Despite new federal limits on who can get a Covid-19 vaccine and the arrival of the cold and flu season, many Vermonters can still get a booster, though details surrounding Medicare reimbursement and federal recommendations remain uncertain.

In a late August post on X, Health and Human Services Secretary Robert F. Kennedy Jr. announced the Food and Drug Administration approved Covid-19 booster shots, but only for those 65 and above or with existing health risks. 

Vermont state officials are now awaiting a recommendation from the Centers for Disease Control and Prevention, which typically guides public health directives and insurers’ coverage, for those who want to get a fall booster shot.  

“Really the best thing that I can recommend is either to go online and see if you can set up an online appointment (for a vaccine), or call pharmacies in your area to see if they’re available,” said Julie Arel, the state’s interim commissioner of health.

In Vermont, pharmacies are moving forward with administering the vaccine. Kinney Drugs and CVS have the updated Covid vaccines in stock. Pharmacies order directly from the manufacturer. Providers — doctors’ offices and other clinics — often get vaccines through the state, which is not yet able to order the vaccines from the CDC. 

Kinney Drugs’ spokesperson Alice Maggiore confirmed that the stores can administer the 2025-26 vaccines to people above 65 and individuals between 12 and 64 who attest to having one of the qualifying conditions, as outlined by the CDC. 

CVS is able to vaccinate anyone over 5 years old, who attests to eligibility under the same CDC’s preexisting conditions list, or anyone older than 65, according to a company executive, Amy Thibault. 

The underlying risks outlined by the CDC range from asthma or a smoking history to mental health disorders, like depression obesity, or physical inactivity. Patients do not need a doctor’s prescription to confirm the underlying condition at Kinney or CVS, both spokespeople said.

Typically, insurers cover vaccines received in a pharmacy. Whether some private and government insurers will be able to cover the vaccines remains uncertain. Even if people can get the vaccine by walking into a pharmacy, it’s unclear if they will have to pay for it:  “It’s a little bit mind boggling,” Arel said. 

Blue Cross Blue Shield of Vermont, the state’s largest private insurer, plans to continue to cover the vaccine for any member, at no cost and with no prior approval, said Andrew Garland, a vice president and spokesperson for the insurer. Blue Cross Blue Shield of VT intends to do so through 2026, as well. MVP, the state’s other private insurer selling plans on the marketplace, also does not anticipate changes in its vaccine coverage policy, said Elizabeth Boody, a spokesperson for the company. 

What employer-sponsored insurers and providers like Tricare, the military health system, might be able to cover, is still unclear.

Since the FDA has already approved the vaccine for those over 65, it is likely that Medicare, which covers the same age group, will cover the vaccines. Dorit Reiss, a vaccine policy expert at the University of California Law, San Francisco, told NBC News that once the FDA approves a vaccine, Medicare has the authority to cover it.

Generally a Covid vaccine undergoes three steps for approval: First the FDA authorizes the new vaccines — which it did in August. Then a panel within the CDC called ACIP (short for Advisory Committee on Immunization Practices) issues a recommendation on the vaccine. It is scheduled to meet Sept. 18-19, to do so. This year many are holding their breath ahead of ACIP’s announcement, since Kennedy gutted the panel and replaced it with many vaccine skeptics. 

The state is weighing whether and how it will need to break from that typical process, and is currently exploring what Vermont statute allows for breaking with that process.

While it is quite common for providers to prescribe a drug outside of what the FDA has authorized them for, it’s not typical, however, for that to happen with vaccines. The FDA’s lack of formal guidance on what qualifies as an underlying condition leaves room for interpretation surrounding who qualifies for the vaccine.

“There’s some flexibility in there, but because it’s not as clear as usual, there is going to be hesitancy, in all likelihood,” said Arel. “And anytime there’s hesitancy, anytime there’s confusion, it’s going to lead to lower immunization rates. We really want to try to avoid that.”

The Department of Health is also looking to Vermont’s neighbors in the Northeast for direction, Arel said. In August, the department joined with other state health departments in the region to build a coalition ready to respond to shifts in federal guidance. Though the group has no unified recommendation, she says it’s something they are considering to help mediate the current disjunctive state of vaccine recommendations and approvals. 

“If as a region, we can become more aligned, it helps people across the whole Northeast region to feel a level of confidence in their state public health department’s decisions and how we’re moving forward,” she said.

In Massachusetts, Gov. Maura Healy required in-state insurance carriers to cover the vaccines recommended by the state’s Department of Public Health, even if they are outside of the federal recommendations. The state’s commissioner of public health also issued a standing order that allows pharmacists to issue Covid shots to anyone over the age of 5. 

In response, Arel said Vermont is watching its neighbors and looking into where state statute might allow for potential action. 

“Getting clarity and having a message be clear and simple, is going to be the most important thing we do,” Arel said. “Unfortunately, we are still working through all of that, but we are committed to finding our way through it and making it as simple and easy as possible.”

Read the story on VTDigger here: As feds tighten Covid vaccine rules, Vermont works to maintain access .

Vermont’s Department of Health confirmed the state’s first-known human case of the mosquito-borne Jamestown Canyon virus. The disease has relatively mild symptoms, especially for young people who do not have underlying health conditions.

The state began monitoring mosquitoes for Jamestown Canyon Virus this year, after it was found in nearby states. The monitoring showed insects in Rutland, Marshfield and Whitingham all carried the disease. This human case, which was confirmed in a Sept. 8 lab test in a Windsor County patient, further confirms the presence of the virus in Vermont, according to Natalie Kwit, the state’s public health veterinarian.

“It is a good indicator and reminder, just like anytime we find the virus in mosquitoes, to continue to take precautions against mosquito bites,” Kwit said.

Mosquitoes become infected when they bite animals — particularly deer — carrying the virus. They then spread it to other animals and people when they bite them. Humans are “dead end hosts,” meaning that the viral load people receive from an infected mosquito bite is too low to spread to other people.

It also means that many people with the virus never experience symptoms, while others can develop flu-like symptoms, such as fevers, headaches, chills and aches. People with compromised immune systems and older people are more at risk for more severe symptoms — for some, more serious disease could escalate to confusion and discoordination, stiffness and seizure. About half of people who do become symptomatic get hospitalized, according to the Department of Health. 

The best way to prevent infection is to prevent mosquito bites in the first place. The Department of Health recommends limiting time outside during dusk and dawn when the insects are most active, wearing long sleeves and insect repellent, and covering windows, doors, playpens and strollers with tight mosquito nets or screens. The department also advises people to clear any standing water that may accumulate in things like pots, buckets or children’s outdoor toys.

In late summer, the risk for mosquito-borne illnesses increases, Kwit said, since there has been more time for the virus to circulate in hosts and mosquitoes. The risk remains — and the state plans to continue monitoring mosquitoes — until the first fall frost. 

The state also tests the collected mosquito samples for West Nile virus and Eastern equine encephalitis — or EEE — virus, as it has in years past. There have been no confirmed cases of either in a human this year.

“We’re just learning about this virus, too,” Kwit said of Jamestown Canyon virus. “We’ve only just started actively testing for it in mosquitoes we collect in Vermont, so over time, we’ll get an understanding of where we’re finding it, as we’re gathering more evidence.”

Read the story on VTDigger here: Vermont confirms state’s 1st case of Jamestown Canyon virus in humans .

Representatives from Vermont’s Department of Health and seven other Northeastern states met last week to form a regional public health coalition that can respond to challenges passed down from the federal government amid dramatic changes brought on by the administration of President Donald Trump, such as disparities in vaccine recommendations or losses in lab funding. 

Vermont’s interim health commissioner, Julie Arel, confirmed that she and her principal adviser went to the meeting in Providence, Rhode Island, as did the state epidemiologist, lab director and other senior staff members in the Department of Health. The meeting was first reported by the Boston Globe.

Arel described a collaboration in its preliminary stages: “The intent of that meeting in Rhode Island was to start to say, ‘What is this thing?’ We haven’t really defined it. We haven’t really decided what it is we’re doing with this.” 

Still, she sees an increasing need for interstate collaboration as the federal Centers for Disease Control and Prevention restricts funding for lab testing and departs from scientific consensus on its immunization messaging. 

“The biggest issue for public health right now is the uncertainty coming from the federal government,” Arel said. “That level of uncertainty is really hard for entities that are as heavily funded by federal grants as we are.” 

No more than a week after the regional meeting, the federal center’s director, Susan Monarez, was forced out of the position, reportedly due to her objections to Health and Human Services Secretary Robert F. Kennedy Jr.’s efforts to change vaccine recommendations. On Wednesday, Monarez’s lawyers posted a letter on X that claimed her ouster was due to her refusal to “rubber-stamp unscientific, reckless directives and fire dedicated health experts.” 

The CDC’s chief medical officer, the director of the National Center for Immunization and Respiratory Diseases, the director of the National Center for Emerging and Zoonotic Infectious Diseases and the director of Office of Public Health Data, Surveillance and Technology all resigned that same day.

On Thursday, Vermont Sen. Bernie Sanders called for a bipartisan congressional investigation into Monarez’s firing, citing in his statement the dangers to public health posed by what he called a “reckless” and “dangerous” decision. 

The regional meeting last week centered on questions of infectious disease epidemiology, vaccines, laboratory sciences and emergency preparedness, Arel said. The coalition included all of the New England states except New Hampshire, as well as New Jersey, New York and Pennsylvania.

“There may be times where we are looking to provide more information than maybe the CDC is. But every state is going to need to do its own thing,” she added, explaining that the idea is that the regional coalition could be a source of guidelines and resources for states to act on independently. 

Attendees were particularly interested in discussing how states might navigate a situation where the CDC’s vaccine recommendations split from state health officials’ scientific consensus, Arel described. 

On Wednesday, the FDA issued approvals for updated Covid vaccines and removed emergency authorizations for their use, which had broadened access to the shots. Kennedy posted on X that the current authorization makes the Moderna, Pfizer and Novavax vaccines available to patients over 12 years old after consulting with their doctors. Still, the end of the emergency designation is expected to make it more challenging for individuals to get the shots without that approval. 

In a Thursday email to VTDigger, Vermont Department of Health spokesperson Kyle Casteel added that what qualifies as an underlying condition to make someone eligible for the vaccine, and how it is proven to someone administering the vaccine, remains unclear. 

The CDC is still expected to issue a recommendation for who should receive those vaccines. In June, Kennedy replaced the vaccine panel at the CDC with vaccine skeptics, and many worry that the panel’s recommendation may further limit access to Covid immunization when it meets in mid-September. 

“The approval of this fall’s COVID vaccine has not followed the typical approval process, and we are still assessing recommendations and potential impacts so we can provide guidance to Vermonters about who can get the vaccine and where,” Casteel wrote. “We are working to reduce any access barriers as much as we can and will keep sharing information as it becomes available.”

He added that the state will continue to communicate with counterparts in other states to inform how to move forward with the confusion surrounding the federal directives. 

Officials at the coalition meeting discussed areas of collaboration in which states can find efficiencies by acting as a larger group — such as buying bulk lab supplies as a region, which would bring cost savings to Vermont as a small state. When the loss of federal funding reduces resources for the state Department of Health, those savings can make a big difference, Arel said. 

Other ideas for collaboration would leverage regional cooperation in less tangible ways — like brainstorming and coordinating messaging, public information campaigns or collectively  strategizing on how to overcome public health challenges as they arise. 

The collaboration Arel described is still at the stage of laying the groundwork and relationships for when the need to collectively act arises: “We don’t want to get out ahead of anything,” she said. “A lot of it has been making those relationships stronger.” 

Read the story on VTDigger here: With CDC in chaos, Vermont joins regional coalition to navigate public health challenges.

The U.S. Department of Health and Human Services on Tuesday threatened to cut funding to Vermont and 39 other states for a program aimed at preventing teenage pregnancy and sexually transmitted diseases if states do not remove “all references to gender ideology” from curriculum materials supported with federal dollars. 

President Donald Trump’s health department cut funding to California last week for that state’s participation in the nationwide program, called the Personal Responsibility Education Program, or PREP. In a press release Tuesday, the department said it could do the same for other states — as well as U.S. territories and Washington, D.C. — if health authorities there did not ax what the feds called “delusional” curriculum language within 60 days.

In Vermont, that puts about $670,000 of federal funding at risk, according to data attached to the health and human services department’s release. The program distributes about $80 million nationwide. 

“Accountability is coming,” Andrew Gradison, acting assistant U.S. health secretary, said in the release. “Federal funds will not be used to poison the minds of the next generation or advance dangerous ideological agendas.”

Gradison wrote a letter to the Vermont Department of Health on Tuesday outlining what he said were examples, taken from curriculum used in the state, that “fall outside of the scope” of federal laws governing the sex education program. The feds asked Vermont to provide curriculum used for the program in April, according to the letter, and Gradison on Tuesday thanked the state for a “timely response.”

The letter cited language from Vermont’s sex education materials stating that asking young people “to tell you their pronouns is a way of creating a safe space for transgender or gender nonconforming youth,” as well as material that included an explanation of differences between the terms “gender,” “gender identity” and “gender expression.” 

The letter also cites material from Vermont stating: “Transgender women and cisgender women are both women. Transgender men and cisgender men are both men. The use of cisgender helps clarify that gender identity exists in both cisgender and transgender people.”

Gradison called the language “irrelevant” to the purpose of the PREP grant program, which he said is to educate young people about abstinence and contraception. He said the program’s federal statute “neither requires, supports nor authorizes teaching students that gender identity is distinct from biological sex or that boys can identify as girls and vice versa.”

The letter directed Vermont to remove “these and all similar language” from curriculum used for PREP in the state or risk losing funding.

In a statement Tuesday afternoon, Kyle Casteel, a spokesperson for the state’s Department of Health, said of the letter that his colleagues were “working to understand it in real time.”

“While we don’t know the full scope of the potential impacts yet, the Health Department affirms our commitment to evidence-based public health programs that reflect the needs of all Vermonters, including the LGBTQ+ community,” Casteel said. 

Olivia Gieger contributed reporting.

Read the story on VTDigger here: Trump’s health department threatens to cut funding to Vermont and other states over ‘gender ideology’ in sex ed materials.

This commentary is by Jen Colman, of Burlington. She is a mental health provider for children and adolescents, and collaborates with youth-based organizations and schools to provide direct mental health services. Colman is also the executive director of Green Mountain Mobile Therapy, a nonprofit organization that provides accessible mental health and social emotional resources for children and adolescents.

As a mental health professional who works with Vermont’s youth, I see how our students are struggling everyday. 

Nationally, young people have reported a dramatic increase in conflict and divisiveness in our communities. A constant barrage of media, combined with social disconnectedness, creates a systemic feeling of hopelessness. 

Earlier this year, Vermont This Week on Vermont Public hosted a panel discussion on the state of youth mental health in Vermont. The conversation focused on the Vermont Department of Health’s 2023 Youth Behavior Risk Survey, released in November 2024, and the results showed that Vermont youth’s mental health is still in crisis with little improvement since the Covid-19 pandemic. 

One of the questions asked in the panel was “What do kids need?” and the collective response was that kids need to be believed and listened to. They need to feel like they belong and that they matter. It’s time for Vermont to get creative in how we approach our youth mental health crisis. 

Through providing youth with evidence-based, relationship-centered mentoring programs, we can help youth feel like they matter and instill a sense of belonging. 

Mentoring programs play a crucial role in supporting youth mental health by providing individualized, one-on-one attention and fostering meaningful relationships between youth and trusted adults. In Vermont, 96% of mentees in mentoring programs funded by the nonprofit organization MENTOR Vermont reported that their mentor made them feel like they matter, and 92% said having a mentor made a positive difference in their lives. 

MENTOR Vermont leads, expands and strengthens the mentoring movement, building capacity to make high-quality relationships accessible to all young people, so every young person in Vermont has the supportive relationships they need to grow and thrive.

Mentors offer emotional support, guidance and encouragement, which are particularly beneficial for youth struggling with mental health issues. They help young people engage in their schoolwork, think critically about their future and navigate personal challenges. This support is essential in preventing risky behaviors among young people. 

Moreover, mentoring meets youth where they live, learn, work and play, providing them with a consistent person outside of their family that they can turn to for support. 

Despite this data, 1 in 3 youth will grow up without a mentor and without the support of a trusted adult. According to the National Mentoring Partnership, young people who have mentors are more likely to improve in areas such as emotional regulation, social skills and overall life satisfaction. A study by the Journal of Primary Prevention found that mentoring can lower the likelihood of depressive symptoms and suicide attempts by providing emotional support, positive role models and a sense of belonging. 

Overall, mentoring programs are a proven tool in promoting mental well-being and ensuring that young people have the supportive relationships they need to thrive. 

Although the Vermont youth mental health crisis may seem overwhelming, it can be addressed by being proactive and putting in place proven early intervention programs such as mentoring. 

Thanks to the work of MENTOR Vermont, such programs already exist in many communities throughout the state, but they need sustainable investment to adequately meet the needs of youth across Vermont. This investment will ensure that every child who needs a mentor has access to one, and the path toward stabilizing and moving out of this crisis will become clear.

Read the story on VTDigger here: Jen Colman: Mentors help Vermont youth feel like they matter.

In Rutland, the Jamestown Canyon virus has been detected in mosquitos for the first time in state history, the Vermont Department of Health announced Friday. Health officials also detected West Nile virus in St. Albans.

There have been no human or animal cases of mosquito-borne illnesses reported this season, but health officials are urging people to protect themselves by preventing mosquito bites. Jamestown Canyon virus can cause similar symptoms to other mosquito-borne diseases. Mosquitoes are being tested for West Nile virus, Eastern equine encephalitis (EEE) virus — which last year caused two people to get ill and one of them to die — and Jamestown Canyon virus starting from this year.

“Every mosquito group is tested for all three viruses now,” said Natalie Kwit, a public health veterinarian at the Vermont Department of Health. “We added it (Jamestown Canyon virus) because it’s something we knew that’s been circulating in the Northeast, and we had a cost-effective test available that we switched to that included all three viruses.”

The Vermont Agency of Agriculture, Food & Markets and the Vermont Department of Health decided to continue allocating funding to mosquito surveillance this year over tick surveillance to track illnesses like Eastern equine encephalitis after the cases occurred last year. The mosquito surveillance program generally runs from June to mid-October when mosquitos are more active.

Kwit said most people who become infected with these viruses don’t get sick, but some may develop symptoms a few days, or even weeks, after the mosquito bite.

Symptoms may include fever, body aches, headache, vomiting, diarrhea, rash and joint pains. The viruses can also lead to more serious illnesses like meningitis or encephalitis — an inflammation of the brain that can cause brain damage, stroke and death.

Cases of mosquitoes testing positive to Eastern equine encephalitis have increased significantly in recent years. According to data from the health department, in 2023, 14 groups of mosquitoes across three Vermont towns tested positive for EEE, whereas in 2024, 86 groups of mosquitoes across 16 towns tested positive.

Kwit said only about 5% of people infected with EEE develop a more serious illness. “The thing that worries us the most about Triple E is that about 30 to 40% of people with that severe form of illness die from the disease, so this one tends to be the most severe that we know of,” she said.

There are no vaccines to prevent Eastern equine encephalitis and Jamestown Canyon virus, nor medicines to treat them. The best way to limit the risk of infection is to prevent mosquito bites, according to the health department.

Recommendations from the Vermont Department of Health include wearing long-sleeved shirts and pants, limiting time outside at dawn or dusk when there are more mosquitoes, using insect repellent — the Environmental Protection Agency has a tool to help people identify the right repellent for them — fix holes in screens attached to doors and windows and get rid of standing water that might attract mosquitoes.

Read the story on VTDigger here: Mosquitoes test positive for Jamestown Canyon Virus for the first time in Vermont.

Dear Editor, 

Vermont Health Commissioner Mark Levine announced his decision to retire in early February and retired at the end of March. A new commissioner of health has still not been announced. 

It is not clear why, but it is clear that with all that is happening with federal changes in health policy and health funding, it is vital to have a new commissioner.

Vermont had one of the best state responses to Covid-19 in the country, which was due to the strong partnership between the governor and the commissioner of health. We need to have this partnership in place in case of another serious outbreak.

In this time of uncertainty in federal health policy and health funding — and distrust in public health — it is important to have strong, capable leadership in the Vermont Department of Health. I urge Gov. Phil Scott to appoint a physician and seasoned health administrator for this important job.

Deborah Kutzko

Burlington

(Deborah Kutzko is a retired nurse practitioner and member of SOS for Public Health, a group of retired and former Vermont health department employees who are dedicated to speaking out strongly for public health in the state.)

Read the story on VTDigger here: Deborah Kutzko: Vermont needs a commissioner of health.

This commentary is by Harry Chen of Burlington. He is former Vermont health commissioner and a member of SOS for Public Health, a group of retired and former Vermont Health Department employees who are dedicated to speaking out strongly for public health in the state.

We Vermonters pride ourselves on Vermont’s being one of the healthiest states in the country. In 2024, Vermont ranked second in the widely respected United Health Foundation rankings and in recent years has been among the top five.

Our rankings track remarkable progress since 1990, when Vermont ranked 20th in the United Health Foundation’s annual list. The rankings are based on broad measures of health, including social and economic factors, the physical environment, clinical health care, behavioral measures and health outcomes. 

Much of Vermont’s progress is due to prioritizing public health. Put simply, public health is what we do as a society to ensure the conditions so people can be healthy. Vermont has made serious investments in public health over the years and has effectively leveraged federal dollars toward this end.

Next year, nearly 60% of the Vermont Department of Health’s $224 million budget will come from federal funding. This does not even count the estimated $13.8 million worth of vaccines purchased directly for the Vermont’s Vaccines for Children Program.

Given the focus in Washington on reducing government spending, it’s not surprising that much of this support is at risk. Add to this the disparaging of hard science, and it’s clear that many strategies that have bolstered our success are in the crosshairs of this administration.

We have witnessed the muzzling of essential federal agencies like CDC and the diminishment of important health and science advisory functions. Much of the country’s food safety capacity has been eliminated. Coupled with spotty and inconsistent outbreak reporting and muted support for vaccines, this is a recipe for disaster.

Here are examples of other possible federal cuts that will impact state programs and the very real health risks they pose:

• Vaccines – Vermont’s high vaccination rate is due to the state’s work to ensure that vaccines are free and accessible to all children and most adults. All recommended vaccines are provided to primary care practices by the Health Department at no charge. Over half the costs are funded by CDC, and the rest is covered by Vermont insurers. 

Federal changes to vaccine policy and recommendations mean people could lose access to free vaccines, leaving the population less protected against life-threatening diseases like measles and whooping cough, even once-vanquished diseases like polio.

• WIC – The Health Department’s WIC program, or Special Supplemental Nutrition Program for Women, Infants and Children, helps income-eligible residents who are pregnant or breastfeeding, and families or caregivers of babies and children up to age five with nutritious foods and nutrition education.

Over 6,000 children in Vermont receive WIC benefits each month. Federal cuts would compromise the health of many young families and threaten our country’s future.

• Lyme disease, EEE, rabies, bird flu – The Health Department works with the Agency of Agriculture to protect people from tick bite illnesses like Lyme disease, mosquito bite illnesses like Eastern Equine Encephalitis, and other diseases like rabies and bird flu.

By tracking cases, epidemiologists detect changes in disease activity, identify people at higher risk, support health care providers in diagnosis and treatment and inform the public on how to protect themselves. Federal cuts to public health and agriculture agencies threaten this vital work.

• Emergency preparedness – Vermont has had its share of emergency events: Tropical Storm Irene in 2011 and more recent floods, PFAS contamination of drinking water, and the Covid-19 pandemic. Federal funding helped us establish a strong infrastructure to deal with such emergencies. If we lose that federal support, how effective will our response be in the future?

• Opioid Use Disorder – Since Gov. Peter Shumlin highlighted the opioid crisis in his 2011 State of the State address, Vermont has pulled out all the stops to address the issue. Vermont’s comprehensive approach includes upstream prevention, broad access to treatment and recovery and community-based harm reduction.

• Most of that has been funded by federal programs like Medicaid. Vermont has seen reductions in overdoses and overdose deaths for two years running. Federal cuts put this progress at risk.

The Scott administration and the Vermont Legislature have been strong proponents of public health, for which we are grateful. Given the whiplash of the current federal budget bill and DOGE, we can’t forecast with any certainty what is coming, though we can certainly predict there will be cuts. 

When the cuts do come, we need transparency by the Scott administration on what is being cut and the likely impacts. We also need strong leadership at the top. We urge the governor to prioritize hiring a permanent commissioner of health for Vermont. 

With good information and using good science, we can analyze the effects and explore how best to mitigate them. Vermonters want to know this information and can weigh in on strategies to lessen their impact.

Like many, we have serious concerns with the federal “Make America Healthy” agenda. We must stick to rigorous peer-reviewed science and not destroy our valued public health infrastructure.

However, it’s important to find some common ground and acknowledge the shared goal of healthier Americans. Public health works 24/7 protecting and promoting the public’s health. Let’s continue to promote this valuable common good that benefits all Americans.

Read the story on VTDigger here: Harry Chen: SOS for public health in Vermont.

An autopsy determined that the woman who was found dead this week at her home in Pittsford died from a “gunshot wound of head and neck,” according to Vermont State Police.

However, the manner of 41-year-old Erica Bovey’s death remains “pending,” according to a Thursday press release from state police. 

An earlier state police press release from Wednesday termed the death as “suspicious.” 

Police began their investigation into Bovey’s death around 2:10 a.m. Wednesday after authorities received a call from a resident at a home on Hollister Quarry Road in Pittsford reporting that a person there had died. 

First responders who arrived at the scene confirmed that the person, later identified as Bovey, who also lived at the home, was deceased, according to police. 

Asked why the manner of Bovey’s death was listed as pending, police spokesperson Adam Silverman replied in an email Friday, “cause and manner of death are determinations of the medical examiner’s office.”

Silverman added, “VSP’s investigation remains active and ongoing at this time while we await further information from the medical examiner.”

No one was in custody related to the investigation as of Friday afternoon, Silverman said.

Kyle Casteel, a spokesperson for the Vermont Department of Health, the state department in which the Vermont’s Chief Medical Examiner’s is located, declined to comment specifically on Bovey’s case and why the manner of death was still listed as pending. 

“I can share that in general, it takes time to establish the manner of death in an investigation, and the record will be updated when the facts are confirmed,” Casteel said in an email.

Read the story on VTDigger here: Police identify woman who died from a gunshot wound in Pittsford.

This commentary is by Ed Baker of Burlington. He has lived experience as a person with drug addiction. He is a member of the Academy of Certified Social Workers, retired from a career in the substance use field. He is currently an activist for public health in Vermont.

The number one leading cause of death for Vermonters aged 50 and below is accidental drug overdose, according to the Department of Health. We are in the very midst of an undeclared public health emergency that deeply affects every county, town, neighborhood and family in Vermont. Downtown Burlington is the epicenter of this tragedy. We experience common suffering daily.   

For calendar year 2023 there were 211 accidental deaths in Vermont, with 176 of these being due to accidental or unknown intent drug overdose, according to the Department of Health. According to State’s Attorney Sarah George, Chittenden County had the highest number of deaths (50) in 2023, with approximately half these deaths concentrated within the downtown Burlington area. 

We Vermonters were alerted to this evolving crisis in 2014 by then Gov. Peter Shumlin in his State of the State address, where he warned that “In every corner of our state, heroin and opiate drug addiction threatens us.”

In 2016 the crisis began to morph into the beast we see today. Fentanyl, the most powerful opioid available, became the leading contributor to opioid overdose death in Vermont.

This continues to be the case today, with well over 90% of opioid-related fatalities involving fentanyl. Today this is complicated by the addition of xylazine to the unregulated drug supply, an animal tranquilizer causing severe infections of soft tissue. 

We collectively face an ever-worsening and increasingly lethal perfect storm. Vermonters often most vulnerable to this near-indescribable travesty are Vermonters with chronically unmet needs, often unhoused, with mental health challenges complicating their addiction. They are very often alienated from the mainstream, outside traditional treatment techniques’ ability to engage them. They are dying. 

It is our responsibility, and this is not debatable in my opinion, to protect them, to see to it that they have the very best and most effective means available to them to keep them alive and support their gradual movement toward health. 

The quote “when things are at their worst we are at our best” comes to mind.

Available research data at this point unequivocally leads to overdose prevention centers as the next medically necessary best practice available to us. These centers are built upon a theoretical foundation called harm reduction. They are not based upon an abstinence-only model.

They engage people by providing what I’ve come to term “unconditional safety,” a stigma-free, non-punitive meeting of the person “where they are” emotionally, while they are using drugs. We meet them there and move forward with them at their pace, toward progressively less harm to themselves and the community.

We are making progress in this process here in Burlington, which will culminate in our opening an overdose prevention center. This is supported by Act 178, based upon H.72 as passed by the Legislature in 2024.

The city of Burlington has entered into an agreement with Vermonters for Criminal Justice Reform, the ideal provider for this life-saving service, which will be called the Downtown Health Project.

This arrangement was approved by the unanimous vote of our City Council on April 28 and since has been approved by the Vermont Department of Health. This process will continue, most hopefully at an urgent pace, the most pressing task facing us being the location of a suitable site.

Mayor Mulvaney-Stanak’s office is presently fully engaged in a comprehensive process outlined by the Vermont Department of Health in the department’s “Vermont Overdose Prevention Center Operating Guidelines.” Part of these guidelines require community input and City Council approval regarding site selection.

If you are undecided regarding this crucial public health intervention please educate yourself. Here are some resources:

A comprehensive website with current information on OPCs   

Vermont Department of Health operating guidelines for the OPC   

I am calling upon Burlingtonians to ask their City Council representatives to stand strongly on science and lead with compassion, to approve locating our OPC at a site that is immediately accessible to those most in need, once this site is determined by Mayor Mulvaney-Stanak’s team. This will support the overdose prevention center’s success which will begin to reduce our common suffering.

The science is clear on this, the need is pressing, and the pieces are in place. Without the will of the people nothing will be done and our common suffering will no doubt increase still.

The choice is ours.

Read the story on VTDigger here: Ed Baker: When things are at their worst, we are at our best.

Trying to stay out of the heat during Vermont’s first heat wave of 2025? The state Department of Health maintains a map of cooling centers open to the public — although there are caveats to keep in mind before you head to one. 

The National Weather Service has issued an extreme heat warning for parts of Franklin, Grand Isle, Chittenden and Addison counties through Tuesday at 8 p.m., and a heat advisory for the rest of the state. Burlington is forecast to hit 97 degrees Monday and 96 degrees Tuesday, with cooler temperatures expected for the rest of the week.

The health department lists more than 400 potential places for Vermonters to go inside for air conditioning or access water to help stay cool. Some locations are only occasional cooling facilities, so the department recommends calling ahead to check if they’re open to the public. Others might only be open during the daytime or only on certain days of the week. You can also call 211 to help find an open cooling location near you.

Other locations are recreation sites with bodies of water but charge an entry fee, like a pool or a state park. Housing advocates have said in previous years that it can be difficult for unhoused Vermonters to access these locations. 

Older adults, young children and people with chronic health conditions are more at risk of heat-related illnesses, according to the health department. It recommends Vermonters stay hydrated, avoid exertion and wear light, loose-fitting clothing if they go outside. 

If your home is not air conditioned, keeping the shades drawn, taking cool showers and using a fan can be helpful to keep the temperature down inside, the department said. It has more information on avoiding heat-related injuries on its website.

Read the story on VTDigger here: Find the cooling center nearest you amid Vermont’s 1st heat wave of the year.

The number of emergency room visits for Covid-19 in Vermont hit zero multiple times over the past week, “at or nearing” a historic low for that indicator, the Department of Health reported Wednesday.

The health department first reported a drop in Covid-19 hospital visits in its weekly surveillance report. Epidemiologist John Davy confirmed via email there have been a few recent days with no emergency room visits, with the rolling average around one. 

He wrote that overall hospitalizations for the disease, which includes Vermonters who have been in the hospital with Covid-19 for days or weeks, have not dropped to zero. But the number of current patients has been in the “low single digits” in recent weeks. 

In past years, the period of late spring and early summer has been marked by low rates, followed by a rise in the late summer into early fall. Davy wrote it “remains to be seen” if that pattern will reappear in the coming months. 

“There have been recent outbreaks in Long-Term Care facilities, so there is clearly some amount of COVID circulating,” he wrote.

The state health department also reported it has detected the presence of a new Covid-19 variant, NB.1.8.1. The variant has made international headlines for causing severe sore throats nicknamed “razor blade throats.” But it has not been found in Vermont in large numbers, Davy wrote. 

“There is no clear indication that NB.1.8.1 is associated with greater disease severity,” he wrote. “Preliminary lab studies suggest that vaccines will be effective against severe outcomes from this strain.”

The future of vaccines themselves are still uncertain, however. Covid-19 vaccines tailored to the dominant strains of the virus have typically become available in early fall, along with other seasonal vaccines like influenza. But U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr., has a long history of anti-vaccine activism. 

Kennedy recently dropped the recommendation for pregnant people and healthy children to receive the vaccine and dismissed all 17 members of the U.S. Centers for Disease Control and Prevention’s vaccine advisory panel, replacing them with eight of his own appointees, some of whom have previously objected to the Covid-19 shots. The panel is slated to hold its first meeting June 25. 

Read the story on VTDigger here: Covid-19 hospitalizations hit new low in Vermont, with future of vaccines uncertain.

Vermont is in for a stretch of intense summer weather, with forecasters warning of heat, humidity and potential thunderstorms.

The National Weather Service is expecting potentially hazardous weather for the state through Wednesday. Seth Kutikoff, meteorologist with the National Weather Service in Burlington, said temperatures are projected to reach the mid- and upper 80s on Thursday. Thunderstorms are expected in the afternoon and evening that should help bring down the temperature on Friday, but hot weather is expected to return this weekend.

“The risk today of damaging wind with the strongest thunderstorms: We want people to pay attention to any severe thunderstorm warnings that may be issued,” Kutikoff said. 

People can sign up with VT- Alert for updates related to weather, roads or emergencies.

Kutikoff said Friday’s temperatures will be much lower, with widespread west wind, whereas weekend temperatures will be moderate with a risk of severe thunderstorms, particularly on Saturday night.

Meteorologists expect high temperatures to continue into next week. 

“This is the time of year that it’s common, but at the same time, the degree of heat that we’re expecting early next week is unusual,” said Kutikoff, adding that the forecast for Burlington is projected to be around 97 degrees.

“The temperature of 97 degrees would tie for the second warmest June temperature over the last 30 years,” Kutikoff said.

The heat will affect the entire state, with the Champlain Valley, Winooski Valley and other areas with towns at lower elevations experiencing higher temperatures.

Kutikoff advised people to be prepared for the heat, finding cooling centers if needed and avoiding activities during the hottest parts of the day, especially on Monday and Tuesday.

Jared Ulmer, climate and health program manager at the Vermont Department of Health, said its cooling centers map will also be updated — likely the day before extreme heat is expected to hit — with additional resources highlighted on the map. Cooling centers at some libraries and fire stations will be open to the public, providing relief from the heat for people experiencing homelessness and without access to air conditioning. 

According to the latest state air conditioning data report from the U.S. Energy Information Administration, Vermont has the fifth-lowest rate of air conditioning in the U.S., with 67% of homes equipped with air conditioning. Of those, 60% have single-room air conditioning units and only 7% have central air — the lowest number in the country after Alaska.

“Heat is a growing concern in Vermont and will continue to be more of a concern into the future,” Ulmer said.

As human activities drive climate change and lead to higher global temperatures, heat-related risks in Vermont are increasing as well, according to the Vermont Climate Assessment. The 2021 study found that “Vermont already is seeing more heat stroke and dehydration from high temperatures and an associated increase in heat-related (emergency department) visits since 2003.”

According to a hot weather preparedness guidance by the Vermont Department of Health, the number of people who visit the emergency room or call 911 for heat-related illnesses is similar to the number of people doing so for cold-related illnesses.

The Department of Health has also compiled a list of heat safety tips available in different languages and specific guidance for caregivers. 

“We’ve done a lot of work just trying to raise awareness about the health impacts of heat, recognizing symptoms, how to prepare and respond, because it really is just a new topic for a lot of people in Vermont to grapple with,” Ulmer said. 

Read the story on VTDigger here: Vermont faces stretch of high heat and thunderstorms.

After years of groundwork, a treatment center for opioid use disorder is set to open on Depot Street in downtown Bennington this week. 

The opening will be a “real game changer for Bennington,” expanding access to methadone treatment and opioid use disorder recovery services in the region, said Kelly Dougherty, deputy commissioner of the Vermont Department of Health.

The department has sought to open an opioid treatment program in Bennington for many years, but the Covid-19 pandemic and challenges finding a provider and location stalled progress, Dougherty said. The department is grateful to work with the Bay Area Addiction Research Treatment program as the operator of the Bennington-based center offering medication-assisted recovery treatments, counseling and other support services, she said. 

The Bay Area Addiction Treatment program runs similar centers in Berlin, St. Albans, St. Johnsbury and Newport.

The Vermont Department of Health provided a $3.9 million grant to help cover startup and operational costs of the program’s Bennington center. The grant will also help cover the cost of treatment for those without insurance through July 2026. The department does not want health insurance to be a barrier to access recovery resources, Dougherty said. 

The center plans to open for clients starting Thursday, assuming its first shipment of medication arrives Wednesday as planned, she said. 

Opioid treatment centers like this one must meet specific federal guidelines and safety measures, such as Drug Enforcement Agency regulations, so the department is glad the team has made it through “all those hurdles” and that the project is “going to be opening very soon,”  Dougherty said. 

Placing the center in downtown Bennington is intended to make  the path to recovery easier and  prevent further loss of lives to opioid use disorder in the region, Dougherty said. According to Department of Health data, rates of opioid-related death of Bennington County residents have fluctuated over the past decade, “but certainly there is a high need in the Bennington area,” she said. 

Vermont’s model for opioid use disorder treatment follows the design of a “hub and spokes,” Dougherty said. Hubs are where people can regularly access methadone to treat opioid use disorder. Spokes are primary care providers, where people can be prescribed buprenorphine and transition to longer-term treatment, she said. 

While Bennington has several spokes or primary care providers, Bennington Town Manager Stuart Hurd said residents have had to travel long distances to Brattleboro, Rutland or North Adams, Massachusetts, to receive methadone treatment. Now, locals can stay in their community while on the path to recovery, he said.  

Lorna Mattern, chief executive officer of Bennington’s United Counseling Service, said health service providers and advocates in the region have been asking for a hub location in Bennington for more than five years. Mattern said the United Counseling Service is glad the community has access to methadone treatment locally.

“With access to treatment in their own community, individuals in recovery can lead fuller, more stable lives — free from the burden of daily out-of-town travel,” Mattern wrote in an email statement to VTDigger. “This means they can stay close to home, maintain employment, and spend more meaningful time with their families, all while receiving the support they need on their recovery journey.”

Bennington Select Board Chair Tom Haley said the new treatment center was a long time coming and can help break down roadblocks to residents receiving necessary medicine. 

“We — like every other town in the country — are struggling with ways to help people with substance use disorder, and this is just one more way that we’re going to be able to do that,” Haley said. 

Read the story on VTDigger here: Opioid use disorder treatment center poised to open in downtown Bennington.

Vermont Attorney General Charity Clark announced Monday that she and 54 attorneys general from U.S. states and territories agreed to sign on to a $7.4 billion settlement with Purdue Pharma, maker of the painkiller OxyContin, and the Sackler family, owners of the drug firm.

If the bankruptcy court approves the agreement, Vermont will receive up to $21.85 million to  support opioid prevention, treatment and recovery programs. The settlement would also make public more than 30 million documents related to Purdue and the Sacklers’ opioid business.

A bankruptcy court hearing is scheduled on June 18. If the settlement is approved, the case would go to state court for approval as well, according to the attorney general’s office.  

This settlement was reached after the U.S. Supreme Court last year overturned the previous settlement, which would have provided about $6 billion to treatment programs and victims of the opioid epidemic but also shielded the Sackler family from future opioid-related lawsuits.

Purdue and the Sackler family agreed to the new settlement in January with a bipartisan coalition of states, including Vermont. The settlement, which resolves litigation over the role Purdue and the Sacklers had in the opioid crisis and ends their ability to sell opioids in the United States, is the nation’s largest to date with individuals linked to the opioid epidemic.

“Purdue and the Sackler family created and perpetuated a crisis that has stolen the lives of our loved ones, neighbors, and community members,” Clark wrote in a press release. “This settlement will never undo the suffering that has touched nearly every Vermont family, but it will hold Purdue and the Sacklers accountable for causing the devastating opioid crisis.”

According to the Vermont Department of Health, the wide majority of accidental and undetermined drug overdose deaths in the state involve opioids. The number of opioid-related fatal overdoses peaked in 2022 with 244 deaths, and then decreased by 22% between 2023 and 2024. 

The settlement agreement states that Vermont’s funds would be divided to allocate 15% to the state,15% to municipalities, and 70% to the State Opioid Abatement Fund to tackle the opioid crisis.

“While we can never be sure about delays or complications that may arise, the parties worked very hard to address the concerns raised by all constituencies to the bankruptcy and the US Supreme Court,” Amelia Vath, outreach and communications coordinator for the attorney general’s office, wrote to VTDigger. “We feel confident about the prospect of approval.”

Read the story on VTDigger here: Vermont attorney general signs on to $7.4B national opioid settlement with Purdue Pharma.

The Turning Point of Addison County unveiled a free, round-the-clock vending machine dispensing opioid overdose mediation and other health care supplies on Tuesday in Middlebury.

Middlebury joins the towns of Johnson and Bennington in Vermont that have vending machines providing free naloxone, more commonly known by the brand name Narcan.

Another vending machine will be rolled out in Bristol this summer to help fill gaps in health access in the region’s rural communities, said Danielle Wallace, executive director of the Turning Point Center of Addison County. Turning Point is a nonprofit organization with 12 satellite locations around the state that focuses on helping people through addiction recovery.

The dispensers will also provide fentanyl and xylazine test strips, educational harm reduction kits, first aid kits and hygiene supplies such as socks, toothbrush, toothpaste, sunscreen, bug spray and hand sanitizer, Wallace said.

The two vending machines in Middlebury and Bristol, both in Addison County, are funded through a $100,000 grant from the Vermont Department of Health. 

The Turning Point Center determined which supplies to offer after assessing the highest needs of the community and will continue to rotate supplies as needs change, Stephanie Busch, injury prevention program director at the Vermont Health Department, said in a statement to VTDigger. An external disposal container for sharp items is available alongside the vending machine, she said.

“Placement of these vending machines ensures more flexible and responsive access to supplies and treatment services information to better serve the whole community,” Busch said.

While people struggle with addiction across the state, Wallace said resources are often sent to Vermont’s more densely populated areas. 

“In rural communities, resources are always lacking,” she said. 

The vending machines will complement the Turning Point of Addison County’s other addiction recovery related-work, such as the recovery coaching program and a street outreach program, which primarily serves the region’s unhoused population, Wallace said. 

Overall opioid-related deaths fell in the state in 2024, but xylazine-related deaths rose 10%, from 32% in 2023 to 42% in 2024, according to a Vermont Department of Health report. Efforts to offer free and readily available overdose prevention resources are important to continue to reduce drug-related deaths, save lives and help people on the path to addiction recovery, Wallace said.

“I think that education, advocacy and access to resources is a huge piece of what’s driving this reduction in overdose deaths,” Wallace said. “This is our effort and strategy to continue that reduction and to continue seeing less people losing their lives from substance use.”

Read the story on VTDigger here: Free, 24-hour naloxone vending machine opens in Middlebury; Bristol to come.

Vermont’s opioid overdose deaths fell for the second year in a row in 2024, hitting their lowest annual tally in four years, according to the latest opioid annual report from the Vermont Department of Health. 

The department reported 183 Vermonters died of opioid-related overdoses in 2024, compared with 236 deaths in 2023. The drop was paralleled by falling deaths at a national level, according to data from the U.S. Centers for Disease Control and Prevention.

Deputy Health Commissioner Kelly Dougherty said her team was happy to see the decline in deaths, but noted they remain high — higher than pre-Covid-19 pandemic levels and higher than in 2015 when then-Gov. Peter Shumlin raised alarms about a rising rate of overdoses in the state.

Health officials had been encouraged by a drop in overdoses in 2019, only for the trend to reverse during the pandemic, when Vermonters saw their lives upended in a variety of ways. Recent years have also seen a continued rise in potent opioids like fentanyl and xylazine, often in combination with non-opioid drugs like cocaine. 

The Vermont Health Department and substance use organizations across Vermont have fought back by aggressively expanding access to naloxone, a medication that can reverse opioid overdoses and prevent them from becoming fatal. Dougherty said the department has distributed naloxone throughout the state, making it available online, in schools, at job sites and even in a few vending machines. 

The department has also widely distributed fentanyl and xylazine test strips and co-created the VT Help Link, a “one-stop shop” to access services and treatment. 

Dougherty said these initiatives are reflective of a shift toward seeing opioid use and substance use disorder as a medical condition that can be targeted with harm reduction strategies. 

Vermont has a handful of community organizations that distribute clean syringes. The state legalized safe injection sites in 2024, but the first site in Burlington is still in the planning stage. 

There are limitations to the overdose data. Dougherty said deaths are falling, but little is known about whether fewer Vermonters are using opioids or have substance use disorders. 

Tracie Hauck, executive director of the drug recovery group Turning Point Center of Rutland, said focusing on death data alone could be misleading. 

“From what I see in our community, things aren’t any better,” she said. “Crime is picking up again. You’re seeing people that are struggling health wise and have no place to live and are using substances.”

Hauck said a lack of supportive transitional housing for Vermonters in recovery is a gap that can make it hard for people to stay sober. 

“A lot of people we’ve sent to rehab are homeless to begin with,” she said. “So if they don’t go to a transitional living program after they complete rehab, they’re back out on the street and there’s no housing for them.”

People without stable housing often find themselves in “survival mode,” leading them back toward substance use, Hauck said. 

“People don’t have phones. They don’t have reliable transportation. They don’t have stable housing, so they’re just in survival mode continuously,” she said. “And that doesn’t lead to real, good, solid recovery because their stress level continues to be so high.”

Hauck said a more holistic approach to substance use disorder is needed that incorporates a person’s mental and physical health, housing, and interactions with the criminal justice system. 

Dougherty echoed the need for more transitional housing along with “step-down” facilities that can help rehabilitate people after their initial medical withdrawal. 

Both urged Vermonters to look past their assumptions and judgements about drug use and consider the human beings affected by the opioid crisis. 

“These are people — 183 people who were somebody’s loved one, somebody’s friend, somebody’s family member,” Dougherty said.

Hauck said despite her reservations about focusing solely on deaths, she still favors harm reduction measures like naloxone that offer people more chances to seek help.

“I am not anybody’s higher power to decide whether they should live or die, and I don’t think any other human being is, but I just know sometimes it takes a lot for someone to go through before they make that decision to get involved in recovery,” she said. 

Hauck said she has seen people on Facebook complain about the distribution of naloxone without considering the full implications of not having it available. Anyone can risk opioid overdose when drugs like cocaine are so frequently contaminated with them.

“They’re not pausing and thinking about how tainted our supply is and how far that reaches, and to who that reaches to,” she said. “It’s not just people with substance use issues. It’s people that use recreationally.”

Dougherty said she was concerned about potential changes to the health care system being discussed at the federal level. Congress and President Donald Trump are working on legislation that could lead to Medicaid cuts. The Trump administration has proposed cuts to the U.S. Substance Abuse and Mental Health Services Administration. 

None of the Vermont Department of Health’s harm reduction services rely on federal funding, Dougherty said. But Medicaid pays for many substance use services in Vermont, so the department is worried about cuts overall, she said. 

“We’re just bracing generally at the health department, beyond substance use, because it’s like a full-out attack on public health,” she said. 

Read the story on VTDigger here: Vermont opioid overdoses fell in 2024 for the second year in a row.

This commentary is by John Puleio of Middlesex. He is a retired educator living in Middlesex, and is married with three grown children raised in Vermont.

Lamoille County’s Morrisville-based Copley Hospital has developed one of the most successful orthopedic centers in the state of Vermont. This high-quality and sought after service has become a gem of this small critical-access hospital.

A newly opened beautiful facility on the nearby Waterbury campus is proof positive that when a service is valued for its success and contribution to health for an increasing number of patients, the service can grow and become an economic engine for the overall benefit of the hospital. Appreciable salaries and generous bonuses demonstrate this success and allow for the sustainability of top-notch practitioners.

Not all services within an institution such as Copley can be large income generators in the manner of the highly specialized offerings of orthopedics. Think of care for infants within early child care centers. Because of high staffing costs, this service is a well-known net income loser. Costs and revenue come into balance because care of preschoolers — in the same setting — is less costly. Not such a naive apples-to-oranges comparison considering that one keeps the other viable while the school as a whole is sustained.

The critical and vital services provided by Copley Hospital’s birthing center could be the beneficiary of the success of orthopedics while adding to the continued viability of the hospital.

It’s quite well known that birthing centers, particularly small rural ones, are not money makers. Never have been. That’s hardly the reason why hospitals have maintained such essential services birthing centers have always provided.

Health care is a birth-to-end-of-life proposition. Birthing centers serve as gateways to future care and relationships for people that hospitals have an obligation to serve. If we look at profitability as the sole rationale to possibly close Copley’s birthing center, we miss the opportunity to grow the value, prominence and attractiveness of the birthing center. Like Orthopedics, it could be a brighter gem in its crown.

Profitability is not the only factor that makes a center shine, and there is certainly room for growth. According to UVM’s Vermont State Data Center, Lamoille is one of the counties in Vermont that shows population growth. And from the Vermont Department of Health’s vital statistics report, Lamoille County had the second-highest birth rate per 1,000 residents in 2022. As has been widely publicized, the March of Dimes 2024 report scored Vermont as the only state with an A grade in maternal and newborn health outcomes.

Surely Copley’s midwifery model — one of three in the state — contributes to this high grade. Midwifery care can be one of the safest, most cost effective means of managing pregnancy and birth. A 2023 Yale School of Medicine paper concluded “that many measures of successful pregnancy are elevated when midwives play a central role.” Certainly this care has led Copley to have one of the lowest cesarean section rates in the state. 

In truth, efforts to simply maintain the birthing center are not enough. Additional efforts to engage consultants to review all management practices and not just at the Birthing Center may yield efficiencies and savings.

Moreso, a vision that puts full force into promoting the birthing center’s exceptional track record, improving the facility to make a beautiful space, honoring nurses as essential links to the vitality of our families, innovating to expand wrap-around services and fully marketing the birthing center can only lead to expanded use and prominence as a leading center of care.

As a gateway and as an exceptional midwifery model, the success of the birthing center could well contribute to the overall value and sustainability of Copley, thus proving itself to be an essential community-affirming crown of multiple jewels, and a model for Vermont.

A decision to keep the birthing center open would show a dedication to the belief that the center is core to the mission of Copley. A decision to keep it alive would highlight its exceptional care and its vital role and importance to the local community’s health and economy.

This decision to save the birthing center would not be possible without a willingness to show a supreme commitment to the care for women, newborns and families, despite the monetary limitations. All of the above are excellent reasons to urge Copley’s board of directors to stand up for sustaining and growing the birthing center.

Read the story on VTDigger here: John Puleio: Birthing an opportunity at Copley Hospital.

This story by John Lippman was first published in the Valley News on April 20.

CHELSEA — A 74-year-old Newbury man who shot and killed his 38-year-old daughter when she came to his home for a welfare check has been found insane and will not stand trial.

James Perry is “not guilty by reason of insanity” following a psychiatric evaluation, according to a court order by Judge Daniel Richardson in Orange County Superior Court. Doctors concluded that Perry was “floridly psychotic with paranoid delusions and hallucinations” when he shot his daughter at point-blank range with a shotgun four years ago.

Upon review of Perry’s psychiatric evaluation, the judge on April 4 said the conclusions met the defendant’s burden to show that at the time of shooting he “lacked the capacity” to understand the criminality of act and that Perry was suffering from a “paranoid and psychotic state.”

Perry was charged with second-degree murder, aggravated assault with a deadly weapon and reckless endangerment for shooting his daughter, Karina Rheaume, on May 3, 2021, at his home on Deerfield Lane in Newbury.

She had come to visit with cookies to check on his well-being.

Rheaume’s boyfriend later called police to report that when he went to Perry’s home after she did not return from the visit that Perry had pointed a rifle at him and told him Rheaume was dead. He told the boyfriend “if he took one step closer, he’d be dead, too,” according to a police affidavit.

Following his arrest, Perry was diagnosed with mental delusions lasting longer than a month but he nonetheless was deemed competent to stand trial, with a court-appointed psychiatrist concluding that he had the “capacity to assist … in the preparation of a defense.”

Perry’s attorneys retained the right to hire their own forensic examiner to assess his mental health under an insanity defense. It was that second evaluation — with which both defense attorneys and prosecutors stipulated they agreed — that the judge relied upon in his ruling earlier this month.

A self-employed carpenter, Perry’s family is well-known in the Newbury and Bradford area, including owning the Perry’s Oil Fuel and propane business.

Perry never denied shooting his daughter, according to police and psychologists who evaluated him afterward.

“In the months leading up to the shooting, (Perry) had become disconnected from reality and was occupying a paranoid and delusional space marked by hallucinations and disordered thinking,” Richardson wrote in his order.

Although Perry’s psychiatric evaluation remains under seal, Richardson referenced eight “contributory factors” cited in the evaluation that led to his psychosis, including a long period of self-isolation due to the COVID-19 pandemic, depression, malnutrition, hearing loss, a prior psychotic event, cognitive decline and “information reverberations” created by watching TV news of political turmoil, including the U.S. Capitol riot of Jan. 6, 2021.

“The facts show that (Perry) acted out of a belief that he was being pursued for assassination by Seal Team 6 and his daughter was working in collusion to poison him and expose him to the assassins,” Richardson wrote.

Perry’s documented state of mind at the time of the shooting met the burden of proof under Vermont law that he lacked “adequate capacity” to understand the criminality of his conduct or conform to the law, Richardson said.

Perry has been held without bail at Southern State Correctional Facility in Springfield.

The judge’s order notes that the forensic psychologist reported that Perry continued to exhibit psychotic “symptoms and issues” while in prison. Only recently, due to “several years of regular nutrition, the socialization that resulted from being lodged with other inmates and a regime of pain management have these mental illnesses begun to recede and (allow Perry) to connect with reality again.”

Perry is next scheduled for a hospitalization hearing on Tuesday in Orange County Superior Court.

The purpose of the hearing, which will be attended the county prosecutor, a representative from the state’s Department of Health, Vermont Legal Aid and the victim’s advocate, is to assess Perry’s current mental condition, treatment program and the appropriate place for him to reside.

Depending on the outcome of that hearing — which typically comes in a follow-up order by the judge — Perry could face anything ranging from confinement to a mental health facility to release back into the community.

Read the story on VTDigger here: Judge rules Newbury man who killed daughter ‘not guilty by reason of insanity’.

The United States is in the midst of a surge in measles cases driven by unvaccinated children. 

The U.S. Centers for Disease Control and Prevention has reported 483 measles cases so far in 2025. If the current pace of spread were to continue, it would make this year the worst for measles in the 21st century. 

About 97% of cases have been in unvaccinated people or people with unknown vaccine status, the CDC reported. Three-quarters of cases have been in people under the age of 20. Seventy people have been hospitalized, and one school-aged child has died in Texas. Another death is under investigation.

Cases have been highest in Texas and New Mexico, according to the CDC. Vermont has been mostly spared thus far, with only one travel-related case reported by the state Department of Health. 

But health officials here are worried about one key statistic: The state’s measles vaccination rate for incoming kindergarteners has been below 95%, the critical “herd immunity” threshold that can prevent individual cases from becoming outbreaks. 

For the 2023-24 school year, the most recent year available, 93% of kindergarteners in public or private schools were up-to-date on their MMR vaccines, which provide protection against measles, mumps and rubella, according to health department data. Adults are also recommended to receive the MMR vaccine if they do not have evidence of vaccination or immunity. 

Even fewer, 91%, were fully immunized with all the required childhood vaccinations, which also include protection against diphtheria, tetanus, pertussis, chickenpox, polio and hepatitis B. 

“If we have 95% of people vaccinated, it would stop the spread,” said Merideth Plumpton, the department’s immunization program director. “Right now in Vermont, we’re below that.”

The measles vaccination rate for kindergarteners in Vermont is similar to the nationwide one, according to a research paper from the CDC. But the state has the second-lowest measles rate in New England, above only New Hampshire. It’s also lower than neighboring New York state. 

While 93% may sound close to 95%, that gap makes a real difference when it comes to herd immunity, Plumpton said. The 95% threshold is effectively a tipping point where vaccinated people act as a buffer, keeping the 5% of the community from coming into contact with each other.

“It just means that if we have a case, the likelihood that it’s going to spread is pretty high, especially if the child goes to school or child care during their infectious period,” she said.

Among all school-aged children, the rate of vaccination was higher, about 96% for the MMR vaccine. But facility-level data, which VTDigger obtained from the health department, shows that the statewide vaccination average was only part of the picture — in reality, many schools are far below the average.

About 26% of K-12 schools and 23% of child care facilities did not meet the 95% vaccination threshold for measles, the department data showed. In three counties — Lamoille, Orleans and Washington — the percent of facilities that do not meet herd immunity rose above 33%.

Vermont requires children entering child care facilities or K-12 schools to receive five vaccines that protect against nine potential childhood illnesses. Students at residential schools, also known as boarding schools, and incoming residential university students are also required to receive the vaccine against meningitis. 

But children can be exempted from those requirements for three reasons: provisional admittance for children with upcoming vaccination appointments, a medical exemption approved by a health provider or a religious exemption where parents attest to “holding religious beliefs opposed to immunization.”

For the 2023-24 school year, only 0.2% of children were medically exempted, 3% were provisionally admitted and 3% were exempted for religious reasons, according to the health department. 

Plumpton said the lowest vaccination rates tend to be found in the state’s most rural areas. “It could be a combination of lack of access and attitudes towards vaccines,” she said. 

Independent schools, which includes private and religious schools, also tend to have lower vaccination rates than public schools, according to the department data. 

Vaccination hesitancy has been bolstered in recent years by anti-vaccine sentiment connected to the Covid-19 vaccine, Plumpton said. The Trump administration has also placed the longtime anti-vaccine activist Robert F. Kennedy in charge of the U.S. Department of Health and Human Services, one of the most powerful public health roles in the nation. 

Plumpton emphasized that most Vermont families still choose to have their children vaccinated. But it’s natural for parents to have questions about the vaccines they’re giving their children, she said. 

“As a parent, I want to make the best decision that I can for my child, and I can only make that decision based on the information that I have,” she said. “And we’re in an age where there’s information everywhere, so it’s really hard to know what the correct information is or where to go to get good, solid, sound, scientific information.”

She encouraged parents to check out reputable websites like Vaccinate Your Family and VaccineInformation.org, which both have thorough FAQs about the safety and efficacy of each vaccine. 

She also encouraged them to discuss their child’s vaccine schedule with their primary care provider or pediatrician. Vermont provides recommended vaccine doses for children and adults at no cost to health care providers. 

But her message to Vermont parents was clear: Measles is a highly contagious virus that can lead to severe illness and death, and “vaccines are the best defense against the illnesses that you’re getting vaccinated against.”

“They’re not going to prevent 100% of the diseases,” she said. “That’s not the way vaccines work. But they’re really highly effective at preventing hospitalization and really serious illness. And there’s a reason that we have these vaccines.” 

You can use the tool below to browse school and child care vaccination rates, or check out the Department of Health’s vaccination dashboard for a fuller picture by year and county.

Clarification: This story was updated to note an additional death under investigation.

Read the story on VTDigger here: Hundreds of Vermont schools and child care facilities do not meet herd immunity threshold for measles.

The federal government announced Wednesday that it would cut $11 billion in Covid-19-related grants to local health agencies, including $6.9 million to two departments in the Vermont Agency of Human Services. 

A spokesperson for the Department of Health, Kyle Casteel, provided a statement on behalf of the agency Thursday that called the cuts a “sudden termination” that would “negatively impact public health in our state.”

Most of the funds, about $5 million, were allocated for vaccination programs at the health department. The statement said the grants began during the pandemic but have continued to support the department’s work beyond the pandemic. 

Among the uses of the funds were to “detect and prevent the spread of infectious disease, ensure Vermonters can access vaccines, help address health disparities among the populations and communities we serve, and more,” the statement said. 

The Department of Mental Health projected losses in the hundreds of thousands of dollars, the statement said. The programs it expects to see cuts include community-based support, crisis response and access to care for “vulnerable Vermonters,” the statement said. One such program provided team-based early treatment for psychosis to young Vermonters. 

“While these grants were always intended as temporary, the demand for mental health services remains high, and this loss of funding will have consequences,” the statement said. 

The statement said the departments were still working to understand the full implications of the cuts. 

The Covid funding cuts were the latest in a series of changes to health-related spending at the federal level. On Thursday, national news outlets reported that the U.S. Department of Health and Human Services planned to lay off 10,000 workers and shut down certain agencies within the department. 

Read the story on VTDigger here: Federal government cuts almost $7 million in Covid-19 grants to Vermont.

A bill that eliminates inspection requirements and licensing fees for smaller Vermont food producers working in a home kitchen has advanced in the Vermont House with broad support.

The changes in H.401 are intended to increase the supply and distribution of locally produced food products and update the statute to reflect cost increases caused by inflation. All eight members of the House Committee on Agriculture, Food Resiliency and Forestry backed the bill unanimously Friday after making some amendments. The bill is currently scheduled for a potential vote in the House Committee on Ways and Means this Thursday.

Current law exempts at-home food manufacturers, or “cottage” food producers, that bring in less than $10,000 in annual gross sales from licensing requirements and fees, and their kitchens are not required to be inspected by the Vermont Department of Health. For baking businesses, that threshold amount is currently less than $6,500 annually, or $125 per week. 

The new law would raise the sales threshold to $30,000 for both at-home food manufacturers and bakers, meaning any business with annual gross receipts falling below that amount would not be subject to inspection or licensing fees. 

The health department said in testimony before the agriculture committee Friday that licensing fees help to offset the cost of providing regulatory services and support for food manufacturers across the state. 

“Increasing the fee exemption for commercial bakers and food manufacturers reduces the resources available for regulating all food manufacturers,” said Liz Wirsing, Director of the Food and Lodging Program at the state health department.

Wirsing also cautioned against putting products into the commercial marketplace without proper inspection. 

“Food safety inspections are a preventative public health service, and the program’s goal is to prevent illness, injury and death from foodborne illness,” she said.

However, small food business owners, such as Peter Hopkins of Hop Valley Farm, said in testimony that it is common practice for cottage foodmakers to uphold food safety in their kitchens even though they are not inspected by the state. 

“Ours are the same kitchens that we use to make meals for our families, friends, loved ones,” Hopkins said. “It’s cynical to think that we take any less care in the preparation of food for our customers.”

Caroline Sherman-Gordon, Legislative Director at Rural Vermont, told the committee the policy change would be “a step in the right direction” toward  Vermont’s goal of satisfying 30% of its food needs within the state by 2030. 

In an interview, Sherman-Gordon said home food manufacturers are “being limited in their business growth by these outdated income thresholds” that do not account for rising inflationary costs.

“Why not update the policy?” she said. “Isn’t the policy supposed to be incentivizing [local producers] in this moment in time where we, as a state, are trying to get towards producing 30% of what we consume?”

The bill is moving forward at what Sherman-Gordon described as “atypical speed.” It is expected to hit the House floor this week, but could face revisions later in the Senate. 

“We’ll be looking at spending more time with the bill, and also looking at what other states have done to advance their regulatory environment to be favorable to cottage food producers. And we’ll see where the bill will end up, then,” Sherman-Gordon said.

Read the story on VTDigger here: Vermont lawmakers consider cutting regulations for more at-home food producers.

This is the second story in a two-part series that looks back on the impact of Covid-19 in Vermont after five years. The first story, “New technology, and mistrust, is legacy of Covid-19 for Vermont public health,” can be found here.

Patsy Kelso, Vermont’s state epidemiologist, remembers hearing about Covid-19 for the first time through the “routine channels.” The Centers for Disease Control and other public health entities regularly share information about emerging infectious diseases, from mpox virus circulating worldwide to Ebola outbreaks in Uganda. 

But there was nothing, at first, that suggested Covid would be the one to shut down the world. “It did take me by surprise, personally, how quickly things ramped up,” Kelso said. 

The spread of Covid within the United States was so misunderstood that the focus of many experts was on preventing transmission from international travelers. In reality, the virus had been spreading nationwide for months. 

Vermont officials recommended hand washing and staying home when sick, but masking and social distancing were not yet on the horizon for the general public. In fact, only three days after Vermont’s first Covid case on March 7, 2020, hundreds of people attended a University of Vermont basketball game. At least 20 confirmed Covid cases were later linked to the event. 

But the situation was quick to change. On March 15, 2020, Gov. Phil Scott ordered K-12 schools to shut down to prevent Covid’s spread. A flurry of other closures followed, until Scott issued a blanket order on March 24: “Stay home” and “stay safe.”  

Covid tracing in the state began with a whiteboard in Kelso’s office listing individual Vermonters’ initials and their test results. Then she had to bring in a second whiteboard. Then the entire office was sent home, and the department was forced to rapidly come up with a system for tracking hundreds of people and tests. 

On the testing side, Helen Reid, then director of health surveillance at the Vermont Department of Health, was scrambling to scale up Covid laboratory testing. Early shortages of basic testing equipment — pipette tips, plastic — hampered their progress. 

“It was hard to anticipate the scale that this would go to,” said Reid, who now heads the department's infectious disease division. “So with every new piece of information, we were sort of pivoting and adjusting our approach, and doing it pretty quickly.”

Along with supplies, the department was in desperate need of more staff. Officials put out a call early on for “basically anyone in state government who had a microbiology degree,” Reid said. Still, she recalled working extremely long hours in the early weeks of the pandemic. 

“We went from, I think it was, testing about 56 specimens a day in the early days of Covid, to our team testing 1,500 per day by the end of May, because we didn't really have a choice at that point,” she said.

As the health department scrambled, state officials tallied the numbers. Early Covid press conferences featured charts of hospital capacity and the amount of need under “best case” and “worst case” scenarios. In those early months of the pandemic, Vermont did not come close to hitting its hospital capacity. In fact, cases ebbed into the spring and summer months, and the state reported zero deaths for months. 

Anne Sosin, a health equity researcher and lecturer at Dartmouth College, recalled Vermonters in that time beginning to talk about the state as an “escape community,” protected from Covid by its relative isolation and rurality. But she said she had reason to be skeptical since her research in health equity suggested rural areas can be uniquely vulnerable to illness. 

Many people think about disease risk as “distances between houses and physical infrastructure,” but rural communities often have tight-knit bonds and anchor institutions like schools and employers that bring them together, she said. 

Rural areas also have more essential workers and fewer hospital beds and other health infrastructure. Yet she was sympathetic to those who wanted to return to their pre-pandemic lives. 

“None of us want to alter our daily lives for months or years on end,” Sosin said.

Vaccine goals

The vaccination campaign in 2021 marked a new stage in the pandemic. After rolling out the vaccine to older and high-risk Vermonters, Scott announced that May a benchmark-based plan to reopen Vermont: If 80% of Vermonters get vaccinated, he said, he would lift major Covid restrictions. 

“Admittedly, this would be an ambitious goal for most,” he said at a press conference announcing the initiative. “And to be honest, most states won’t come close to reaching it. But I believe Vermont can show the country how it’s done.”

On June 14, 2021, the state hit that goal, and Scott followed through on his promise. Once again, Vermonters enjoyed a summer light on Covid limitations. 

Vermont remains close to the top of the nation in its initial Covid vaccination rate, tied with three other states, according to USAfacts.org. Kelso praised the policy, saying that it helped limit deaths later in the pandemic. 

“I think that was a strong policy that resulted in both large uptake of the vaccine, and also quickly, because Vermonters wanted things to reopen,” she said. 

But once again, the Covid ease was not to last. 

That summer, the more severe and infectious Delta variant began circulating through Vermont. Cases and deaths surged in the fall. Then Omicron hit. The less severe, but extremely contagious, variant spread quickly nationwide. In Vermont, reported hospitalizations topped the state’s hospital bed capacity, forcing them to take emergency staffing measures for weeks. 

Scott pushed forward with reopening despite the rise. Just as Omicron began to wane, he announced the end of school mask mandates, citing the need for children to return to normalcy. 

Three years later, Sosin remains critical of this policy. She said the state leadership early in the pandemic was “fast and effective,” but “lost discipline in responding to the pandemic in later stages.” 

She argues that masking, tied with other Covid-concious policies, actually helped to keep schools open during the worst of the pandemic. 

“None of us thought that we should shut the state down the way we did in March 2020,” she said. “We knew a lot more and had many more tools to respond to the pandemic.”

Kelso took a more positive view of the state’s response, but said the restrictions and regulations were a balance that had trade offs. 

Statewide and public health policies in Vermont contributed to the state having the lowest death rate in the nation, she said, but there were downsides to some of them as well. 

“Limiting visitation in long-term care facilities, for example, really helped reduce introduction of the virus into a facility where it could then spread quickly and result in terrible outcomes, but that also had devastating impacts on individuals’ lives,” Kelso said. 

Vermont might have had a comparatively low death rate, but that’s not how Sosin thinks when evaluating the state’s performance. “I never think about it in terms of Vermont versus Texas. I think about it in terms of lives that didn't need to be lost,” she said. 

“I always think we measure this on our own terms, and we would not resort to lowest-common-denominator metrics in thinking about public health, or the preservation of human life,” Sosin said. 

Correction: An earlier version of this story was wrong about the current job title of a public health official with the Vermont Department of Health.

Read the story on VTDigger here: A visual history of Covid-19’s path through Vermont.

The Vermont Department of Health has confirmed a case of measles in a school-aged child in Lamoille County — the first to be discovered in 2025. 

The unnamed child became sick after travelling internationally with family. The risk to the public is believed to be “low,” but Vermonters who may have been exposed to the child at the Copley Hospital emergency department may need to take action to protect others, according to a Tuesday press release from the department. 

The child tested positive Monday after visiting Copley Hospital in Morrisville the day prior. Anyone who was inside the hospital’s emergency department between 3:15 p.m. and 6 p.m. on Sunday should confirm their immunity to measles through vaccination or previous infection, and monitor for symptoms through March 30, according to the release.

If you cannot confirm your immunity by contacting your health care provider or requesting your immunization records, you should call the health department at 802-863-7240, option 2 for guidance. 

Although this is the first case of measles reported in the state in 2025, there were two documented cases in 2024, one in 2018 and another in 2011, according to the release. 

This most recent case has not been linked to ongoing outbreaks in the southern United States and Québec, according to the department. The U.S. Centers for Disease Control and Prevention has reported more than 200 cases of measles so far this year, up from just 58 in 2023. 

Health department officials urged Vermonters to get themselves and their children vaccinated for measles. 

Health officials attribute the recent uptick in measles, in part, “to an increase in the number of unvaccinated people, which impacts community immunity,” the department said in the release. About 93% of school-aged children in Vermont are vaccinated for measles — below the 95% benchmark that experts believe is essential for herd immunity. 

Measles is one of the most contagious diseases worldwide and can be deadly, especially in children under 5. One in five unvaccinated people with measles end up hospitalized for the disease, according to the release. 

Symptoms of measles include a high fever, a cough, and a rash a few days after initial symptoms appear. For more details about measles symptoms, how the virus is spread and how to get vaccinated against the disease, visit the health department’s website. 

Read the story on VTDigger here: Vermont reports case of measles in school-aged child .

The Vermont Department of Health has stopped including data on Covid-19 cases and deaths in its weekly surveillance reports. 

The department posted on its website on Feb. 19 that Covid data reporting would transition to “to a format similar to other respiratory viruses like the flu.”

The latest surveillance update contains data on emergency department visits for Covid, the proportion of variants from clinical specimens, Covid levels in wastewater sampling and a count of the latest outbreaks. 

Emergency department and wastewater data suggest that Covid levels are on the decline from a relative surge in December and January.

The department said on its website that case data has become “a less meaningful” indicator of Covid trends as individual cases have been reported on a limited basis by health care settings and laboratories. Officials have warned that case data, based on PCR testing, has been less accurate since the widespread adoption of antigen testing in 2022. The department stopped publishing daily Covid case counts in 2023. 

“Reporting of individual SARS-CoV-2 infections to public health has become increasingly sporadic as testing patterns have changed (including widespread use of at-home testing),” state epidemiologist Patsy Kelso wrote in an email when asked if there was a specific justification for the more recent shift.

A higher proportion of Covid infections now tend to be asymptomatic, Kelso said, meaning they were less likely to require health care intervention that would result in a Covid PCR test. 

Data on individual test results is no longer being analyzed at the federal level or published in the U.S. Centers for Disease Control and Prevention’s Covid tracker, a change made in 2023. The disease is still reportable on a state level, meaning health care providers, laboratories and certain other officials are required to report positive cases to the health department, according to Kelso.

When it comes to Covid deaths, the department said it stopped releasing death data because Covid has shifted from being the underlying cause of Covid-associated deaths to only a contributing cause.

When asked for more details on that shift, Kelso said 87% of deaths associated with Covid in Vermont had the disease as an underlying cause early in the pandemic, compared with 55% during the Omicron wave. Omicron has been the dominant strain of the Covid-19 virus in Vermont since early 2022. 

The final surveillance update with death data, released Feb. 12, reported that 1,258 Vermonters had died from Covid since the beginning of the pandemic, including 16 in January. The CDC continues to publish provisional mortality statistics, including for Covid, on a national basis in its database. It’s unclear what data will be published on Covid deaths from Vermont through the CDC. 

Read the story on VTDigger here: Vermont stops publishing Covid-19 death and case data.

This commentary is by Margaret Gadon of Strafford. She is a retired physician who has worked in public health in health care policy, academia and clinical care. She is co-chair of the Strafford community nurse program.

What are we going to do about the rising costs of health care in Vermont? In just six years, rates for individual small-group plan health insurance premiums have increased up to 80% with a doubling of the cost of policies under the state health exchange. A recent study directed by the Green Mountain Care Board identified a key element of cost containment; shifting resources from high-cost hospitals to community-based and local primary care, where the social barriers to good health and health care can be addressed. Through this many hospitalizations and costly emergency room visits can be avoided.

Vermont’s Blueprint for Health, with its statewide system of community-based care, was created in 2003 to achieve this. It is a great start. It has improved health care quality and decreased health care costs but it needs to be more robust to save big dollars. This can be achieved with the widespread use of trusted health care coordinators/navigators who know the community and its resources, and link to both Blueprint and the traditional health care system. Will this work? A national demonstration project has in fact demonstrated the cost-effectiveness of these workers through a reduction in repeat hospitalizations and length of stay.

So what are we waiting for? The Green Mountain Care Board, which oversees the distribution of health care resources in Vermont, has focused only on the traditional health care system. To oversee the costs of care comprehensively, it needs to incorporate community care into its vision. With the upcoming changes in health care funding in Vermont, The time is now to develop a system of these care coordinators throughout the state. 

Vermont is a small state with a small population. This may make it one of the costliest to provide health care, but it also gives it the opportunity to take the lead in offering a truly comprehensive and community driven  health care system that makes its  health care affordable. 

You can make a difference by writing your legislators and asking them to support H.140. 

This bill directs the Department of Health to administer a grant program for the purpose of establishing community nurse or community care coordinator programs in Vermont communities. The goal of establishing a statewide network of municipal non- clinical healthcare workers is to improve health outcomes and to prevent avoidable care and over utilization of institutional care, as recommended in the report completed by the Green Mountain Care Board’s consultant in November.

Read the story on VTDigger here: Margaret Gadon: Community nurses and care coordinators reduce health care costs and improve quality of care.

On Feb. 5, a neighborhood of duplexes in a wooded corner of Chapel Hill, North Carolina, was jarred awake before sunrise by the sound of bangs and bullhorns.

In the predawn gloom, dozens of federal agents and sheriff’s officers swarmed the area and entered two homes, according to news reports and residents.

“I looked out my window and I saw dudes in paramilitary gear, I saw several trucks, several vehicles, and I could tell that something serious was going on,” said Paul Lascara, who lives next door to one of the homes that was raided.

Two people linked to the Northeast Kingdom shooting that resulted in the death of a U.S. border patrol officer had previously stayed in that residential area, according to neighbors and media reports. 

Those individuals, named in court documents as Felix Bauckholt and Teresa Youngblut, were stopped on Jan. 20 by agent David Maland in Coventry, while driving a blue 2015 Prius with North Carolina plates. According to media reports and acquaintances, Bauckholt, a German national, was transgender and used the name Ophelia. 

In court documents, federal prosecutors have alleged that Youngblut “drew and fired a handgun toward at least one of the uniformed Border Patrol Agents without warning” during the traffic stop. 

Youngblut fired a handgun at least twice from the driver’s side of the vehicle, according to court documents, while Bauckholt “attempted to draw” a handgun. The court documents go on to say that “one or more Border Patrol Agents” returned fire with “at least” seven shots. 

In the shootout, Maland suffered a fatal gunshot wound to the neck and Bauckholt was fatally shot in the chest, according to death certificates provided by the Vermont Department of Health. Youngblut was arrested and is in custody.

According to reporting from the Associated Press and local news outlet WRAL, both Youngblut and Bauckholt had rented units via Airbnb in two duplexes in a Chapel Hill neighborhood in the past two years. The units’ landlord told the AP that Bauckholt had begun renting a unit starting in July 2023, while Youngblut began renting a unit in November 2024 and paid to stay through the end of March.

Many of the units in the Chapel Hill neighborhood searched by the FBI are duplexes owned by a single landlord and rented via Airbnb, according to property records and Airbnb listings. The landlord declined to comment to VTDigger. 

‘Kind of weird’

Lascara, who lives next door to one of the units searched by the FBI, said he did not interact much with his neighbors and was not exactly sure who was renting the units. But he recalled seeing two of them walking around the neighborhood dressed in black — “like, lots of black,” he said. “I think they both had trench coats.”

Shown a picture of Bauckholt, Lascara said he “definitely” recognized the individual. Although they never interacted, Lascara said, Bauckholt had a “socially awkward sense.”

Lascara said he was not sure who Bauckholt’s companion was. But that person, who Lascara described as a woman no more than 5-foot-8, with dark hair and a “roundish face,” once came to his door asking if he’d received a package. 

The neighbor had ordered a smartwatch that had not arrived, Lascara said. Their interaction — in which the neighbor had pointed out that Lascara was wearing a watch of the same kind that they had ordered — was brief and “kind of weird,” he said. 

Another neighbor, who asked to speak anonymously for fear of their safety, told VTDigger they recognized Bauckholt and Youngblut from news reports. The neighbor had seen the two walking around the area, “all in black, black trench coats,” they said. 

The pair generally kept to themselves, according to the neighbor, who said they also saw other people staying with them as well, as well as multiple other vehicles — including a box truck that was parked in a cul-de-sac for an extended period of time.

At one point, the neighbor said they saw Bauckholt, Youngblut and “two adults, all in black, coming back from the store.” One of those two strangers was very tall with dark hair, the neighbor said. 

The identities of those other people are unclear. But Youngblut and Bauckholt have ties to multiple other individuals, some of whom are linked to killings in California and Pennsylvania. 

A photo of an empty Amazon package from the property, obtained by VTDigger, lists the name “Felix Bauckholt” and another Chapel Hill address. That address is for a Staples store roughly 20 minutes away. 

An employee of that Staples told VTDigger that the store offers a service called “iPostal1,” through which members of the public can receive and pick up mail. The employee, who did not provide a name, declined to answer questions about Youngblut and Bauckholt.   

Last week, the FBI spent hours searching two residences in the Chapel Hill neighborhood, according to neighbors and media reports. Lascara said he heard agents announce that they were in possession of search warrants.  

Randall Rigsbee, a spokesperson for the Chatham County Sheriff’s Office, confirmed that sheriff’s officers were involved in the raid but directed a reporter to the FBI. 

“We assisted the FBI, but it’s really their operation,” he said. “So I don’t have any additional details.”

Shelley Lynch, a spokesperson for the FBI’s Charlotte, North Carolina office, said only that the bureau had “conducted court authorized investigative activity in connection with an ongoing federal law enforcement investigation.”

It was not clear when Bauckholt and Youngblut left the properties, but by mid-January, they were in Vermont. According to court records, the pair was placed under surveillance by law enforcement on Jan. 14 in Lyndonville.

‘Not able to comment’

In Vermont, too, the FBI has been tight-lipped. The federal law enforcement agency, which is leading the investigation into the Jan. 20 incident, has yet to release key details about the shootout that left two dead.

Among the lingering questions: who fired the shot that proved fatal to Maland — Youngblut, or another border patrol agent?

According to charging documents in the only criminal case filed stemming from the shootout, Youngblut fired two shots and “at least one” border patrol agent returned fire.

Youngblut faces federal firearms offenses, but has not been charged directly with firing the shot that killed Maland. According to court filings, “Multiple uniformed Border Patrol Agents were present at the stop in three USBP (U.S. Border Patrol) vehicles with emergency lights illuminated.”

On Jan. 22, two days after the incident, Sarah Ruane, an FBI spokesperson, declined to respond to specific questions about the investigation.

“At this time, there are no additional details available for release,” she wrote. “FBI investigations are thorough and meticulous, and our updates take time. We will continue to work with all parties involved to determine if/when more information can be released but appreciate your patience.”

Ruane again declined to answer similar questions Thursday, writing, “In accordance with a longstanding DOJ (Department of Justice) policy, I’m not able to comment on an open investigation.”

Read the story on VTDigger here: Weeks after shooting of border patrol agent, FBI searched connected residences in North Carolina.

Updated at 4:31 p.m.

Health Commissioner Mark Levine announced his retirement Friday after eight years serving as the head of the Vermont Department of Health.

Levine, a medical doctor, led the department through several crises, including the state’s most significant health challenge in decades: the Covid-19 pandemic.

“Dr. Levine was a steady, reassuring voice through the pandemic, and in the months of recovery that followed,” Secretary of Human Services Jenney Samuelson said in a statement. “Each week, during marathon press conferences, he calmly tackled complex topics in epidemiology and public health.’

The Department of Health tracked Covid-19 data, provided Covid guidance to Vermonters and organized mass vaccination campaigns, among other measures. Levine also served as an adviser to Gov. Phil Scott on health matters. 

“I will be forever grateful for his advice and counsel over the years, but especially during the pandemic, as he appeared with me daily at press conferences during those difficult days, giving much comfort to Vermonters as our very own ‘Country Doc,’” Scott said in a statement.

Along with Covid-19, Levine led the Department through some of the worst years of the opioid epidemic, which hit a new peak during the Covid pandemic but began dropping in 2023.

The press release announcing his retirement cited other accomplishments during his tenure, including creating a nurse home visiting program for newborns.

Levine, a 71-year-old resident of Shelburne, had an internal medical practice and served as associate dean for Graduate Medical Education at the University of Vermont Larner College of Medicine before joining the health department. He plans to officially retire at the end of March.

Levine and Scott were not available for further comment on Friday afternoon. 

Read the story on VTDigger here: Vermont Health Commissioner Mark Levine announces his retirement .

President Donald Trump’s executive order that aims to block federal funding and restrict gender-affirming care for people under 19 has transgender residents and advocates alarmed, though health care officials have sought to offer a measure of reassurance. 

“There’s a lot of anxiety and a lot of fear,” said Shawna Trader, a trans and nonbinary resident and volunteer at the Rainbow Bridge Community Center in Barre, a nonprofit that serves LGBTQ+ needs in central Vermont.

While a number of states have already restricted access to gender-affirming care, in Vermont such care remains available and is, for the most part, covered by Medicaid. 

Trump’s order, signed on Tuesday, includes directives to remove federal guidelines on gender affirming care, civil rights and patient privacy and prevent Medicaid and Tricare — a form of military health insurance — from funding such procedures. The order also takes aim at medical institutions that receive any type of federal funding and provide such care.   

Mike Fisher, Vermont’s chief health care advocate, acknowledged there was “a great deal of fear and uncertainty” provoked by the order but emphasized that such health care services remain protected in Vermont. (In 2023, the state passed a “shield law” to protect providers and patients from potential investigations related to gender-affirming care and abortion services.) 

“We want to assure Vermonters there have been no changes to the protections for accessing care that are protected in Vermont state law,” he said. He and others pointed to the likelihood that the order will face legal challenges. 

‘Services are still available’

Planned Parenthood of Northern New England, which provides gender-affirming care, has adopted a wait-and-watch approach, in the meantime.

“It’s tough to say what is going to happen because there are so many steps in between the executive order and things going into effect,” said Jessica Barquist, vice president of public affairs for Planned Parenthood of Northern New England. The organization has been fielding a high volume of inquiries from concerned people, she said.  

“I think part of the strategy here is to get people to panic,” she said. “And so, part of what we’re hoping to do is reassure patients that services are still available. And as of right now, there are no impacts.”

Daniel Barlow, executive director of the People’s Health & Wellness Clinic in Barre, which treats patients 18 and older, called the order “a dangerous escalation in the ongoing political attacks on transgender and nonbinary people, and we fear it will deny lifesaving care to Vermonters of all ages.”

But the clinic, he said, will continue to provide care to all patients who qualify, regardless of gender identity. 

A spokesperson from the Vermont Department of Health declined to comment.

‘We’re all just petrified’ 

Trader, the Rainbow Bridge volunteer, who facilitated a meeting Tuesday night for parents of transgender children, said residents are deeply worried about access to medication and health care in the wake of orders that target and discriminate against a very vulnerable group — transgender youth.

“Basically, if you have a trans kid, an actual minor, you are right now wondering: how am I going to be able to get the care that my child needs and wants? And so, a lot of those people are basically making contingency plans,” Trader said.

This includes mothers trying to get their own physicians to write prescriptions for hormone medications on behalf of their children or trying to access health care in Canada, Trader said.

“We’re all just petrified,” said Andrea, whose 22-year-old daughter is transgender and who asked that her last name be withheld because of concerns for her family’s safety. While she’s always worried for her daughter’s safety, she is more so now, given the current climate.

“I’m constantly afraid,” she said. “The reality is that she is more likely to be targeted, violently, sexually (and face) harassment.”

When Andrea heard about the latest executive order rolling back protections for transgender people, she said she cried and was overwhelmed with a “feeling of dread” and helplessness. Parents of trans children are going off social media, and changing emails and phone numbers because they’re afraid their children and their families could be targeted, she added.

About 3% of Vermont middle school students and 5% of high school students surveyed identify as transgender, according to the 2023 statewide youth behavioral report compiled by the state health department. As students who identify as LGBTQ+, they are disproportionately more likely to face bullying, experience or witness violence, and self harm, the report states.

Nationwide, there has been a significant rise in hate and violence toward the transgender community in recent years. Trump’s campaign promise to protect children from “left wing gender insanity” further fueled the fire last year, CNN reported. 

‘Gender-affirming care is health care’

Advocacy groups are pushing back on the Trump administration’s latest executive order, which comes on the heels of earlier orders that seek to ban transgender people from serving in the military (which already faces a court challenge) and to require the U.S. government to only recognize two sexes — male and female.

“The anti-trans executive orders are largely rooted in baseless facts and extremist ideologies,” said Dana Kaplan, executive director of Outright Vermont, a statewide nonprofit that supports LGBTQ+ people, in an email.

Kaplan noted that executive orders do not have the authority to override the United States Constitution, federal statutes or established legal precedent.

James Lyall, executive director of the ACLU of Vermont, called the order “an unprecedented abuse of federal power that will be challenged.” 

Vermont Attorney General Charity Clark said her office is reviewing all the Trump administration’s executive orders, including ones with the potential to impact health care for trans and nonbinary youth and is exploring options to challenge any orders it deems unlawful.

“I want to reassure our trans and non-binary friends, family members, and especially kids that I will use the full force of my office to defend their rights,” she said in an emailed statement. 

The executive order states the United States will “not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another” and will enforce laws that prohibit or limit such “destructive and life-altering procedures.”

It further states that “medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions.”

Organizations that provide gender-affirming medical treatment pushed back on that language.

Standards of medical care for gender dysphoria have been around for decades and involve the consent of the patient or their caregivers if the patient is a minor, and an in-depth screening and assessment by mental health professionals, said Heather Ely, executive director of the Rainbow Bridge Community Center in Barre.

“All of the leading medical associations endorse this medical care because scientific research shows it to be effective and essential to the health and well-being of transgender people,” she added. “Regret for transition-related care is about 1% or less. By comparison, regret after knee replacement surgeries can be as high as 30%.”

Trader, 38, who has received gender-affirming care at Planned Parenthood and at the Barre clinic, criticized the order and the language used.

The word “mutilation,” she said, has a connotation that is at odds with medical science that overwhelmingly indicates that gender-affirming care saves lives.

“Gender affirming care is health care,” Trader said. “So to receive it as a trans person is no different than booking an appointment with your cardiologist and having an echocardiogram. You are taking care of your heart. And when a trans person gets gender affirming care, they are taking care of themselves.”

Read the story on VTDigger here: Trump order curbing access to gender-affirming care for youth creates ‘a lot of anxiety and a lot of fear’ in Vermont.

This story by Christina Dolan was first published in the Valley News on Jan. 29.

WINDSOR — One person has died and several have been hospitalized due to an outbreak of Legionnaires’ disease at the Cedar Hill Continuing Care facility, according to the Vermont Department of Health.

The department issued an advisory to health care providers Wednesday morning stating that six cases of the pneumonia-like illness had been reported among residents and staff at the Village at Cedar Hill.

“This outbreak is unusual for Vermont,” said Health Department spokesperson Kyle Casteel, noting this is the first facility outbreak in the state in five years.

Legionnaires’ disease is caused by Legionella bacteria. Symptoms include cough, shortness of breath, muscle aches, headaches and fever, according to the health advisory.

People over 50, current or former smokers, and people with lung disease or compromised immune systems are at particular risk.

The fatality rate for Legionnaires acquired outside of health care settings is 10%, according to the Health Department advisory.

In health care settings, however, the fatality rate rises to 25%.

The Village is an independent and assisted living apartment complex on the Cedar Hill campus, which also includes memory care and skilled nursing facilities.

The outbreak originated in the facility’s water system, according to the health advisory. Cedar Hill’s management is taking steps to reduce the risk of exposure by limiting the aerosolization of water — the creation of mist or tiny droplets — and installing filters, Casteel said in a Wednesday afternoon email.

“Once we learned of this case, we immediately put in place water restrictions, including the use of bottled water,” Cedar Hill Executive Director Patricia Horn said in a Wednesday afternoon email.

The source of the outbreak is currently unknown, she said.

Cedar Hill has hired IWC Innovations, a legionella consulting firm, to help locate the cause, she said.

“In 2011 and 2012, we had isolated cases of Legionnaires’ disease. Following these incidents, we immediately implemented a comprehensive water management plan that includes regular testing, monitoring, and preventive maintenance of our water systems,” Horn said.

Legionella bacteria occur naturally in freshwater environments such as lakes and streams. It can become a health concern when it grows and spreads in the water systems of buildings. Outbreaks are often linked to large or complex water systems, such as those found in hospitals, hotels and cruise ships.

The most common sources of infection are showers, air-conditioning cooling towers, decorative fountains and hot tubs, according to the Health Department.

The outbreak at Cedar Hill does not affect people living in the surrounding area, Casteel said.

An outbreak of Legionnaires’ disease at the Mount Ascutney Hospital and Health Center in 1982 resulted in the death of one patient.

Cases of Legionnaires’ disease have been increasing since about 2000, dipping briefly during the Covid-19 pandemic and then trending upward again, according to data from the U.S. Centers for Disease Control and Prevention.

More information about Legionnaire’s disease and ways to prevent the bacteria’s growth may be found on the health department’s website.

Read the story on VTDigger here: One dies in Legionnaires’ disease outbreak at Windsor senior living facility.