Representative Van Donahue wins committee approval to add disparity and reporting language to S.126

Representative Van Donahue told a legislative committee on May 20 that her amendments to S.126 aim to emphasize disparities in access and to add limited reporting for non‑hospital facilities to inform a statewide health delivery strategic plan.

"This amendment is really just about maybe clarifying the intent ... to highlight this priority issue in reducing disparities in access resulting from demographic factors or health status," Representative Van Donahue said, describing the first amendment as adding and relocating language to make reducing disparities an explicit goal of the bill’s statewide strategic plan.

She told the committee the amendment moves disparity language into the portion of the plan that defines a shared vision and goals instead of leaving it in an identification list, and that the change aligns with recommendations from the integration council. Van Donahue also urged attention to parity in reimbursement for mental health and substance use services, saying the lack of parity has contributed to service closures: "Central Vermont Medical Center, the reason the psychiatric inpatient unit closed was because it was losing money because inpatient psychiatry ... was funded at less than the cost of care." She cited the example of a state subsidy required to open an adolescent unit at Southwestern Medical Center.

Van Donahue’s second amendment would add a provision directing the Agency of Human Services, in developing the integrated statewide health delivery strategic plan, to determine "appropriate reporting requirements for health care facilities that plan to offer a new health care service, terminate a health care service, or establish a new health care facility to provide advance notice to relevant state entities." She characterized that requirement as an inventory or notice mechanism for the strategic plan, not a new certificate of need or new authority to block providers.

Committee members voiced mixed reactions. Mari said she supported the intent but worried about the broadness of the reporting requirement and the potential for AHS to create burdensome mandates without additional legislative oversight: "We don't know that AHS won't create any burdensome reporting requirements." The committee chair and other members described the proposed language as a way for the strategic plan to gain awareness of service openings and closures and as a tool for resource allocation and gap identification rather than direct regulation.

Representative Van Donahue offered concrete examples of the types of notice she expects: summaries such as a nursing home increasing bed counts or a substance use treatment facility planning to close or build new space, describing these as "summarizing the service or the project" so AHS can include them in the strategic plan.

The committee voted on Van Donahue’s first amendment; the chair recorded 11 members in favor. The committee then voted on the second amendment; the transcript records members expressing both support and concern about scope, and the chair announced the amendment was approved. Members asked that any reporting proposals from AHS be developed collaboratively with providers to avoid unnecessary burdens.

Why it matters: The amendments place disparities in access and parity for behavioral health reimbursement explicitly in the statewide strategic plan and direct AHS to design notice/reporting that could make openings and closures of smaller non‑hospital services visible to planners. That visibility could shape strategic decisions about resource allocation and highlight where access gaps exist.

What’s next: AHS is expected to incorporate the language into the strategic plan work and to develop recommended reporting practices; committee members requested follow‑up and cautioned that any substantial new reporting requirements would likely require additional legislative action.