SPRINGFIELD, Vt. — Leaders in Vermont health care and directors from four health care organizations gathered on Thursday to discuss rural health care and celebrate receiving $2.72 million in federal grants.
While those funds and a spirit of collaboration made panelists optimistic, all were in agreement: Rural health care is in a crisis.
“Our health care system is fragile, and it is under extreme stress,” said Sarah Waring, state director of USDA Rural Development in Vermont and New Hampshire. “We’ve moved from an urgent emergency during the pandemic to a clear and enduring emergency, particularly when it comes to our workforce and our business model.”
Of the financial windfall, $1 million will go to Springfield Hospital to ease pandemic losses and update infrastructure; $1 million will support an expansion of the Little Rivers Health Care clinic in Wells River; $637,000 will go toward modernizing equipment at Brattleboro Memorial Hospital; and $88,000 will help fund kitchen and food-storage improvements at the Upper Valley Haven’s food shelf.
The money comes from the U.S. Department of Agriculture’s Emergency Rural Health Care grant program. In total, the grants will supply up to $475 million nationwide through the American Rescue Plan Act, $74 million of which was announced in August.
Vermont’s hospitals relied on government aid to stay afloat during the pandemic but are still reeling financially from the crisis and the staffing shortages and cost inflation that followed.
The University of Vermont Medical Center and Rutland Regional Medical Center — the state’s two biggest hospitals — both asked for significant annual budget increases, 10% and 16% respectively, for the coming year. The budget increases were approved, but the Green Mountain Care Board trimmed the amount it will allow The University of Vermont Medical Center to increase its charges to commercial insurance carriers.
They aren’t alone. Springfield Hospital, which had financial troubles before the pandemic, has requested a 7.5% increase, citing, among other factors, increased costs associated with traveling staff.
In an August presentation to the Green Mountain Care Board, Springfield Hospital said it had spent more than twice as much on traveling staff in 2022 as it had the year before, totaling a projected $4 million this year.
As part of its increased budget request, the hospital proposed a 39% increase in recruiting and advertising expenses. At Thursday’s panel, Robert Adcock, Springfield Hospital’s CEO, said the hospital had used marketing funds to hire a dedicated recruiter and create incentive programs to retain staff, both of which would decrease reliance on traveling workers.
Panelists outlined three recent phases of crisis experienced during the pandemic: COVID-19 itself, associated mental health issues, and later, economic hardship. Christopher Dougherty, CEO of Brattleboro Memorial Hospital, highlighted the pandemic-related “absorbed costs” now added to hospital budgets. Things like at-the-door health screenings, increased personal protective equipment and COVID-19 testing are all new costs that have to be endured, he said.
Adcock told those present he anticipated a fourth, which will occur “when we see the long-term effects of untreated health care issues” related to care put off or unavailable during the pandemic.
That fourth crisis, though, might be eased by this federal funding, according to Little Rivers Health Care’s CEO Andrew Barter.
“It allows us to have the infrastructure to provide those services,” he said. “The first antiviral medications we provided were in a three-sided garage. This funding bills for isolation exam rooms.”