Draft bill would require 60‑day notice, public hearings before hospitals cut services

The House Healthcare Committee on Thursday reviewed S189, a bill that would create a formal notice and engagement process before a hospital intentionally reduces or eliminates a service.

Legislative counsel Jen Carvey told the committee the bill would require a hospital proposing an intentional service reduction to provide at least 60 days’ notice to the Agency of Human Services, the Green Mountain Care Board, the Office of the Health Care Advocate and the members of the General Assembly who represent the hospital service area. The hospital would have to post the notice on its website, publish it locally and conduct a public engagement process with at least one public hearing and a 30‑day comment period.

After the engagement, the hospital must summarize public comment for AHS. The agency would evaluate the proposal for consistency with the statewide health‑care delivery strategic plan (the first iteration of which is not due until 2028), consider community impact and provide nonbinding recommendations to the hospital, the Green Mountain Care Board and the public. The board would then review the proposed change’s budgetary impact and could adjust the hospital’s budget order or direct that savings be returned to Vermonters, invested in primary care/prevention, or reflected in premiums.

Carvey said the provision is intended to prevent sudden, unexpected service reductions and to allow regulators and communities to assess consequences. Members noted the bill distinguishes intentional reductions (subject to notice) from involuntary loss of capacity due to a provider leaving or retiring.

Lawmakers discussed recent, widely noticed examples — including inpatient and psychiatric bed reductions and closure of primary‑care sites — and said the bill responds to community concerns that hospitals and systems have sometimes changed service lines with little public notice. Several committee members pressed for testimony from the Green Mountain Care Board and from hospitals about whether the board should have mandatory ("shall") versus discretionary ("may") authority to adjust budgets following a service reduction.

The committee recessed for a break and plans to take further testimony and markup at a later session.