Community providers press Senate Health & Welfare to include mental‑health, long‑term care and home health in statewide delivery plan

Simone Rischenmeyer, executive director of Vermont Care Partners, told the Senate Health and Welfare Committee on Feb. 26 that any statewide health care delivery plan must include community mental health, substance‑use and developmental disability services alongside hospitals and clinics.

Rischenmeyer said Vermont Care Partners represents the state's designated and specialized service agencies and that an integrated plan that omits community providers will not achieve the quality, access and equity goals described in the Act 167 report. She urged stronger language to require collaboration among the Green Mountain Care Board, the Agency of Human Services (AHS) and community providers and asked that community providers be named participants in advisory and evaluation roles.

The testimony followed from Jill Olsen, executive director of VNAs of Vermont, who described structural funding and workforce problems in home health and hospice that she said cannot be fixed by planning alone. Olsen said home‑health agencies operate largely on Medicare and Medicaid reimbursements and compete for staff against hospitals and retail employers. She told the committee Vermont home health agencies are being paid about 67% of Medicare rates on average and said her members requested $2,200,000 in the upcoming budget to bring long‑term care payments closer to cost. Olsen also repeated a 2023 state rate study finding that Choices for Care required roughly a 50% rate increase to reach cost; she said the state provided only a portion of that in a recent budget cycle.

Both witnesses urged clearer definitions in the bill about what services the statewide plan covers (community, clinic, hospital or all payers) and recommended asset mapping to align services across sectors so closures or hospital changes do not inadvertently reduce access to community‑based care. Rischenmeyer suggested the HIE steering committee be engaged to support integration of clinical and cost data and asked for careful attention to federal privacy rules when the bill directs data sharing.

Committee staff and senators asked clarifying questions about how the plan would interact with existing efforts including Act 167 hospital transformation work, CCBHC and home‑and‑community‑based services. Olsen urged the committee to prioritize rate studies (H.13 was mentioned as an upcoming rate‑study vehicle) and to consider dedicated state funding for long‑term care rather than relying on payment model changes alone.

The witnesses did not ask the committee to adopt specific statutory mandates beyond inclusion, clearer role delineation for community providers on advisory bodies and funding requests; no formal votes were taken during the testimony.

Rischenmeyer and Olsen said they will submit written recommendations and supporting details to the committee.