Health commissioner tells Senate Appropriation he will prioritize immunizations, substance-use treatment and access to care

Bill Grant, commissioner of the Department of Health, told the Senate Appropriation meeting on Jan. 13 that his top priorities for the coming year include protecting immunization access and public trust, expanding substance-use disorder treatment, and addressing transportation and access-to-care gaps that contribute to hospital readmissions.

Grant framed his approach around a detect‑connect‑prevent‑respond model and described his background in inpatient hospital medicine and health-system leadership. He said those experiences led him to prioritize system-level, community-partnered solutions rather than relying solely on hospital-based care. "Our announcement is we're not changing anything," Grant said about recent federal vaccine guidance, calling for clear state messaging and insurer cooperation to preserve access to recommended vaccines.

On substance use, Grant said Vermont's hub-and-spoke model has increased treatment engagement and the use of medications for opioid use disorder (MOUD) but warned the state is seeing an increase in stimulant use disorder for which MOUD is not effective. He said residential treatment and long-term recovery residences remain constrained and that additional capacity will be needed to support people transitioning from treatment to employment and stable housing.

Grant also highlighted access-to-care problems including obstetric care shortages and transportation barriers. He said emergency medical services are designed for urgent response and not for routine patient transport between systems, and argued that sustainable nonemergency transport will require reimbursement arrangements with insurers or other funding mechanisms as the state pursues regionalization of services.

The commissioner said he will work with legislative partners and local stakeholders to preserve trust in public health and to ensure Vermonters continue to receive evidence-based information and services. The department then turned to budget items and asked the panel to place those on the record.