations Committee Dec. 16 that preserving public trust, monitoring vaccination rates, addressing rising stimulant use, improving EMS payment models and protecting reproductive health access are top department priorities.
Raquel Debrant, the new commissioner at the Vermont Department of Health, opened her first House Appropriations Committee appearance Dec. 16 by describing her clinical background and immediate priorities for the department. "My name is Raquel Debrant. I am an internal medicine trained hospitalist," she said in presenting her goals and the agency's mission.
Debrant framed the department’s mission around equity and a four-part public-health approach: detect, connect, prevent and respond. She used a recent pertussis (whooping cough) cluster in a Washington County school as a concrete example of the department’s response: alerting providers, supplying school resources and ensuring vaccine access for under‑vaccinated people.
The commissioner told members she wants to preserve public trust in public health nationally and locally. "We need to be the rock that people can rely on," she said, warning that misinformation and national turmoil have eroded confidence in some states.
On immunizations, Debrant said Vermont’s coverage has been strong but expressed concern about slippage for COVID and flu vaccines and signaled the department will propose legislation to protect access and information flow; she said immunization outreach is not a current funding ask. Committee members asked for clearer metrics on how many Vermonters Planned Parenthood and other providers serve; department staff agreed to follow up on service‑level breakdowns (primary care versus other services).
Debrant highlighted substance use disorder as a primary focus. She said opioids remain the largest driver of harm but that stimulant use — including methamphetamine and cocaine — is rising and requires different treatment approaches. "Recovery is measured in many, many...years for opiates, but it's even longer for methamphetamines," she told the committee, noting the lack of established medications (MOUD/MAT) for stimulant-use disorders.
Responding to questions about emergency medical services (EMS), Debrant described a structural revenue problem in many rural EMS units: most programs are reimbursed only when they transport a patient to a hospital. That payment model, she said, leaves EMS “strapped” and makes it hard to adopt community paramedicine or other non‑transport care that could reduce costly ED visits. She urged legislators and EMS leaders to explore reimbursement models and better regional coordination.
On reproductive health, Debrant emphasized the department’s priority of protecting access and said the BAA would include funding‑source adjustments so services remain available regardless of federal changes. She then turned the hearing to agency finance staff to explain the specific swaps in the budget adjustment.
The department’s presentation set context for the fiscal questions that followed; Debrant and staff said they will return with more granular data (for example, vaccination and provider service breakdowns) in upcoming budget briefings.
