So.

A big shakeup in health care this week.

As UVM Health Network President and CEO Sunny Eappen announces he's stepping down.

There's not a person in this state that's not impacted by the work of the in-house.

This is just not right.

The firm, the largest employer in the state to people that receive care or family members that work or receive care, just not a person in the state.

And when you have a leadership change of this magnitude, it's going to impact people.

Plus, Governor Scott signed an executive order to spur housing construction, and one of Vermont's most iconic entrepreneurs leaves the company he co-founded.

All of 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.

Thank you for joining us.

I'm Mikaela Lefrak in for Mitch Wertlieb.

It's Friday, September 19th.

With us on the panel today, we have Mark Johnson from Wcax.

Carly Berlin from Vermont Public and Vtdigger and Laura Ullmann from Wcax.

Thank you all for being here.

So we have some big things on the docket to discuss today health care, housing and ice cream, which we will save for later.

Let's start with health care though.

So Thursday afternoon, one of the top leaders in our region's health care system, Sunny Eappen stepped down from his position.

He was the head, the CEO and president of UVM Health Network.

This comes after a pretty turbulent week, Mark, or really a turbulent year for the Health Network, which is the largest medical system in our region.

Tell us about Sunny Eappen and why he stepped out.

Sunny Eappen was the CEO.

It's a six hospital network, the biggest one being, of course, the University of Vermont Medical Center.

There are three hospitals in Vermont, three in New York, arguably one of the top 3 or 4 most powerful people in the state of Vermont.

He stepped down.

I think a lot of people were taken by surprise by this.

As you say, this is coming at the end of a very contentious period of time, which really culminated last year at the end of 2024, when the Greenmount Care Board, which is the state regulatory body, ordered cuts to the network.

And their response has, was that what really, I think set this off, where they decided to cut services to patients and I think a number of people, and at the same time, they wanted to giving $3 million in bonuses to network executives, including $600,000 to sunny up.

And and I think there is a lot of outrage on the part of public officials and the public about this.

How can you be cutting services at the same time giving bonuses?

And so this then resulted in a lot of back and forth.

And I think what sunny up and feeling was that, you know, as he said, the organization needs to move forward in a different direction.

You know, when somebody resigns in a situation like this, it's hard to know how much the person resigned or how much they were encouraged to, move along.

And, you know, this also was coming after a number of very well-respected public officials, including former Agency of Human Services Secretary Mike Smith, talking about this disconnect between the health network and the general public.

You know, using phrases like fundamental disconnect.

He felt that the cuts that were made at the end of 2024, in fact, could have been, reckless and haphazard at best, dangerous and vindictive at worst.

I mean, you can't have a stronger condemnation than you can at that.

I would say two things about this.

One, I think it shows that the networks trustees who oversee the network and who the CEO reports to, they've been really under a lot of criticism, too, for not really being engaged in the way that they should be.

So I think this indicates, at least to people that know more about this than I do.

That they've really stepped up their game and really stepped up and understood that their role is to serve the public.

The other observation I would make is that this really shows that the Greenmount Care Board has finally gotten some teeth, and I think you've really got to give Owen Foster, the chair of the board, some credit here.

You know, the Greenmount Care Board was started back in 2011.

It routinely just gave hospitals their budget.

You know, hospitals would say, well, you know, we need the money.

And if you don't give us what we need, we're not going to be able to provide the kind of health care you need.

It was a very intimidating approach that they were taking.

And I think the Greenmount Care Board under at foster has said, you know, enough is enough.

And there's been some pushback here and they've said, you know, you can't just keep doing business the way you are.

Insurance increases were double digits for several years in a row, and this was just becoming increasingly unaffordable.

Yeah.

You can't keep doing business the way you are.

That message really came through quite clearly in the hospital budgets that the Green Mountain Care Board approved just last week.

They're in charge of approving budgets for all of 14 of Vermont's general hospitals.

Laura, you reviewed those budgets and, the the headline news here.

I think, is, as Mark was saying, that they really push back against, UVM Health Network and ordered some major cuts to their projected revenue for their biggest hospital, UVM Medical Center.

Yeah, $88 million taken away from their net patient revenue.

And I just wanted to take a second to sort of explain why these hospital budgets matter to you.

So the Green Mountain Care Board sets limits on how much a hospital can charge or earn for services, also known as in that patient revenue, which I just mentioned, took that $88 million cut.

They also determine what insurance companies pay them with commercial reimbursement rates.

So these decisions affect how much you pay for your health insurance.

When hospital expenses go up and that patient revenue goes up, pay for these costs onto the insurance companies, which then get tossed on the consumer, which is you.

And then your premiums go up.

So by the hospital revenues and payment rates going down, the board is trying to slow premium and co-pay increases for Vermonters.

Yeah.

So they are trying to push back on UVM Medical Center.

So you can't bring in as much revenue.

And part of the reason for that that they gave was that, UVM Health Network has a couple of different hospitals in New York, and they're saying, you know what?

You're taking revenue from Vermont and using it to bolster those hospitals that are in New York.

So in a way, Vermonters are kind of helping to uphold the health care system of folks in another state, which the Green Mountain Care Board says, that is that is not okay anymore.

And that may very well have been sort of the final straw for sunny up.

And when that came out that the Vermont hospitals were in effect, subsidizing the New York hospitals and these New York hospitals are very rural hospitals, like many of the hospitals here in Vermont that are also struggling.

You know, there may have been some justification reason for that, but that just does not fly after everything else that's been happening with Vermonters.

Right?

There has also been a lot of discussion as part of this around executive pay.

So as these hospital systems are trying to balance out their budgets, there are also paying some executives top dollar in order to lead these, these massive systems.

I want to play a clip from an interview that we did with Owen Foster, who's the chair of the Green Mountain Care Board.

This was from Vermont Edition on Thursday.

What I say is, if you demand top dollar, maybe this isn't the right environment for you, because we want people who are committed to the community not getting their benchmarks or their market, if you will, right that your market is really driving success for the state, and you should be thankful for the opportunity to do that and not say, oh, I'm only getting the 35th percentile.

I don't want to be here.

I don't think we want those people.

He didn't mince words there.

He was referring to Sonny Ethan's previous statement on Vermont edition that he was earning around the 45th percentile for hospital executives, and Owen Foster said, I don't care.

Now, this issue of executive salary law has been has been a big one.

I know you've reported on it, and it's, one that affects not just hospitals, but also the insurance companies in Vermont.

Right?

It does.

I'll start with hospitals, just for a second.

For UVM Health Network, 20% or UVM Medical Center, around 20% of its 2024 budget went towards administrative costs and salaries for insurance executives.

I'll take a second to say that Vermont state statute essentially 18 VSA 9371, which you don't have to know, but health care costs need to be contained.

That's what it says, and balance the needs of the population with their ability to pay for such care.

And the Green Mountain Care Board essentially said insurance executive salaries in Vermont are out of line with that law, but it doesn't mean that they're breaking the law.

It just means that it's not exactly in line with our goals.

So I'll tell you that the Blue Cross, Blue Shield, Vermont CEO made $943,890 with a 66 $266,215 bonus.

So that's over $1 million in pay.

That's a nice cushy salary, which I got that as a journalist.

Envy CEO made over $1 million with a $1.2 million bonus.

So that's a lot of money.

And health care is very expensive for a lot of Vermonters.

So, I think Owen Foster was trying to point this out in the board, was trying to point this out, that this doesn't really align with our goals.

Yeah.

And in the past year, the legislature and Governor Scott has granted the Green Mountain Care Board more power to oversee the salaries, at least of folks in the hospital system.

Not necessarily with insurance companies, though.

Carly.

Hello.

You have been doing a lot of work over the past few.

Not just weeks, but months looking into, another big, not to untangle here in Vermont, which is the the shortage of affordable housing.

I'm so excited to talk to you about this, this remarkable piece of journalism that you published, along with a colleague at Vtdigger.

It's about the amount of public money that has been spent on housing in Vermont over the past 4 or 5 years.

How much?

Tell us how much.

So I I'll start by just saying I wanted to look at the amount of money that the state funneled into housing in the years following Covid, right.

We've heard our elected leaders and housing officials say we've spent hundreds of millions of dollars on housing from things like Covid era federal relief bills.

I wanted to know exactly how much and what did we get for it.

So I worked with Vtdigger data reporter Erin Petrenko on this for many months.

And we gathered information on housing spending from all of the major agencies that oversee that here.

And the top line number is $790 million, directed towards affordable housing development between 2020 and 2024.

So put that in context.

For us.

It sounds like a lot of money, but we have a massive gap in affordable housing.

I mean, the governor has been saying we need, what, 40,000 more units in the next five years to help us reach demand.

So did 790 million.

Help us get there.

You know, it made a dent.

You know, this created about 4400 homes.

There's a lot of nuance there.

So let me break it down a little bit.

About 2200 of those homes were new.

Think, you know, newly constructed affordable apartment complexes, for example, about another 1100 were rehabs, which is, you know, kind of a catch all term in the way that these housing agencies use it.

It can mean, you know, we renovated an old school into apartments.

So those are kind of new.

And in some cases it means we preserved an existing affordable housing complex to to keep it going as, as affordable in the future.

So bit of a mixed bag there.

Then there's another thousand units that we got through a program that was new during this, this Covid era period that was focused on bringing vacant apartments back up to code, bringing them back into the housing market, building, you know, accessory dwelling units in people's backyards.

So that's what's under that, that $4,400 or 4400 unit banner.

You know, one of the things that I thought was really interesting, another piece you reported is talking about the average price of a single family home still being about a half $1 million.

And, you know, I think about that and I think about the next generation and how on earth they're going to be able to afford buying those homes.

And here we are trying to attract younger people with families to come and live in Vermont.

And that that seems like a number.

Now, I know interest rates are supposedly going down.

That'll help some, but that's a that's a stretch.

We all got to be hospital executives.

Yes.

One thing I was so fascinated about when read when I was reading this piece, Carly is thinking about how you actually reported it out.

Like, were you sitting there calling every town clerk saying, hey, how many more units did your town bring on this year?

How do you figure out these numbers?

You know, we were looking not at the municipal level, but at, you know, the state entities that doled out this money.

So I went to the Vermont housing Finance Agency and the Housing Conservation Board and the State Agency of Commerce and Community Development and said, hey, this is what we're interested in looking at.

We, you know, we're looking at this 2020 to 2024 time period.

Can you give us your spreadsheets of of, where this money went?

And the thing is, so many of these larger scale projects, they get money from each of those places.

So, so much of the work for really my colleague Aaron was going through and trying to duplicate all of these different systems that track where this funding goes.

It was a Herculean effort, truly, and it underscores, you know, the state is not doing that.

You know, this was a novel analysis that we were able to do, to be able to show, you know, okay, so what across the board, across these many different funding streams, you know, what?

What are we getting for the money that we're putting in?

Yeah.

And we're also getting something different from the money we're putting in than we might have expected we would a couple of years ago before changes in, construction cost before tariffs went into effect.

How did all of that, those market, changes influence your reporting?

Yeah, I think that's a really important point to make.

Right?

Because at the same time that we were doling out all of this money, you know, inflation was skyrocketing, the price of materials in the construction world was getting so much more expensive.

So when you look at, you know, the the per unit cost of an affordable rental pre-COVID.

And now, I mean, it's double it's more than double in some cases.

And so the money, you know, we simply just did not get as much bang for our buck as we would have in a pre-COVID economy.

Yeah.

And supply and demand, I mean, the pandemic, you know, that demand has lessened, but it's not completely gone away.

I mean, try to find a house in Burlington or Chittenden County, and there are not that many listings when you compare it to the rest of the country.

It's true.

And, you know, the other thing that's important to bear in mind when we think about, you know, how much of this money move the needle is.

This funding was focused on, you know, affordable housing, you know, subsidized housing that has some kind of income restriction on it or a cost cap on rents or sale price.

Right.

That is a relatively small portion of the overall market.

So when we look at, you know, how much we are building overall, we are still not meeting those projections that say we need to build, you know, 35,000, 40,000 homes by the end of the decade.

It's still a relatively small portion.

And so there is a lot more work to do to be trying to meet those benchmarks.

Yeah.

So meanwhile, you dropped this report, and then Governor Scott signed an executive order to spur housing construction.

Let's let's hear from the state's commissioner of the Agency of Housing and Community Development, Alex Farrell.

These actions are going to have the effect of expediting permitting timelines, reducing the cost to build homes, increasing the number of units in projects, and setting in motion enterprise wide reviews of processes and policies that impact housing development.

Laura, you went through this whole executive order.

What stood out most to you?

What stood out most to me was probably just the prioritization of these multifamily residential, homes.

So those will go to the top of the docket for boards and authorities that review those applications.

It's going to be a huge change.

And something else that stood out to me was that the public comment time is going to be limited.

I've sat through some of these meetings where public comment takes up three different meetings.

Now they're going to have to issue these decisions, and I believe 60 days, that's going to be a huge change.

And Carley, do you think it's significant that this, executive order came out when the legislature is not yet in session?

Does the governor have authority to do all these things?

Yeah.

You know, I think that that's there are certainly murmurings right now of is the governor overstepping legislative authority here?

I think we're going to see sort of where those conversations land at.

Certainly.

Interesting timing.

You know, part of what this order does, too, is sort of set up, you know, reports to be made, inventories to be taken before the legislature reconvenes in January.

So they'll be, you know, kind of presented with some more information to say, do we want to further some of these things?

We'll have to see how much traction there is.

And it's worth saying to you that some of the things included in this quite technical order that's really focused on deregulation and streamlining, permitting, you know, there are things that lawmakers have discussed in recent years that have been left on the cutting room floor in some cases.

And so now the governor is saying, you know, really this is a priority to push through.

And politically, it's a pretty smart move, right?

I mean, here he is.

He's laying it out, and now he's put it in the legislature in a position to say no.

And they're going to be saying no, essentially, at least in the public side to affordable housing.

So, you know, smart move.

In his part, it made me wonder about what his future plans might be.

Sure.

Yeah.

I mean, I think it's to tie back to the funding piece, too.

You know, one thing that was emphasized in this order in this press conference this week is, is something we have heard the governor say a lot recently, which is we can't spend our way out of this problem.

We're not going to have all of this money that we had during the Covid years to throw towards housing development anymore, and we need to try these other things.

This was him, you know, kind of moving that chess piece saying, we we need to do these things right now.

And developers are happy about it very happy about it.

Environmental groups and the Democrats, they haven't had enough time to really dig deep into this executive order and respond yet.

Well, that'll be something, surely, on the docket for this upcoming legislative session, which begins in January.

But before we get there, though, we get to hit cold and flu season.

We wanted to share during this program some important news that just came out about the Covid vaccine.

I'm guessing a lot of you are probably thinking about when to get your flu shot and maybe getting your Covid booster shot as well.

On Thursday, Governor Phil Scott and officials with the Department of Health announced some steps that they're taking to make sure Covid 19 vaccines are accessible for Vermonters.

It essentially authorizes pharmacists to give the shot to anyone over five, including those who are pregnant.

And this action comes as a panel of CDC advisers was just beginning to meet to talk about recommendations for some vaccines, including Covid.

I heard what you guys have experienced this year with all these changes to the, to the CDC that we're seeing at the federal level.

For me, it seems like it's made it a lot harder to figure out, just as a regular person.

When do I get a Covid shot?

Can I access one?

Do I get my kid one?

Do I urge my older parents to do so?

It feels different than past years.

Well, certainly having Robert F Kennedy Jr as the as the head of the health agency, I think it's confused a lot of Americans.

He certainly has sent out a message of questioning not only those vaccines but vaccines in general.

And, you know, I think that that's what the governor in the state of Vermont may be pushing back against, too.

Well, we'll see.

I you know, I was at I was actually at a pharmacy today and pretty good line of people that were in there, I think more for flu than Covid vaccine.

But I think there's a lot of confusion out there.

Yeah, yeah.

What do you think?

Well, I think it's really interesting.

These questions, these philosophical questions sort of about people's freedom to choose what they want to put in their body and then other people's safety and how those sort of ideas kind of infringe upon each other.

And then sort of science.

And are we going to trust the science, or are we going to sort of trust what, people who aren't looking at the science are trying to say, well, I promise you all, we would talk a little bit about ice cream today.

It's not as fun as I made it sound, but still an important story out of our region.

Jerry Greenfield of Ben and Jerry's stepped down from the company that he founded 47 years ago with Ben Cohen.

Mark, what happened?

Why do you go?

He stepped down because he said the Ben and Jerry's doesn't have the freedom to discuss social issues, which is really a fundamental part of Ben and Jerry's.

They started back in 1978.

Some of you who might be older might remember the piece pops, and they have taken on a number of causes.

Ben and Jerry's has always felt as though it's not just about ice cream, but it's really about talking about some of these major issues they sold to Unilever back in 2000 for $325 million.

They were able to make a carve out with Unilever, which is a big multinational, to have this independent board that would allow them to continue this social mission.

Unilever is now trying to spin off their ice cream division to a group called Magnum, and what Jerry is really reacting to is Magnum really wants to change that.

And I think so some of the issues are guys, on diversity, equity and inclusion, even Black History Month, they were saying they weren't really allowed to be pushing that.

And I think we're also you know, let's be let's be candid.

I mean, where I think we're living in a time in an era where speaking out about social justice issues is something that corporations are worried that there's going to be a backlash about.

So he decided to step aside.

Interestingly to me, Ben did not and feels as though he should stay on and continue to try to in some fashion, push the social issue.

But, you know, and I will tell you, the reaction on social media that I saw in social media is not necessarily a great barometer, but, you know, the pushback of, well, you know, you guys saw that 25 years ago has been, like a lot of cases of social media.

Pretty harsh.

Yeah, yeah.

Well, it does seem like it's news that has really reverberated through Vermont.

It's a company that, you know, many of us still hold near and dear to our hearts, even though it is part or part of a larger conglomerate.

That, might be changing as well.

So before we end, since I kind of lied about the fun ice cream story, I would love to chat with you guys about the season that we're in.

It is Apple picking season here in Vermont.

I'm sure many of you live in a place that is just starting to see those leaves turn.

I have been really finding solace in going out and enjoying this early fall.

With everything else going on in the world, what are your what are the ways that you all are enjoying this season?

I love late summer, early fall.

It's my favorite.

Feels like a deep breath of fresh air.

I went apple picking yesterday and I don't often call out places that I go, but Yates family orchard and I got a sunrise dreamy, which we talked about before, was so delicious.

It was a cider and maple creamy twist on top of a apple cider donut that was fried and crispy to perfection, and gooey and soft on the inside with homemade caramel on top.

And I just felt so elated after that.

And let me tell you, there was so much fruit on the trees.

So even if you're worried about the drought, there's tons of fruit out there to pick.

And I'm going to make a crisp this Sunday and hope corn ice cream.

I'm going to make homemade corn ice cream to have a dinner party.

All right.

We are not sponsored by Yates, but maybe we should be.

Y'all real quick.

I'm glad we're neighbors.

Yeah.

Why not?

Definitely bring you some.

I'm going to make two batches of corn ice cream, so if you like it, you like it.

If you don't, that's your problem.

Carly, any thoughts of a dreamy?

You know, it's been a while.

I've got.

I've got to go back evidently.

All right, well, that does it for Vermont this week.

Thank you to our panel.

Mark Johnson from Wcax, Carly Berlin from Vtdigger and Vermont Public and Laura Ullman from WCAX.

Thank you so much for watching and listening.

And we'll see you next week.