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Appropriations reviews rate study funding to shore up home and community‑based services
Summary
Committee members heard that a Medicaid rate study showed residential care rates far below cost and the Human Services committee is proposing $4.4 million to finish implementing rate increases and additional funding for HomeShare, Meals on Wheels and other home‑and‑community services.
The Vermont House Appropriations Committee heard testimony March 11, 2025, from the House Human Services Committee about funding to implement a Medicaid rate study for home‑and‑community‑based services and a set of preventative programs aimed at keeping people in their homes.
Theresa Wood said a rate study completed in fiscal 2023 found several home‑and‑community service rates were substantially below cost; the committee described the residential care rate as roughly 79% below cost and said the state has lost dozens of residential care homes. Wood said the governor’s proposal would fully fund the remaining phase of the rate study with $4,400,000 in general funds, funds eligible for Global Commitment.
Committee members discussed the goal of the funding: to slow closures of residential care homes and to help providers recruit and retain staff by boosting wages so they can keep people in home‑based settings rather than nursing facilities. Staff and members said implementation occurred in year 1 of a planned three‑year approach but that year 2 saw no changes, increasing urgency for the proposed FY26 funding.
Wood also described smaller, preventative programs: HomeShare, a low‑cost program that matches homeowners and household seekers, would receive funding to expand into the Northeast Kingdom and serve roughly 100 people; Meals on Wheels would receive an additional $2,000,000 general fund and $4,850,000 in Global Commitment funds to raise average state and federal reimbursements to about $10.65 per meal against an average delivered cost of $13.43; and an $800,000 one‑time request to stabilize adult day centers for allowable absences.
The committee noted a $5,800,000 budget line for conflict‑free case management required by federal rules; Human Services said the administration budgeted for a full year of implementation but that some developmental disability contracting may delay spending until later in the fiscal year, producing a one‑time savings.
Why it matters: legislators framed these investments as preventive, less costly alternatives to nursing home placement, and as measures to stabilize a provider network that has been under severe financial pressure.
No formal appropriations were adopted at the hearing; members asked for additional fiscal detail and implementation timelines from the Department of Disabilities, Aging, and Independent Living and the Agency of Human Services.
