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Committee reviews long-term-care rate study, Meals on Wheels boost and seeks details on pilot recovery campus
Summary
Members recommended implementing the 2023 long-term-care rate study in phases (roughly $6 million gross to reach study rates), discussed a proposed $2 million allocation to raise Meals on Wheels reimbursement, and sought more details about a $500,000 pilot recovery campus request.
The Human Services subcommittee discussed a range of aging and behavioral-health items on Feb. 12, including phased implementation of a 2023 rate study for long-term-care services, a request to raise Meals on Wheels reimbursement, and a pilot recovery campus proposal in the Health Department budget.
Presenters summarized the rate-study implementation: approximately $3.8 million general fund would bring ERC (elder residential care) levels 1' 3 up to the study targets, and an additional roughly $2.2 million GF-equivalent would cover personal care, respite and related services, for a combined approximate GF total just over $6 million to align with the 2023 study rates. Committee members also discussed a broader home- and community-based-services (HCBS) request to provide a 4% across-the-board provider increase; 1% was estimated at roughly $6.57 million gross, and a 4% increase was presented as approximately $12.1 million (committee members asked staff to confirm gross vs. GF shares and exact tallies for any final recommendation).
On home share expansion, a committee member proposed a targeted $235,000 GF investment to expand home-share options in the Northeast Kingdom to create additional housing options for older Vermonters.
The committee also considered a proposal to increase Meals on Wheels reimbursement. Presenters said nearly 987,000 meals were served last year at an average per-meal cost of $13.42; the current reimbursement is about $5.80 per meal. The committee discussed a $2 million GF addition that would leverage Medicaid match to raise reimbursement toward $10.20 per meal; presenters estimated the gross (matched) impact at roughly $4.8 million depending on the final match rate (the department cited a blended match of about 41.2%). Members asked for the meal-cost analysis and precise match calculations before acting.
Separately, committee members asked for more detail about a $500,000 one-time Health Department request listed as acquisition/fit-up for a pilot recovery campus. Members said the budget spreadsheets show the item in the one-time section and that it appears in the global-commitment/up-and-downs spreadsheet in a way that suggests potential Medicaid matchability, but they reported conflicting information from staff and asked for follow-up, including whether this project had been vetted by the Opioid Settlement Advisory Committee.
The committee also heard a small, one-year request of $40,000 from the Empty Arms peer-support program; members were inclined to consider it given the program's limited statewide availability.
No final appropriations votes were taken; staff were asked to gather exact cost breakdowns, meal-cost analyses, match-rate calculations and additional documentation on the recovery-campus concept and its engagement with advisory bodies.
