Senate Health & Welfare weighs competing budget requests as revenue outlook weakens

Senate Health & Welfare members spent their April 15 session reviewing two consolidated spreadsheets of health- and welfare-related budget requests and signaling that primary care, long-term care and maintenance of home- and community-based services are likely priorities as the state faces revenue uncertainty.

The committee heard from Nolan of the fiscal office, who said the materials presented were draft work-in-progress and described the two sheets: “The first one has pink on the top, and that is for new requests that aren't already in the budget... The orange ... is stuff, requests that were already in the budget.” Nolan cautioned that the lists include duplications and are not ordered by priority.

Committee members repeatedly emphasized that the committee must balance requests for primary care support, long-term care and child-care programs against limited revenues. One member warned the appropriation process will require “cutting $80,000,000” from requests when the budget reaches the Appropriations Committee, and several senators urged the group to prioritize sustaining services that keep people housed and fed.

The group discussed several items contained in the house-passed budget or under active bills: SASH and Blueprint primary care transition funding (one-time $4.5 million, grossing to $10.8 million in global commitments), an increase in statutory nursing-home rates (roughly $6.3 million in general fund; $15.4 million global commitment), and a 2% home- and community-based-services increase (house figure discussed as about $2.8–$5.0 million net, depending on grossing assumptions). Nolan also flagged a proposed $4.4 million FQHC (Federally Qualified Health Center) rate increase and said it was unclear whether Rural Health Clinics (RHCs) would be included.

Members noted overlap among requests (for example, similar proposals from Maple Mountain residency and Gifford Health Center) and flagged items tied to special funds—most notably opioid settlement dollars and the child-care special fund generated by the payroll tax. The committee discussed whether the $19 million state share tied to the child-care payroll tax should be reserved for child-care purposes rather than redirected for other uses.

Committee members also reviewed smaller but locally significant requests, such as the Vermont 2-1-1 funding request and proposals for food banks, Meals on Wheels and cash assistance programs that support both food security and local farmers. Several senators said the committee should prioritize “keeping people alive” and preserving basic services in the near term.

Chair directions and next steps: members were asked to submit short bullets of priorities to the chair and Nolan ahead of a follow-up session scheduled for 10:00 a.m. the next day, when the committee hopes to consolidate recommendations to Appropriations.

Ending: The committee avoided final votes at this meeting and focused on positioning its priorities before Appropriations, with members repeatedly warning that federal and economic uncertainty will constrain future appropriations.