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Senate advances bill requiring notice, public hearings before hospitals cut services
Summary
The Senate amended and ordered third reading of S189, which would require hospitals to give 60 days’ notice, publish a notice of intent, hold public engagement (including hearings), and notify the Agency of Human Services and the Green Mountain Care Board before reducing or eliminating services; the bill also directs savings from reductions to benefit Vermonters.
The Senate on the floor advanced S189, a bill that would create a formal approval and notice process for hospitals proposing to reduce or eliminate services.
Senator Lions, reporting for the Health and Welfare Committee, said the bill requires hospitals that intend to cut services to provide a 60-day notice of intent to the Agency of Human Services and the Green Mountain Care Board, publish that notice, conduct public engagement (including one or more hearings), and submit a summary of community responses to the agency. The agency would then analyze the proposed reduction in the context of the statewide health-care delivery strategic plan and provide a non-binding recommendation to the hospital, Lions said.
The bill responds to recent local service changes, Lions said, citing closures of a UVM dialysis program, the Copley birthing center and pediatric-bed reductions in Rutland. "When a hospital proposes to intentionally reduce or eliminate any service ... it does have effects and it does send a wave out across the local community," Lions said.
Senators pressed for detail on implementation. One senator asked how "savings related to the reduction or elimination" would be returned to Vermonters; the presenter said such savings would be evaluated through the Green Mountain Care Board's budget review and coordination with the Department of Financial Regulation, insurers and the Agency of Human Services to determine how savings could be reflected to payers or reinvested in primary care and community services.
Other senators raised concern that the bill does not define "service," worrying that without a definition minor changes could trigger the full notice-and-hearing process. The presenter said the committee debated this and chose not to codify a tight definition, intending to capture reductions that have meaningful local impact while excluding minor line-item adjustments.
Several senators also noted that the statewide strategic health-care delivery plan referenced in the bill is not yet finalized; supporters said hospitals are already engaged in regional transformation work and that the bill creates communications and public-engagement requirements to reduce surprises for communities.
The Senate voted to amend S189 as recommended by committee and ordered the bill read a third time.
