Beginning July 1, 2024, employers and self-employed individuals are required to pay the Vermont Child Care Contribution tax. Act 76 (H.217), an act related to child care and early childhood education, became law on June 20, 2023. The law makes major investments in Vermont’s child care system, and mandates policy changes that will impact child care in both early childhood and school-age settings.
The law makes major investments in Vermont’s child care system.
By the end of 2024, thousands more children and their families may be eligible for free or reduced tuition.
Per Act 76 of 2023, enacted by the Vermont Legislature, employers will pay a 0.44% payroll tax on wages paid, with an option to withhold up to 25% of the tax from employees. Self-employed individuals will pay a 0.11% tax on self-employment income.
Employers will remit Child Care Contribution payroll tax payments to the Dept. in the same manner and frequency as they remit Vermont Income Tax Withholding, with quarterly reporting on the WHT-436 Quarterly Withholding Reconciliation. Self-employed individuals will pay the self-employment Child Care Contribution when filing their 2024 Vermont personal income taxes in calendar year 2025.
Employees may see information related to the tax on their paychecks beginning after July 1. Information may include the portion of the tax that their employer has chosen to withhold and the employer-paid portion.
For more information, visit: tax.vermont.gov/business/child-care-contribution.
to the news release from RRMC.
There are a number of criteria that must be met in order to be awarded the Blue Distinction Center for Maternity Care, including that the facility has an internal quality improvement program; uses a standardized obstetric hemorrhage emergency management plan; uses standardized protocols for management and treatment of key severe maternal morbidity events (severe hypertension, eclampsia, seizure prophylaxis, and magnesium overdosage, as well as postpartum hypertension and preeclampsia); and safely reduces the number of cesarean section births. This effort is combined with other factors that include regular emergency drills and preventative measures.
Over the past four years, RRMC’s Women and Children’s Unit and Birthing Center has decrease cesarean and episiotomy rates, decreased obstetric complications, and increased breastfeeding rates. Last year, the hospital also expanded their care team to include midwifery.
This didn’t happen by chance. Working with Blue Cross VT’s quality metrics, RRMC’s Birthing Center set goals across their entire team to systematically improve the health outcomes of babies and birthing patients. They took the feedback from their initial application, worked on the gaps, and then reapplied. The Blue Distinction affirms the measurable results of their efforts.
“People struggle with change. So, when you have a complex organization with many different people moving in many different directions, it takes a lot of intention for a change agent to implement something,” RRMC said in a statement.
For a complex organization to implement changes that result in demonstrable quality improvement, data and learning from best practices are both key. The year before Romine was named the director of the Women and Children’s Unit, the team applied for the Blue Distinction designation and didn’t get it. They looked at the data and dug into innovative practices and policies nationally.
The real time data exchange helps to incentivize a little friendly competition and the entire team takes pride in improving their rates.
“People struggle with change. So, when you have a complex organization with many different people moving in many different directions, it takes a lot of intention for a change agent to implement something,” RRMC said in a statement.
“If we don’t know how many first-time moms are having C-sections, and why they’re having those C-sections, how can we change what we’re doing? So, to think about this as a learning opportunity for other hospitals, you can look at something like C-section data and move the needle,” Romine stated
There are supportive perinatal quality collaboratives that have published toolkits, such as the California Quality Maternal Care Collaborative or the Northern New England Perinatal Quality Improvement Network, a program from Dartmouth Health. Also, reviewing charts monthly in provider committee meetings through Vermont Child Health Improvement Program and attending quality conferences builds collaborative support across facilities which can improve outcomes. “It’s really a collaborative open sharing environment. It’s so nice to connect to peers outside of the confines of each hospital. There’s no reason to reinvent the wheel,” Romine added.
Another strategy for change is finding an ambassador in each service area.
“You get their buy-in by getting support from a champion, whether it’s another nurse or an obstetric doctor, or a midwife, and then you bring in other people and eventually you have a great program. Change is hard. You need these ambassadors because if you go in as a leader and say, ‘we’re going to do this change,’ people are going to resist and it’s not going to get done. So, you can’t just dive right in. You have to go at it in a roundabout way and engage everybody as a team.”
