Vermont S 189: An act relating to survivor benefits for public employees

Bill Text

No. 146 Page 1 of 7
2026

VT LEG #390230 v.1
No. 146. An act relating to establishing a process for the elimination of
certain hospital services.
(S.189)
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 18 V.S.A. § 9405d is added to read:
§ 9405d. HOSPITAL SERVICE ELIMINATIONS; NOTICE REQUIRED
(a)(1)(A) A hospital that is considering eliminating any of the following
services shall provide a preliminary notice of intent to the Agency of Human
Services, the Green Mountain Care Board, and the Office of the Health Care
Advocate as set forth in subdivision (B) of this subdivision (1):
(i) emergency department services;
(ii) primary care services, including closing a site at which
primary care services are provided;
(iii) obstetrics;
(iv) perinatal care;
(v) inpatient psychiatric services;
(vi) treatment for substance use disorder, including medication for
opioid use disorder;
(vii) dialysis, including closing a site at which dialysis services are
provided; or
(viii) inpatient pediatric services.

No. 146 Page 2 of 7
2026

VT LEG #390230 v.1
(B) The information to be provided by the hospital in its preliminary
notice of intent shall include:
(i) the rationale for the proposed elimination;
(ii) the financial impacts on the hospital both of maintaining the
service and of eliminating the service; and
(iii) a description of all possible alternatives to the proposed
elimination that were considered and the reasons they were not pursued.
(2) The Agency of Human Services shall evaluate the information
provided by the hospital in its preliminary notice of intent pursuant to
subdivision (1) of this subsection, the financial impact of the proposed
elimination on Vermont’s health care system, and the impact of the proposed
elimination on access to health care services in the region.
(3)(A) The Agency and the Green Mountain Care Board may consult
with a hospital that has submitted a preliminary notice of intent pursuant to
subdivision (1) of this subsection (a) regarding the proposed elimination in
order to explore opportunities to maintain the service or otherwise to address
the circumstances that prompted the proposed elimination.
(B) A hospital that is considering eliminating any service other than
those listed in subdivisions (1)(A)(i)–(viii) of this subsection (a) may choose to
provide a preliminary notice of intent to the Agency of Human Services and
the Green Mountain Care Board that includes the information described in
subdivision (1)(B) of this subsection (a) and to engage with the Agency and the

No. 146 Page 3 of 7
2026

VT LEG #390230 v.1
Board in the consultation process set forth in subdivision (A) of this
subdivision (3).
(4) All information and materials related to a preliminary notice of
intent and related consultation pursuant to this subsection, including all
materials provided by the hospital to the Agency or the Board, shall be exempt
from public inspection and copying under the Public Records Act and shall be
kept confidential, except that the Agency and the Board shall provide access to
information and materials related to the proposed elimination of a service
described in subdivisions (1)(A)(i)–(viii) of this subsection to the Office of the
Health Care Advocate, which shall not further disclose this confidential
information.
(b)(1) If a hospital elects to proceed with the proposed elimination of a
service described in subdivisions (a)(1)(A)(i)–(viii) of this section after
engaging in the processes set forth in subsection (a) of this section, then within
90 days after the hospital provided the preliminary notice of intent required by
subdivision (a)(1) of this section or upon the conclusion of the confidential
consultation process set forth in subdivisions (a)(3) and (4) of this section,
whichever occurs first, the hospital shall provide a notice of intent 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.

No. 146 Page 4 of 7
2026

VT LEG #390230 v.1
(2) The notice of intent required by subdivision (1) of this subsection
shall:
(A) explain the rationale for the proposed elimination;
(B) set forth a proposed timeline for the proposed elimination and a
transition plan;
(C) be provided not less than 60 days prior to the effective date of the
proposed elimination;
(D) be posted on the hospital’s website; and
(E) be published in a newspaper of general circulation in the hospital
service area within 10 days after notice is provided pursuant to subdivision (1)
of this subsection (b).
(3) In addition to the notice of intent required by subdivision (1) of this
subsection, the hospital shall conduct a public engagement process, including
holding one or more public hearings in the county in which the hospital is
located and soliciting and responding to public comments, regarding the
proposed service elimination. The public engagement process shall con