[{"_1":2,"_111":-5,"_112":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87,99],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6373531,"mediaKeyId","2145793-95e9326b62ffe43bee8160ddabbe0106","parentId",2145793,"title","Joint Fiscal Office explains CCFAP payroll-tax receipts and one-time revenue moves; childcare base not cut","audioSeconds",630,"startMs",6718000,"endMs",7348000,"viewUrl","/Search/View?dp=1&key=2145793-95e9326b62ffe43bee8160ddabbe0106&start=6718&end=7348","thumbnailUrl","https://assets.pipeline.soar.com/2145793-95e9326b62ffe43bee8160ddabbe0106/thumbnail_6718000.jpg","articleUrl","/articles/6373531/Vermont/Joint-Fiscal-Office-explains-CCFAP-payroll-tax-receipts-and-one-time-revenue-moves-childcare-base-not-cut","mediaUrl","https://secure.pipeline.soar.com/6373531-674b7265ed5e70811cf3c307d9ccfe49/orig.mp4?Expires=1777256810&Signature=Pgyqa836NNspSqdS5sXGThFJP03E3FPU3A1~VO7~Y4rqCtSr-Rjs4sxtTImJvO3Ev~VAP71moKvNsRvf7Mbw9C-Ka1WhAXaaXG9OU8KKQAx7wsAoh5gMeHr~kQ0S-GL2CEpB1rNwzuLFsDTaEPYAFA7o-QsBsAX-AxAZshw3vYh7~AKLyK66EOJfFvXE8xKMCVMCIOgWlFgqmNDsUiWuYzg3cS3d3X80JmXUUEnmlDFVjd4RtzNXxTB8w33GWf4P-QEgJZNXy1iqomjETR6yham8Ty1HydofjPw9CR7MkmLPeEHeBV5PYT7c9MOR4mk6798giMphsiUu-z24SUmIIA__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-01-24T04:24:34Z","article","Nolan Langwell of the Joint Fiscal Office returned to the committee to explain recent figures tied to the Child Care Financial Assistance Program (CCFAP) payroll-tax receipts and a proposed one-time swap of general fund and payroll-tax revenue in the FY25 package.

Langwell said there are two separate items often conflated in press coverage: a forecast increase and current-year collections. The first is an upward revision made in July to the payroll-tax revenue forecast that raised the expected receipts by roughly $13.1 million compared with the original budget assumption; the second number that has circulated (~$18.2 million) represents collections to date in the first quarter, not an additional permanent increase.

Langwell explained that the administration's proposed budget adjustment would, in part, use the additional payroll-tax receipts above the original budget estimate to replace general fund in the CCFAP appropriation for this fiscal year. He emphasized the swap is a one-time technical reallocation and does not cut the childcare base: the underlying child-care entitlement benefit and base appropriations were not being reduced. JFO staff said the economists continue to project that the payroll-tax receipts will reach the revised forecast and that the apparent timing differences (Q1 collections vs. full-year estimates) cause confusion in coverage.

Why it matters: Members and advocates had received outreach indicating child-care base funding was being cut; Langwell and staff were explicit that the childcare program's base entitlement is unchanged and that the proposal is a one-time swap of revenue sources in the current year budget.

Questions members raised included whether the tax-department implementation costs reduce the net benefit of the swap, and whether collection timing poses compliance or administrative costs. Langwell said those implementation costs exist but staff were clarifying how much had been appropriated or spent for tax department implementation and would report back.

Ending: Committee staff said they expect a short JFO memo with spreadsheet detail in the coming day; members asked that staff confirm the one-time nature of the swap and identify whether any implementation costs should be reflected in net available resources.","mediaType","Video","parentTitle","House Human Services - 2025-01-23 9:00 AM","oneSentenceSummary","The Joint Fiscal Office clarified that a roughly $13.1 million upward revision to CCFAP payroll-tax receipts and an $18 million-to-date collection figure refer to different things and that the proposed FY25 swap is a one-time reallocation that does not cut childcare base funding.","taxTitle","Human Services, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont","taxId",35147,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6373536,"Committee weighs extending winter emergency hotel program, uses of unspent GA funds and ReachUp one-time payments",3269,4411000,7680000,"/Search/View?dp=1&key=2145793-95e9326b62ffe43bee8160ddabbe0106&start=4411&end=7680","https://assets.pipeline.soar.com/2145793-95e9326b62ffe43bee8160ddabbe0106/thumbnail_4411000.jpg","/articles/6373536/Vermont/Committee-weighs-extending-winter-emergency-hotel-program-uses-of-unspent-GA-funds-and-ReachUp-one-time-payments","https://secure.pipeline.soar.com/6373536-e6ce72cf4e736ad4f9b633956e7fcfb7/orig.mp4?Expires=1777256810&Signature=g9wDD3lYC5IzJLqr6LPsa0fSurQQjtQ39iNY1EkcYM~CAb-WcN5QAe~Lq3yuB9YKRpPPs9GPfzmIiK84ybY310bKyNy2sgIViueXVsOklWk39d3M6wH9fD73L6-Be1meiFRggAHVWZvGV2DIXgbQEq7lM5f7whBuC7-LvDvU4Y7GYYr72VBNRjTT71IJJpJUWDrQjjNoNZCsa~91CZT2qYncyuSdnVEV-OE~G9pAb9W1mm8KXxbH8TlRxXYUsy7R0xsKK4ryfZh4oyOEQXu9I28uL5P073WakPTHdXLDYhGRsRZ0jvtQ2Zmv0Rk9rfwbtYR0vnf9KjGvfGe3ztXvcw__&Key-Pair-Id=KUT5TJCACFTXG","The House Human Services Committee discussed a package of economic-services items bundled for FY25 budget adjustment, including a proposal to reallocate a small General Assistance (GA) balance to extend emergency hotel placements, an option to remove the 80-day cap for certain vulnerable households through June 30, and a separate ReachUp one-time payment proposal.

Theresa Wood, committee chair, summarized the OEO and Economic Services recommendations and said a detailed memo and updated report would be circulated. Committee staff reported $351,627 available in GA that could be repurposed to the GA Emergency Housing Program; members discussed whether to apply those funds to extend hotel placements for vulnerable households who meet statutorily defined eligibility.

Why it matters: Committee members emphasized the population affected are among the most vulnerable: households with a member age 65 or older, households with documented disabling conditions (SSI/SSDI or verified by a medical professional), households with children under age 19, pregnant households, households experiencing domestic violence or the loss of a child or spouse, or households displaced by natural disaster or eviction. Staff said about 1,408 rooms are currently in use and recommended planning for a modest buffer to 1,425 rooms if the committee extends winter-housing provisions to June 30.

Other items under discussion:
- ReachUp one-time payment: Economic Services proposed distributing some or all of $499,995 in projected caseload savings as one-time payments to ReachUp households. Staff presented three options: $100 per household (leaving a small contingency), evenly splitting the full amount across all households (about $134 each), or distributing only to traditional ReachUp participants (about $152 each). Committee members generally favored option one ($100 per household) while keeping remainder as contingency in case of caseload variation.
- SNAP and program administration: Members agreed to prior-day recommendations to preserve SNAP administrative allocations and to avoid program disruptions.

Eligibility and verification: Committee members noted statute-language enacted last year defines who qualifies for hotel emergency housing under winter or emergency exceptions and requires medical verification for disability-based eligibility; multiple members asked for details about after-hours intake procedures (211) and verification protocols. Staff promised to invite 211 and DCF staff for follow-up questions.

The committee did not record a formal vote in the excerpted transcript. Members asked for an updated December/January report on GA balances and obligations, and staff said about $990,757 remained unobligated in the December 31 housing report; members asked whether any of that funding could be used before July 1.

Ending: The committee agreed to await a short DCF response on the unobligated funds and to return to the recommendations after receiving those numbers; if needed, the committee said it would forward alternative options for appropriations to the appropriations committee.","Members discussed OEO and Economic Services recommendations for the FY25 budget adjustment: using $351,627 in unspent General Assistance funds for emergency housing, possible short-term extension of winter hotel placements through June 30, ReachUp one-time payments, and SNAP administration adjustments.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6373541,"Committee hears $56 million FY25 budget adjustment request tied to long-term care, nursing facility utilization and worker wage policy",523,3812000,4335000,"/Search/View?dp=1&key=2145793-95e9326b62ffe43bee8160ddabbe0106&start=3812&end=4335","https://assets.pipeline.soar.com/2145793-95e9326b62ffe43bee8160ddabbe0106/thumbnail_3812000.jpg","/articles/6373541/Vermont/Committee-hears-56-million-FY25-budget-adjustment-request-tied-to-long-term-care-nursing-facility-utilization-and-worker-wage-policy","https://secure.pipeline.soar.com/6373541-d8c60b4c2d119ba0c1dd80a5144d41b1/orig.mp4?Expires=1777256810&Signature=YMpSHzGhz8B7zphDYIZiIj~LDD54HHptMRqs4sVicbLPgEN8VcTUJq323H5VUwtNY8F~-jGlxAVPL41JIMfGTQFBm3hkUuVxSkd3JhOEH2lxaneUxeKT~5eMFvJzw8BgRBSqk2ebBQja8jvg19hElynbJ3eTFiobnCUtFu5qB7gUuz1MkAMPs8XwJNCcYEMnV6pDtLlrF5npjFlQGapi1~GbVPBqgLl7zTDLOCMrwt7Kb0DcOfQgBKRy873n5zSALNqmtJWnRQ~Z0qXRP70LUtcEN2aa2aGL6t5ZlY~Y0Nwg5pskue9yNfxg8Ek~F5yQ~k-ZlTuZg2lwZQWh6edt7w__&Key-Pair-Id=KUT5TJCACFTXG","The committee discussed a fiscal-year-25 budget adjustment request that staff described as one of the largest line items in the current supplement: roughly $56 million tied to long-term care and disability services.

Committee members heard that the package reflects three drivers: increased days of care in skilled nursing facilities, collective-bargaining wage and bonus provisions for direct support professionals, and other utilization changes across developmental and residential services. Committee members said the single-year true-up is largely a response to actual utilization exceeding the amounts budgeted earlier in the fiscal year.

Why it matters: The presenters and members noted that specialty long-term care spending is high and that even small changes in utilization produce large dollar effects. Committee members said that a roughly 77,000-day utilization increase in nursing facilities was a large share of the request and that the high cost of skilled nursing means relatively modest bed changes can drive tens of millions of dollars in budget pressure.

Discussion points and context: Committee members repeatedly raised wage levels for direct support professionals. The presenters referenced a starting wage included in a collective-bargaining agreement of $14.75 per hour and bonuses tied to annual hours worked; members said that low wages contribute to staffing instability, closures of residential-care settings and downstream shifts of people into nursing facilities.

Members also discussed emergency financial relief (EFR) and whether repeated EFRs and nursing-home placements could be reduced by earlier investments in lower-cost residential supports. One member cited a prior estimate that 77,000 additional nursing-home days equate to roughly 213 staffed beds for a year, underscoring the scale of the fiscal impact.

What the committee did: Committee members discussed the matter at length and signaled they will examine the long-term policy steps (bills and the FY26 budget process) to address pay, residential care financing and the mix of community supports. No formal vote or final appropriation decision was recorded in the transcript excerpt.

Ending: Members asked staff for more utilization detail and caseload breakdowns for developmental services. They said they will take up policy options — including potential legislative language in the FY26 process — to reduce future unplanned budget true-ups.","Committee members reviewed a fiscal-year-25 budget adjustment tied to increased skilled nursing utilization, collective bargaining wage increases for direct support professionals, and concerns about residential care closures shifting people into higher-cost nursing homes.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_47":105,"_49":106,"_51":107,"_53":108,"_55":56,"_57":58,"_59":109,"_61":62,"_63":64,"_65":110,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6373547,"Joint Fiscal Office, AHS give committee a Medicaid 101 and outline Vermont's 1115 'Global Commitment authority",3598,2000,3600000,"/Search/View?dp=1&key=2145793-95e9326b62ffe43bee8160ddabbe0106&start=2&end=3600","https://assets.pipeline.soar.com/2145793-95e9326b62ffe43bee8160ddabbe0106/thumbnail_2000.jpg","/articles/6373547/Vermont/Joint-Fiscal-Office-AHS-give-committee-a-Medicaid-101-and-outline-Vermonts-1115-Global-Commitment-authority","https://secure.pipeline.soar.com/6373547-d73f5c7c765a593be4646da7a7f67a08/orig.mp4?Expires=1777256810&Signature=U63p2liG59~m6nVVkFnaJDchGhe~bPbvcOE4wjIMoqCFJSxUS6CLS5SB-I9JIJf02yvyfLvQJe4U40cSg8Cp56duVZiXXn6RipDEu9wDkDQ4ZSDvDm2jk8TAR8-Ni89cGMs0MS65VnGhJgJPsF63G1Upx5ks1ZP51OL-MESrhiiBQBzywHx84ke-U3z0Mlu6fCIS7Az3TLe0cnQungAQz1eN~wYdzVTCkYQNqn03goo0YO1HE0IArpx~YwBTbG5K9ybNRdEhJW7XtaPXH72zEbFol34y5asPd01fCnSKqYeiQjylo2TG0DuYr-yNa0k3jWXl0ChweFTfXKqBECBlkA__&Key-Pair-Id=KUT5TJCACFTXG","The Joint Fiscal Office and Agency of Human Services on Wednesday gave the House Human Services Committee a high-level briefing on Medicaid coverage, finance and Vermont's use of an 11-15 (1115) waiver known as Global Commitment.

Nolan Langwell, fiscal analyst with the Joint Fiscal Office, told the committee, \"Medicaid is very, very complicated,\" and outlined enrollment, spending and the federal-state match formula that pays for the program. Ashley Berliner of the Agency of Human Services described how Vermont's 1115 waiver funds services not otherwise matchable under federal law and creates flexibility for the state's Medicaid operations.

The presentation focused on why Medicaid matters to Vermont: about 197,000 Vermonters receive some form of Medicaid or CHIP assistance; roughly 151,000 people (about 23 percent of the state) have Medicaid as their primary coverage and another roughly 46,000 receive partial assistance such as exchange subsidies, the speakers said. Langwell warned that some of the data sources used in the slides are lagged, and that newer household-survey and expenditure-analysis numbers will appear in coming months.

Why it matters: Medicaid accounts for a large share of state health spending and the state budget. Langwell said Medicaid accounted for roughly 27 percent of Vermont's state budget in fiscal 2024 and about a quarter of health-care spending overall. Changes in the federal matching rate would therefore have immediate budget consequences for the state.

Key details from the briefing:
- Federal match (FMAP): Langwell explained that the federal medical assistance percentage is calculated from multiyear income comparisons and varies by state; Vermont's regular FMAP is about 58.8 percent federal to 41.2 percent state. \"For every $1 we spend on Medicaid, we get a dollar 43 in federal match for a gross total of $2.43,\" he said, characterizing the leverage that federal dollars give the state. He noted other FMAPs exist for CHIP and for the Medicaid expansion \"new adult\" group.
- Medicaid expansion/new adult group: Ashley Berliner and staff described the post-ACA expansion group (commonly called the new adult group) that provides coverage to low-income adults who are not categorically eligible under older rules. Vermont receives a 90:10 federal match for the expansion population; the speakers said about 41,000 people currently receive that match in Vermont.
- Mandatory vs. optional services: Berliner reviewed that certain benefits are mandatory under federal law and others are optional, and she stressed that many long-term supports (personal care, many developmental-disability residential services) are treated as optional federal benefits even though most states cover them. Vermont has adopted nearly all optional services and provides a broad benefit package through its program.
- 1115 Global Commitment waiver: Berliner described Vermont's long-running 1115 authority (in place since 2005, most recently renewed in 2022 and amended this month) that permits the state to obtain federal match for programs and payment approaches that would otherwise be outside traditional Medicaid rules. The waiver must remain budget neutral to the federal government and gives Vermont two major advantages: (1) it allows federal match for \"waiver-only\" services (examples the presenters listed included marketplace premium assistance, enhanced pharmacy wraparound benefits, pay-for-institutions-of-mental-disease stays at Brattleboro Retreat and the Vermont Psychiatric Care Hospital, and the new permanent supportive housing benefit); and (2) it permits the Department of Vermont Health Access to operate with managed-care-like flexibility (value-based payments, participation in all-payer models, and investment authority).
- Investments and caps: Berliner said investments are a distinctive tool in Vermont's waiver model: funds that would otherwise accrue to private managed-care margins instead can be reinvested in public programs. She said roughly $120 million is being spent on roughly 69 investments this year; those investments must meet waiver criteria, are subject to CMS approval, and now have state-side caps.
- New and pending programs: The presenters said the state has authority under the waiver to launch permanent supportive housing supports (including up to six months of rent and six months of medical respite for eligible Medicaid enrollees), but implementing that authority requires state match dollars and an implementation timeline. The presenters said implementation cannot begin before January 2026 at the earliest.

Committee members asked about timing of federal and state approvals for waiver changes, data lags in expenditure reports, the population counts for expansion subsidies and exchange subsidies, and how the investment authority is evaluated. Langwell and Berliner said the state will begin negotiation and renewal work in 2026 for waiver expiration in December 2027 and that the state has contracted with the University of Chicago to evaluate investments over several years.

The presenters urged members to remember the distinction between Medicare (a federal-only program) and Medicaid (a federal-state partnership) and to account for lagged source data when citing precise enrollment or expenditure numbers.

Looking ahead: Langwell and Berliner said renewal of the 1115 waiver will be a major policy negotiation in 2026 and 2027, and that the state must identify any state match for new waiver-funded services in upcoming budgets.

Ending: The committee thanked the presenters and said they might invite the fiscal office back for additional briefings on child-care finance and other budget items.","The Joint Fiscal Office and Agency of Human Services briefed the House Human Services Committee on Medicaid basics, federal matching (FMAP), and Vermont's 1115 Global Commitment waiver, emphasizing the program's scale, optional vs. mandatory benefits, and flexibility afforded by investments and waiver-only authorities.","actionData","errors"]

Article not found

Joint Fiscal Office explains CCFAP payroll-tax receipts and one-time revenue moves; childcare base not cut

Committee weighs extending winter emergency hotel program, uses of unspent GA funds and ReachUp one-time payments

Committee hears $56 million FY25 budget adjustment request tied to long-term care, nursing facility utilization and worker wage policy

Joint Fiscal Office, AHS give committee a Medicaid 101 and outline Vermont's 1115 'Global Commitment authority