[{"_1":2,"_99":-5,"_100":-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],{"_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",6256505,"mediaKeyId","3155680-4d5fb47820ab412e166a813cb34cbc87","parentId",3155680,"title","State expands Meals on Wheels funding with Medicaid match; department reports early-quarter results","audioSeconds",542,"startMs",44000,"endMs",586000,"viewUrl","/Search/View?dp=1&key=3155680-4d5fb47820ab412e166a813cb34cbc87&start=44&end=586","thumbnailUrl","https://assets.pipeline.soar.com/3155680-4d5fb47820ab412e166a813cb34cbc87/thumbnail_44000.jpg","articleUrl","/articles/6256505/Vermont/State-expands-Meals-on-Wheels-funding-with-Medicaid-match-department-reports-early-quarter-results","mediaUrl","https://secure.pipeline.soar.com/6256505-84bf1b3fb63a5fae7e60956ec7f4ab17/orig.mp4?Expires=1771172340&Signature=Cypgvr0GWvYc5Z67qTczJdbFZDw7781fdEReYw~l6o91o588Twja7MjZ56rLOItDbAYxaKLFTR0vn04odPoe1E7QCJewNW0p78UxaH90RRtWnIS~iDi1ZWAOMXTePMRF8R47Jrrzwz-3ElLXOoEZIMj~omTR7q-KQifozsLHbKdNGihAoX~uIqRwc8~rr02mTYr75xv1y2XZ5mFJBzlr9msSvujNKW0oQhIwourLYPau0ZTQVIdfUP670uxqj6Zt0Onv9iWyXuza-z0vClZvA6Svhd~gEOCshf9LGc7gmXsPFApZMZ5YpAYp2Mc07Sd~VIPXifhH0Dc9sSmZfPQkkw__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-04-30T11:51:00.53Z","article","Dr. Jill Bowen, commissioner for the Department of Disabilities, Aging and Independent Living, told the Legislative Oversight and Accountability Committee that Vermont converted $1 million in state general funds into Global Commitment Medicaid funding for home-delivered meals in federal fiscal year 2025, creating a $2.4 million pool for Meals on Wheels and related services.

The change “added approximately $1,400,000 in federal match, which totaled $2,400,000 in the Global Commitment funding,” Jason Palapidas, State Unit on Aging director, said. He told committee members the Global Commitment grants run from Oct. 1, 2024, through Sept. 30, 2025, and obligate area agencies on aging to reimburse meal providers at a minimum of $6.50 per meal.

Why it matters: The Global Commitment conversion increases federal match for Vermont’s home-delivered meals program and imposes reporting and targeting rules intended to direct services to “the most food insecure” older adults. The size and durability of that additional federal match affect how many meals and what kinds of nutrition services Vermont can provide for older residents across the year.

Committee members pressed staff for figures and clarifications. Palapidas and Bowen said federal Older Americans Act dollars continue alongside the Global Commitment funds: federal fiscal 2024 included $1.8 million in Older Americans Act funding plus $1.3 million in state general funds for home-delivered meals. With the Global Commitment conversion, the department reported that in the first quarter of the Global Commitment grant nearly 3,000 older Vermonters categorized as the most food insecure received 86,000 home-delivered meals funded through that source. Across all funding sources in that same quarter the department reported serving roughly 4,193 people; in fiscal 2024 total recipients numbered 8,237 older Vermonters.

Palapidas described grant requirements: area agencies on aging must prioritize those unable to cook or obtain groceries and those at or below poverty, report quarterly on participants with three or more activities of daily living (ADL) needs or instrumental ADL needs, and may use grant funds for nutrition education, therapeutic or medically tailored meals, and food-safety certification for site staff and volunteers.

Several legislators asked whether the department will use the new reporting tied to Global Commitment to reallocate funding among area agencies on aging. Bowen said the department intends to analyze the new data but cautioned that any long-term allocation changes depend on whether Global Commitment funding continues beyond the current grant year. “We want to make sure that come Oct. 1, we actually still have the Global Commitment dollars,” Bowen said; if not, she said the state could revert to the fiscal 2024 funding baseline.

Legislators also sought clarification about eligibility and the data the department is collecting. Palapidas said the department is collecting ADL/IADL counts for reporting and planning, and that Older Americans Act eligibility remains broadly age-based (60 and older) while Global Commitment targeting focuses on higher-need recipients. Bowen and Palapidas said the department will provide additional details legislators requested, including the poverty threshold used in reporting.

No committee vote or formal policy change was recorded; members requested follow-up information on the allocation formula used to distribute the Global Commitment grants among area agencies on aging and on the precise federal poverty threshold used in the reports.

The department and Palapidas also cautioned that the Global Commitment match is a one-year grant for FY25 and that sustaining the larger funding level into future years depends on budget and Medicaid decisions.

Committee follow-up requests included: a copy of the Global Commitment quarterly report when available, a clear breakdown of how the $1.3 million in state funds was allocated in FY24 and how the $1.4 million federal match was distributed, and the methodology used to allocate funds among the state’s area agencies on aging.","mediaType","Video","parentTitle","House Human Services - 2025-04-29 - 1:00 PM","oneSentenceSummary","Dr. Jill Bowen, commissioner for the Department of Disabilities, Aging and Independent Living, told the Legislative Oversight and Accountability Committee that Vermont converted $1 million in state general funds into Global Commitment Medicaid funding for home-delivered meals in federal fiscal year 2025, creating a $2.4 million pool for Meals on Wheels and related services.","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},6256496,"Health department urges limiting expectations for proposed Rare Disease Advisory Council in H.46",213,3835000,4048000,"/Search/View?dp=1&key=3155680-4d5fb47820ab412e166a813cb34cbc87&start=3835&end=4048","https://assets.pipeline.soar.com/3155680-4d5fb47820ab412e166a813cb34cbc87/thumbnail_3835000.jpg","/articles/6256496/Vermont/Health-department-urges-limiting-expectations-for-proposed-Rare-Disease-Advisory-Council-in-H46","https://secure.pipeline.soar.com/6256496-251439491034d7594a48df27b0ec57c0/orig.mp4?Expires=1771172340&Signature=HTp4b5J3zbgV0uk3E5UED4k~~vAW8TZ5hL0SuMT8QKHLZsj3uJjfZpFrCJ0~1W5Y8DoI17WHe0fH83GuxNVtiP2AJZYvU88gGyVctkWzYcInJC~2HJurNrmH2pznbuN0bspbweJJzSG0pYlKCCq1byteLovY3vikBFdFizck9nuU5D~64~9G9HVD81hD6WZ8NaW-9RzqC4E5F9v67eUCOvitFnu1lC95UZKnsCJrBQs0J6EZ6-qEY8q58odbYBtebkB8K9rhKS~vkuoTFi2Z-i346yL5j753L56Pn7i210Ddhsc7LM46DFs4dZkAWZ4uXRxZsBVu5BqNUCeBSC6jqA__&Key-Pair-Id=KUT5TJCACFTXG","Kelly Dougherty, deputy commissioner of the Vermont Department of Health, told the Legislative Oversight and Accountability Committee that while the department supports the intent of H.46 to give the rare disease community a formal advisory platform, the bill’s required deliverables exceed what a volunteer advisory council can reliably accomplish without dedicated staff or resources.

Dougherty said the bill requires the council to “convene and conduct public hearings, create a needs assessment, provide testimony on pending legislation and rules, consult with experts and develop policy recommendations including newborn screening, and draft reports to committees” all within four meetings per year. She said those tasks require “a high level of policy, medical, and clinical expertise” and that the department can provide administrative and legal guidance (scheduling, open-meeting advice, web hosting, meeting space) but cannot perform the substantive research, policy or legal work on the council’s behalf.

Dougherty recommended changes to H.46 to make the list of activities optional (change “shall” to “may”) so the council can set a realistic pace and identify resource needs. She also told the committee that the department already hosts a Newborn Screening Advisory Committee with interdisciplinary membership (laboratory, hospitals, specialty clinicians, family representatives and payers) that advises the state newborn screening program on diseases to add and Vermont-specific testing logistics.

Committee members acknowledged that some items in the bill — such as broad health care affordability goals — overlap with other existing efforts and could be narrowed. Legislators and department staff agreed to continue drafting work that would pare back mandatory deliverables, cite the newborn screening advisory body where appropriate, and allow the proposed council to articulate its own priorities and resource needs.

No formal vote was taken. The department said it will provide written suggestions to the committee and work with the bill sponsors on revised language that reduces mandatory tasks and clarifies the department’s administrative role.","The Vermont Department of Health told the committee that H.46’s current list of required deliverables is unrealistic for a volunteer-based advisory council; the department recommended changing mandatory duties to optional and cited an existing Newborn Screening Advisory Committee as a related body",{"_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},6256501,"State program lets parents and other legally responsible individuals be paid as direct support under safeguards",774,2270000,3044000,"/Search/View?dp=1&key=3155680-4d5fb47820ab412e166a813cb34cbc87&start=2270&end=3044","https://assets.pipeline.soar.com/3155680-4d5fb47820ab412e166a813cb34cbc87/thumbnail_2270000.jpg","/articles/6256501/Vermont/State-program-lets-parents-and-other-legally-responsible-individuals-be-paid-as-direct-support-under-safeguards","https://secure.pipeline.soar.com/6256501-63cc0f1de0d923bb234304b8f798b6e6/orig.mp4?Expires=1771172340&Signature=YIqXR-PGDQaUQDK6ssnQyuuoVeEstInczwJ-e~wokmBYZagHUWYI9hISUIGpvkWpMiI2m1Qrir7fzAK0gxsuEW03byNhQlAFQPMFhzFzqfDiX0BQGyCdfnjkTW2mqCyqGCInvM3npuzVgTuS9l7sQyMS208C~nPVCHdXmjf8csi2hlChwwRVIScZeLZOl5uO70FZg2Uh8y7EayShVZbw1fz2fy~7zYVsXZdSTUMypxujnQY-Tis2kTV~u-tkA9P3Aduf6PIFg4Og8MvoYgRoHbui8XYsCz0F7BaJs1h~CF5hiw9x6PEw4H3jDG8bu4o6mNfclqTpDmmwUXJKFKwXrA__&Key-Pair-Id=KUT5TJCACFTXG","Jennifer Gervigan, Developmental Disability Services Division director for the Department of Disabilities, Aging and Independent Living, briefed the Legislative Oversight and Accountability Committee on a newly approved protocol that allows legally responsible individuals — including parents and private guardians — to be paid as independent contractors to provide authorized community or in-home supports for enrolled adults under specified conditions.

\"The legally responsible individual can be paid for the authorized community supports or in-home support services up to 40 hours a week,\" Gervigan said, describing the principal limit imposed as a safeguard by Centers for Medicare & Medicaid Services during the approval process. The protocol ties eligibility for payment to circumstances such as a lack of qualified direct support professionals, prolonged gaps in authorized services (50% or less of authorized services provided for 45 days or more), or complex medical, behavioral, or communication support needs.

The department said the arrangement was developed after public input and was approved under Vermont’s Section 1115 Medicaid waiver and Global Commitment authorities. Payments use the department’s fiscal/employer agent arrangement: legally responsible individuals are enrolled as independent contractors and paid through the state’s fiscal employer-agent software (ARRIS), with payroll controls intended to flag duplicative claims.

Gervigan described built-in quality controls: individualized review cycles for each arrangement, periodic in-home visits and disability quality reviews, opportunities for the enrolled adult to communicate privately with a service coordinator (and later conflict-free case managers), and annual reviews of appropriateness. The department said pay rates for the arrangements start at the collectively bargained minimum for independent direct support workers and are indexed to that standard; the department noted it can revise rates over time.

Department figures: the option has been available since about November 2024; as of the committee hearing there were 34 arrangements in place and nearly 2,000 paid hours since January. Of the agencies engaged, eight of 16 designated or specialized agencies have been working with families on this option; two-thirds of compensated hours were for in‑home supports rather than community supports, the department said.

Committee members asked about safeguards to prevent \"double-dipping.\" Gervigan said the state’s payroll vendor, ARRIS, uses software controls that flag duplicate payments for the same date and time for human review. Lawmakers also asked about whether the payments produce W-2s; department staff said recipients receive 1099s (independent contractor paperwork) and tax information through ARRIS.

Legislators raised concerns about the length, notice and nature of in-home or quality-review visits; the department said visits for individuals living with family generally should provide advance notice and not be limited to a brief, one-hour interaction, and that the program will follow up on complaints about specific encounters.

The department framed the change as a formalized, monitored option rather than a broad replacement for agency-provided services. Officials said the protocol is intended to preserve person-centered choices — including for people who prefer family-provided supports for privacy or complex needs — while adding safeguards and review cycles.","The Department of Disabilities, Aging and Independent Living described a new protocol allowing legally responsible individuals to be paid for authorized in-home or community supports under Vermont's 1115 waiver; the department reported 34 arrangements and nearly 2,000 hours paid since payments began in January","actionData","errors"]

Article not found

State expands Meals on Wheels funding with Medicaid match; department reports early-quarter results

Health department urges limiting expectations for proposed Rare Disease Advisory Council in H.46

State program lets parents and other legally responsible individuals be paid as direct support under safeguards