Vermont's largest hospital system announced dozens of layoffs this week as part of a plan to cut nearly $185 million in spending by the end of next year.

This isn't a reflection of their work, but of the changes happening in health care that are demanding us to take this kind of action.

What we're seeing today is a microcosm of what's happening throughout the country, and particularly in rural health care.

Plus, a Vermont Agency of Education higher raises questions and a big weekend ahead for soccer fans in the state.

All that and more ahead on Vermont this week.

From the Vermont public studio in Winooski.

This is Vermont this week, made possible in part by the Lintilhac Foundation and Milne Travel.

Here's moderator Mitch Wertlieb.

Thank you for joining us.

I'm Mitch Wertlieb.

It's Friday, August 1st, and with us on the panel today, we have Mark Johnson from WCAX, Lexi Krupp from Vermont Public and Liam Elder-Conners from Vermont Public as well.

Thank you all so much for being here.

We're going to start with a story that we kind of saw coming, Lexi Kropp I guess we knew this was going to happen.

It's not great news.

UVM Health Network, the largest health network in the state, has announced layoffs and also some millions of dollars in cuts to help save money.

Let's talk about the layoffs.

First, about how many are we talking about here at the network and what kind of positions are being laid off?

Yeah, it's 77 positions, that are filled right now and a couple dozen others that are unfilled.

This is across finance.

It H.R a couple leadership positions as well.

And this is because the hospital is in this position of needing to save money, but also trying not to cut patient services.

So they're like, all right, what can we do here?

And they've identified these positions that will save about $5 million a year.

They said and then it's part of this bigger plan to save 185 million, million dollars by the end of next year.

So they have a bunch of different, initiatives, sort of that, that these layoffs are just one piece of does it look like this is the end of it, though, when it comes to the layoffs?

Or can we be expecting that there may be even more?

Yeah.

Doctor Sunny Ethan, who's the CEO of UVM Health Network, would not did not could not say whether there would be more layoffs or not.

But he did go through sort of their plan to save all this money.

So that included, cutting their capital budget.

So that's money that they're spending on new buildings or, maintenance by $70 million next year.

So, he mentioned, not the pausing a couple projects that had been planned, including, a new emergency department at Porter Medical Center in Middlebury and then also pausing, expansion of the parking garage at UVM Medical Center in Burlington.

And there was there's some other stuff.

They also, last month, the board of UVM Health Network said they're not going to give any bonuses this year to any executives.

So that's expected to save between 7 and $10 million.

They also have these plans for, increasing clinical efficiency.

So a bunch of different things to try to, save money by standardizing the medications they use, the devices they use, trying to shorten stays in the emergency department in the hospital.

And, the hospital has said all of these efforts will save around $60 million.

They're estimating, which is a a a lot.

So we'll, we'll we'll see if these savings are, are realized.

But that's part of being able to meet their, budget next year.

And they had hospitals submit their budgets to state regulators.

They've just been going through that process.

And, UVM Medical Center, the biggest hospital in the state, has said that they're going to cut commercial insurance rates by 8% next year.

And so all of these cuts are part of that.

Okay.

So this is the start of this process.

And very briefly, we also heard that there were some smaller hospitals now looking at layoffs.

Two.

Right.

Yeah.

And some of those actually would impact, patients services.

So just this week, northeastern, in Saint Johnsbury said that they are going to layoff five people, including the team that does occupational medicine.

And that's after cutting three administrative positions earlier this year.

Okay.

Thanks, Lexi.

Mark Johnson, I know you've been digging into a lot of this, too.

You've been talking with Owen Foster on your podcast a lot about a lot of these health care issues.

What's going on?

First of all, with Vermont health Care 911.

What can you tell us about that?

Well, that's a that's a group.

It's a coalition of public policy makers, business people who are basically backing up with the Green Mountain Care Board is doing, you know, one point, the, head of the Greenmount Care Bordeaux and Foster said, you know, where's the business community?

And they can't just do this by themselves.

And the business community is the one that's being most impacted by these double digit rate increases.

You know, to answer your question about, is there going to be more?

There is absolutely going to be more.

Oh.

And foster said, you know, as as difficult as these cuts are going to be on families, you know, the cost of health care in this state is, out of control.

And so this is really just the beginning.

The folks at Vermont Health Care 911 describe, the cuts that were announced this week is step one of probably two through ten are on the way.

And you know, a number of these for example, you know, Lexi was talking about reducing the number of tests, trying to cut the number of inpatient days.

I mean, these are all aspirational.

I mean, these are unlike layoffs.

These are not hard dollar figures.

You know, these are sort of hopes.

So, you know, we'll see.

And you know, one of the real challenges here is that it's more expensive to get your care at the University of Vermont Medical Center than other hospitals.

But even more importantly, you know, Owen Foster used the example of tick bites.

You don't want to be going to the emergency room for tick bites, but if you don't have a primary care physician, you don't have a lot of options about where to go.

And the state of Vermont is so, bereft of the right number of primary care physicians, you know?

And the other thing is, if you delay tests or try to get more patients in, that can have a snowballing effect in a not positive way.

And, you know, I look at somebody like these members of the Greenmount Care Board is having the most difficult job in Vermont right now.

I mean, this is impacting education costs with teacher, you know, health insurance benefits and trying to get your arms around this, you know, the medical center, Hospital of Vermont, even though we're talking about $185 million in cuts, it is a $2.3 billion a year operation.

So, you know, one of the issues, though, is that, and I think most people, business people would agree with this, you know, finding that first labor cuts is a whole lot easier than finding this second, third and fourth layer.

And you got to be careful because, you know, we all want to have a healthy institution.

That's the one tertiary care facility in Vermont.

You know, you know, you don't want yourself.

You don't want your grandmother not being able to get in.

And some of the waiting times for some pretty routine tests can be months and months and months.

So trying to find that balance and that sweet spot is is really difficult.

Let me just mention one other thing.

Sure.

You know, compared to last year when, the health network tried to make these cuts, I mean, they really, in a lot of people's in, I really blew it.

You know, they went directly at patient services.

I think a lot of people, including Mike Smith, he's now going to come in and try to help them view this as reckless, haphazard.

Those are two of the words he used.

And, you know, part of it was, I think, to try to inflict a little bit of pain.

And I think these cuts reflect what I think is the sort of new relationship that's going on between the Greenmount Care Board and the network.

They're now meeting on a every other week a couple of times a month basis.

You know, the relationship is just a lot better.

And that's going to benefit all of us.

You know, it.

I was talking to a friend of mine about this the other day.

You know, you really got to wonder if at some point what would make the most sense is if Phil Scott, some other public policy leader, said, let's get all the hospital heads together, get them in a room and try to sort this out because there seems to be an awful lot of, you know, maintain my turf and maintain my revenue stream.

And you know, that's just not going to be in the in the best interests of ratepayers at this point.

We're all in it all together.

And to Lexie's point before about cutting certain things, the optics of it certainly I would think it looks a lot better to cut some of these bonuses, than to cut into patient services.

And so I would just say, like the, leadership at UVM Health Network has really changed their tune from last year when they were, casting blame on some budget orders.

You know, in saying these are we are being forced to make some of these changes to cut access to patient care.

You know, and this year, the framing around these layoffs was, you know, health care costs are out of control.

And and we're going to try to do our part, to, to reduce them.

And, you know, we we have to do layoffs as a result.

And just one more stat to add in here is, I was just looking at this hospital spending has risen by 50% as of last year since, before the pandemic.

So that's $1.6 billion, than than just a few years ago.

So that's really what this is all about, trying to rein in, spending that.

Yeah.

That, you know, increasingly we as a state cannot afford.

But the health insurance rates are also an issue.

Now, we're hearing this year that they're not going to be the double digit increases that we've been having.

However, for, a lot of people are saying that even with a more minimal, increase in insurance rates, it's still very unaffordable.

Right.

So this the insurance rates you are referring to are on the state marketplace.

Yeah, called Vermont Health Connect.

Most other insurance rates are sort of commercial insurance rates.

They're sort of black boxes.

Right.

Like we we don't get a look into them.

So, so the, rates on the state marketplace, those are public.

There's this public process to go through them.

So so there are yeah, these numbers that are imperfect but can be a bit of a proxy for, how we might expect other commercial rates, to change.

So the Green Mountain Care Board is going through this process of deciding whether to approve these rates or not, by next month.

But the current figures that we're looking at, there's, there's two insurers that offer plans on the state marketplace MVP health care and Blue Cross Blue Shield.

Yes, exactly.

And Blue Cross Blue Shield is, the the big player in our, commercial health insurance market.

It's like 75% of Vermonters with commercial insurance have a plan under Blue Cross Blue Shield, including me.

And, MVP is, not based in the state.

Vermont is a pretty small share of of their, the plans that they offer.

So MVP, health care has said, we're going to raise rates by about 3%.

That's for individuals and families purchasing insurance on the state marketplace and then also small businesses.

It's called small group insurance.

So that's way less than in recent years where we've seen these double digit increases.

But yeah, it's still it's still going up a little bit.

Blue Cross Blue Shield, on the other hand, their proposed rates are a lot higher, 15% for individuals.

So it's still double digit rate still right there.

Yeah.

And then 7% for small businesses.

And we can talk about why, why you're seeing this discrepancy.

Well, I think that at the point is those, those increases, as you mentioned, Lexi, it was already very expensive for people to purchase these Vermont Health Connect, it premiums.

And it's still going to be expensive even without the big increases we've seen over the last few years.

And, you know, I do want to move on to another story now that Liam Elder Connors has covers.

Mitchum.

Yeah.

Yeah.

Please.

You know, one of the other wild card factors here is the bill that's coming out of Washington, DC.

If there's a cut to 45,000 people on Medicaid, you know, the pressure on these rural hospitals, which this report came out last year and said 4 or 5 of them are going to go out of business.

A lot of these hospitals depend on Medicaid patients.

And if those people just sort of get dumped, that's just going to increase the emergency department usage and we'll put a lot more pressure on it.

Foster said.

That report that came out might actually be generous in terms of the the financial peril that I mean, that's pretty frightening.

And one one last thing is that, on the state marketplace, so many people have relied on federal subsidies.

They're called enhanced tax credits, that are expiring this year.

At the end of the year, which had capped how much of your income you can pay on these plans.

So that is actually a huge change that is happening.

If you make over, say, $62,000 a year.

You used to be capped at about 8.5% of, of your income.

Now those caps off the subsidy is going away.

You're going to have to pay the sticker price for these plans.

So some people who've been paying $10 a month are now going to see, you know, premiums of $800 a month.

I mean, that's incredible.

Yeah.

The X factor here about what's happening at the federal level is just adding.

So much more stress and worry to this whole thing.

But thank you both for updating us on that.

What we can expect to maybe see in the coming months.

Liam, I do want to get to this story that you reported, about a Vermont agency of education.

Higher.

It's a really disturbing story.

This is a guy named Bill Simmon, who was found to have done something pretty terrible after he was hired by the Vermont edge of education.

What can you tell us about what he did and what the outcome of all this has been?

Yeah, according to, police report in a civil lawsuit, back in 2012, Mr. Simmon is, he, invited two young women to, to do a photo shoot or a video shoot with him where he had set up a camera in the changing room and then recorded them changing.

And, police believe and posted that video on the internet where it was viewed, millions of times.

Now, the women who were filmed didn't find out about the filming until many years after it had happened.

They learned about it in 2018 when a friend of a friend sent them, a note saying that this video of them had showed up online.

At that point, the police, when they did their investigation, had found evidence that this happened but couldn't file criminal charges because, the incident was so long ago, was past the three year statute of limitations for the voyeurism charge that they had evidence for.

So the civil case, it's a little bit of a different scenario, but the two women were able to file a civil case, and, jury found that Mr. Simmons had invaded their privacy and ordered him to pay millions of dollars to the two young women.

I mean, what's so tough here is that the statute of limitations, as you said, three years.

So he can't be criminally charged at this point.

But there's no statute of limitations on the internet.

This is going to live in perpetuity, right?

I mean, that's something that the police officers who investigated this and some law enforcement officials have said, you know, is in the age of the internet, like maybe something to look at is whether or not there should be longer a statute of limitations in this cases.

Defense attorneys, point out generally that making new laws based on unique cases can often lead to sort of, bad results or we don't know the unintended consequences.

And there's a lot of good reasons to have a statute of limitations that, you know, means evidence is collected closer to when the, alleged crime actually happened.

But, certainly this case has raised concerns among law enforcement about whether or not we need to reconsider some some of these things.

And to be clear, before he was hired by the Agency of America, years before he was hired by the agency.

Yeah, that's a good point.

He was hired in, December of 2024.

And obviously, the question is, why didn't anybody know about any of this behavior since the civil lawsuit was public?

And, you know, one, the state of Vermont, policy doesn't allow a criminal background check in most hires.

According to what the Agency of Education told me, there are some cases where they do a criminal background check.

But again, another crucial point is Mr. Simmon was never criminally charged, right?

They never were not going to show up in a criminal background.

You wouldn't have helped in this case.

What about, the penalties against him?

As you said, a civil suit here.

He's been ordered to pay millions.

I'm wondering if he has that kind of money.

And if not, I mean, how is the restitution going to come to these women?

That's something that we'll we'll get worked out according to their attorney.

And, she expects that will take some time.

I did reach out to Mr.. And he didn't want to comment, but, eventually threw in an attorney.

An attorney said that Mr. Simmons greatly regrets his actions and the harm that he caused.

They were compensated, in part because they also sued, the victim, the the place that he was working for.

And there is a settlement of about 3.5 million that their insurance company paid on that.

And of course, the age of education.

Liam, I'm still still looking at this, like you said, not a lot they could have done at this point, but it's got to be concerning moving forward.

Yeah.

The secretary in a note to staff said that it's something that they're looking at their policies and working with other state agencies to sort of figure out what they might be able to say.

You know, you've mentioned in your story that there's some sort of self-reporting of when you're hired, I mean, who's going to self-report something like that?

I mean, you know, I don't know.

I mean, in this case, right.

Again, there was no criminal charge filed.

So like, criminal history, I wouldn't you might not report just that the police investigated you and never filed any charges.

But who would self-report that?

You know, I don't know.

I mean, yeah, probably not a lot, probably not a lot of people.

But it depends also on what the alleged crime is, too, right?

Yeah.

I appreciate very much that you wrote that article, Liam, and brought that to people's attention.

I want to move on to another issue now.

Vermont Republican Governor Phil Scott has denied a request from the US Department of Defense to activate Vermont Army National Guard soldiers in support of federal immigration enforcement activities.

They were being requested for the emergency executive order that he had for the southern border.

I didn't see the correlation between having 12 deployed into the state for a year of clerical positions.

Now, in a press release last week, chief Pentagon spokesman Sean Parnell said the Department of Defense was invoking title 32 to increase the National Guard's role in ISIS immigration law enforcement mission.

The New York Times reports National Guard troops would be deployed in 20 states with Republican governors including Florida, Georgia, Virginia, Texas and Louisiana, according to a Defense Department official who was not authorized to speak publicly on this.

Liam, I think you've been following the story as well.

You know, Governor Scott was not, hesitant to keep Vermont's contract with Ice for detaining people in, like Saint Albans.

But for this, he drew a line here.

Yeah.

And I think it's interesting when you look at, the statements that the governor's made and also, his chief of staff to, one of our colleagues that he's sort of not closing the door completely.

He's he's walking a bit of a line saying, like, I didn't really see the, the need in this case.

But if the request was could be more clearly articulated for counterterrorism or drug enforcement or if there is something more specific, that might be something that he would consider.

So I also I think it's interesting just looking at the rhetoric, not coming out and saying no completely, but, kind of a qualified know and explanation as well, which is an interesting approach.

It was an interesting you say, know at your own peril to the Trump administration.

So I think, you know, he's going to be careful how he words this.

I mean, this is just a loser for him.

I mean, for him to have agreed to do this, you know, the trade off is he might raise the ire of the Trump administration.

But imagine the response of Vermonters if the state of Vermont gets involved in this, considering all these cases we've had.

And I think, you know, you mentioned the stories and Weinstein did for Vermont Digger about the ice in the connection with the Vermont prisons.

You know, that I think that story had a pretty big impact across the state.

And I think people really kind of raised their eyebrows, had no idea the extent that this was going on.

You know, you mentioned Louisiana.

There was a story in the times yesterday that this has become, you know, the deportation hub of the United States of Vermont.

And they show planes coming in, planes going out down south to South American countries.

You know, frankly, I think this was an an easy call for Phil Scott.

It will be interesting, though, to see moving forward.

We mentioned title 32 there.

Without getting too much in the weeds of this, there could be the ability of the president to sort of force the hand.

Yeah, but this hasn't happened yet.

But to your point, Mark, you know, you crossed the Trump administration that year.

But, you know, if that happens, then he can just throw up his hands and say, I don't I don't really have any any say about it.

But anything where he's got any sort of discretion on this, you know, I think he would just be overwhelmingly criticized for any decision like that, even if it's just 12 clerical workers.

It's the it's the the larger point, you know, going back though, you know, there is this whole funding that was supposed to come for electric vehicles that the Scott administration basically let go in order to save the much larger transportation money down the line.

You know, that was that might have been viewed as a much smarter, calculated decision than offering up 12 clerical workers to be working down on the southern border.

Okay, let's zero in in our remaining minutes here on some very local stories.

One of them is kind of sad for those who have been to, classic, venue in Burlington known as nectars is going to be closing soon.

It will not reopen.

Liam.

Is that right?

It's really sad.

It's been around for, I think, almost 50 years now.

Many decades.

It's the the house that launched fish, the, you know, some, some, some people's favorite jam band.

Not my favorite jam and but, you know, that's an important band nonetheless.

And I think about all the great things there.

You know, Metal Mondays was a big draw and trivia and that it wasn't just a place, though, being known for fish, it wasn't just a place for jam music, a real community hub, a real music hub, and they're just fewer and fewer of those places in Burlington now, which is which is sad.

Yeah.

That was very courageous of you to say that about fish.

You know, I, I speak truth to power, Mark.

It's a good thing Calvin Cutler is not on the panel today because he's a big fish fan.

Yeah.

The, the other part of the story is what's going on in downtown Burlington in this construction project.

There's multiple projects going on at the same time.

I mean, nectars is a ground zero of these, and I think there's going to have to be some real navel gazing in the city of Burlington by their public works officials and others looking at the wisdom of having done all of these projects at the same time.

There are an awful lot of businesses in that area that are really struggling.

I live in Burlington.

If you try to get from one end of Burlington down to the waterfront, it's a, it's a, it's a labyrinth and a maze.

Yeah.

No question.

Lexi Krupp I know that you're a big fan of this last story.

Because Vermont Green FC has a chance to win a national championship tomorrow night.

Saturday.

You're going to be attending that game.

I will, I will, yeah, I was there, on Sunday.

And at that point it was unclear where the nationals would be.

Whether it'd be in Seattle or here.

So the fact that it's here is so exciting.

Tickets sold out in about ten minutes.

I mean, everybody is within one minute.

They saw incredible.

Yeah, but you, you know, there's a at least last week, a big section of of folks who just showed up without a ticket.

And that was okay.

You know, I think they're going to win.

I got to tell you, they're following in the footsteps of the UVM men's national soccer team, which won the D1 title.

They had two huge comeback victories.

Vermont Green has won three comeback victories just to get to this point.

They are absolutely playing on fire and with the hometown crowd with them on Saturday.

I hope I'm not wrong about this.

I really do think they're going to win the, the national championship, which would be a remarkable thing for Vermont.

Thank you so much for our panel this week, Mark Johnson from WCAX, Lexi Krupp from a Vermont Public and Liam Connors from Vermont Public.

I'm Mitch Wortley.

Thanks for watching Vermont this weekend.

Go green.