Legislative committee staff outline S.189 changes to hospital notice and public-engagement requirements
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Summary
Staff from the Office of Legislative Council walked committee members through S.189, which would require hospitals to give 60 days’ notice, post and publish a notice, hold public hearings and let the Agency of Human Services review proposed service reductions or eliminations before changes take effect.
Jen Carvey of the Office of Legislative Council summarized S.189 during a committee meeting, saying the bill would require a hospital that "proposes to intentionally reduce or eliminate any service" to provide at least 60 days' notice to the Agency of Human Services, the Green Mountain Care Board, the Office of the Health Care Advocate and the legislators representing the hospital service area and to post the notice on its website.
Carvey told members the bill would also require hospitals to "publish the notice in a newspaper of general circulation in the hospital service area within 10 days" and to "conduct a public engagement process, including holding at least one public hearing in the county in which the hospital is located and soliciting and responding to public comments regarding the proposed service reduction or elimination." She said the public engagement period must continue for at least 30 days following the notice and that hospitals would have to provide AHS with a summary of public comments after that process concludes.
Under the draft language Carvey described, the Agency of Human Services would analyze each proposed reduction or elimination for consistency with the statewide health care delivery strategic plan and the hospital's community health needs assessment, "consider the community's response and the impact of the proposal on access to necessary care and services in the hospital service area," and provide nonbinding recommendations to the hospital, the Green Mountain Care Board and the public. If a hospital chooses to proceed after the process, it would notify AHS and the Board "within five business days after making the decision to proceed," allowing the Board to "review the impact of the reduction or elimination" on the hospital's budget and to adjust the budget as necessary.
Committee members raised questions about the bill's scope and language. One member noted federally qualified health centers had removed primary-care services in their community and asked whether those providers would be covered, observing that current statute applies only to hospitals. Carvey confirmed the current statute is hospital-specific and that the bill as drafted likewise focuses on hospitals, though members discussed whether the committee should consider expanding notice requirements beyond hospitals.
Members also pressed for clearer definitions. Several asked what would count as a "service" — for example, whether the retirement of a single specialist would constitute a reduction — and whether the bill should apply only to eliminations rather than reductions. Carvey said the bill's use of the word "intentionally" was intended to distinguish deliberate changes from ordinary staffing turnover, and she recommended the committee step back to define the circumstances that should trigger notice.
The Chair presented several paths forward — leave current law unchanged; adopt the bill's public-notice elements; require AHS to make an affirmative decision; give the Green Mountain Care Board decision authority; or modify the bill to strengthen or weaken its requirements — and asked members for their preferences before scheduling additional testimony. No formal motions or votes were taken during the session. The committee recessed and agreed to reconvene at 10:03 to continue discussion and to hear a scheduled presentation later in the day.
The bill, S.189, would take effect on passage under the version Carvey reviewed. The committee plans a fuller discussion Thursday to determine scope, definitions and which entity should be the final arbiter of proposed service reductions or eliminations.
