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In a presentation titled “A time of challenges and needed stabilization,” Southwestern Vermont Medical Center CEO Tom Dee and his executive team made a case to the state’s oversight board Monday for a 6.35 percent budget increase in 2023.

Dee, SVMC Chief Financial Officer Stephen Majetich and Dr. Trey Dobson, chief medical officer, appeared before the Vermont Green Mountain Care Board, a five-member group that — among other duties — reviews and establishes hospital budgets across the state.

The message from SVMC was similar to presentations from other hospitals, all facing similar pressures related to COVID, the economy, a tight workforce and other seemingly widespread issues challenging the medical community.

In a presentation to the board by the Brattleboro Memorial Hospital team, this is “the most difficult time this (BMH) Board has experienced,” and the team described being “very concerned about the financial performance and how fragile BMH is.”

Forces driving the proposed SVMC increase of approximately $11.3 million included: financial uncertainty (the hospital faces its first potential operating deficit since 2009), workforce shortages, capital projects, inflationary pressures up to 40 percent over budget, uncertainty over COVID’s continued impacts, health system gridlock and a growing number of incidents of violence against health care workers.

Majetich put together the financials for the Monday presentation. The chart showed a roughly $10 million surplus for 2021, but a deficit of $1.3 million projected for the current year.

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Over $5 million of expenses are directly related to COVID costs — testing, vaccination, therapy services and inpatient services — although revenue growth was seen in emergency room visits, Express Care services and other areas.

Majetich reported that the operating budget also took a huge hit, expected to be $12.6 million over budget. Salaries and wages are projected to be over $6.3 million or nearly 12 percent over plan, his information indicated.

In addition, SVMC has seen a 40 percent increase in patients with behavioral health needs since the beginning of the pandemic and a 17 percent increase this fiscal year, the Green Mountain Care Board was told. In one extreme case, the hospital reported, SVMC’s Emergency Crisis Area housed a patient for seven weeks — a patient who was dropped off by a local nursing home that refused to re-accept the patient.

The team outlined the risks or unknowns that make accurate budgeting more difficult, including workforce issues, inflation and COVID.

The Green Mountain Care Board is now hearing from all the local hospitals in the state, with hearings scheduled through Aug. 26. Deliberations on the proposed increases get underway on Aug. 31.


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