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Long-term care providers urge rate increases, ask to include home-based services in FY26 budget
Summary
Representatives of long-term care providers, home-health agencies and the Long Term Care Crisis Coalition told the Senate Health & Welfare Committee they need higher Medicaid rates and inclusion of adult day and skilled home health services in rate adjustments.
Nursing homes, home-health agencies and community-based long-term service providers pressed the Vermont Senate Health & Welfare Committee on Monday to increase Medicaid reimbursement and expand rate adjustments to services not fully covered by the House budget.
Several witnesses said the House's funding would move many services partway toward the 2023 rate-study recommendations but left gaps. Jill Nazareth Olsen, executive director of VNAs of Vermont, said the House adds “about two thirds” of the money the field requested from an updated rate study and stressed that funding home-based alternatives helps keep people out of higher-cost institutional settings.
Molly Doonan, representing the Long Term Care Crisis Coalition and several housing organizations, told senators “housing is health care” and called for more funding to preserve SASH (Support and Services at Home) and for the SASH for All pilot that serves younger adults and families. She asked for a $400,000 request for that pilot.
Speakers requested that adult day and skilled home health be included in the 2% increase that community-based providers received in the House budget. VNAs provided a figure for skilled home health — about $1.84 million in general funds and $756,000 in federal funds for that change — but said the total for adult day services was “not specified” during the hearing while staff continue to reconcile technical spreadsheets.
Helen Maiden of the Vermont Healthcare Association, which represents nursing homes and assisted living, urged the committee to support the House approach to nursing-home payments that follow an established formula and to preserve access across communities. “The number one predictor of whether you need long term care services is age,” Maiden said, noting Vermont’s demographic trends.
Witnesses asked the committee to fund the rate-study updates and the 2% across-the-board increase for home and community-based services, and to add adult day and skilled home health where they were left out. Committee staff said they will consolidate written materials and cost sheets for appropriations consideration.
