Committee prioritizes implementing 2023 rate study and boosts for community-based services

House Human Services reviewed proposed budget changes for home- and community-based services, recommending implementation of the remaining FY2023 rate-study increases and a mix of ongoing and one-time investments to shore up providers.

The discussion focused on completing funding tied to a 2023 rate study, raising reimbursement levels for services such as enhanced residential care (ERC) and personal-care/homemaker/respite services, expanding a HomeShare program into the Northeast Kingdom, increasing Meals on Wheels funding, and considering targeted one-time support for adult-day centers facing revenue loss from participant absences.

Why it matters: committee members and presenters said community-based providers face cost pressures from inflation, workforce and administrative fee increases that are built into state employee budgets but have not historically flowed to private or nonprofit providers. Members framed implementation of the 2023 rate study as a priority to reduce systemic inequities and stabilize services that support older Vermonters and people with disabilities.

What was proposed

- Implement FY2023 rate-study recommendations: Presenters recommended finishing the multi-year implementation that updates provider rates to the cost levels identified in the 2023 rate study. They proposed a $3.8 million general-fund increase to bring enhanced residential care (ERC) up to the 2023 rate levels and an additional $2.2 million for personal-care, homemaker and respite/companionship services; together these were presented as the top priorities to complete the 2023 rate-study adjustments.

- HomeShare expansion: Presenters proposed funding to expand HomeShare into the Northeast Kingdom to increase housing matches that help older Vermonters and people with disabilities remain housed. Presenters cited current statewide matches (about 274 unduplicated matches historically) and said uptake in a new region would depend on local start-up capacity; the number of expected matches in year one was not specified in the presentation and presenters said first-year uptake may be lower as programs ramp up.

- Meals on Wheels: The presenters proposed adding $2,000,000 general fund (about $4.85 million gross when accounting for…