Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Developmental Disability Services topic
No spam. Unsubscribe anytime.
Self-advocates push H13 to stabilize Medicaid home- and community-based service rates; counsel outlines court ruling that may compel Agency action
Summary
Green Mountain Self Advocates urged the House committee to pass H13 to create predictable, cost-based Medicaid rates for developmental disability services, citing workforce shortages and the federal Medicaid access rule. Office of Legislative Counsel Jen Carvey summarized a Vermont Supreme Court decision finding the Human Services Board can order
Green Mountain Self Advocates representatives told the House Housing and Services Committee that H13 (referred to in testimony as H 13) would create a fairer, data-driven process to set Medicaid payment rates for home- and community-based developmental disability services.
Max Barrows, outreach director for Green Mountain Self Advocates, said long staffing gaps leave many people with disabilities without supports for months, and described having "no support staff" for 13 months after a longtime worker left. Karen Topper, a Green Mountain Self Advocates staff member, told the panel H13 would require regular rate reviews tied to cost data and federal rules and said the federal Centers for Medicare & Medicaid Services "access rule" (issued April 2024) requires states to review payment rates to ensure access.
Topper and Barrows argued that regular, transparent rate reviews will help agencies pay competitive wages, reduce turnover and increase access to employment for people who receive services. Topper said the state reports that 48% of people receiving services have jobs and pay taxes and that many more want to work but lack supports. Both witnesses described plain-language outreach and peer mentor work Green Mountain Self Advocates does to help beneficiaries understand rights under home- and community-based services.
Office of Legislative Counsel Jen Carvey summarized a Vermont Supreme Court decision arising from a Human Services Board case (cited in the transcript as the appeal of "Kilometers") that the court issued last fall. Carvey said the high court reversed the Human Services Board's dismissal of a petition by a beneficiary who alleged decades-long underprovision of hours; the Supreme Court concluded the board has authority to order the Agency of Human Services to provide prospective benefits to an individual when the agency has not furnished services with "reasonable promptness" under federal and state Medicaid law. The opinion, Carvey said, explained that although statewide workforce shortages can make compliance difficult, the board may still order individualized relief and remand matters to the Board for further proceedings.
Committee members discussed whether the Department of Vermont Health Access or Agency of Human Services has submitted implementing bill language; Carvey and members said the department had not provided proposed language to the committee at the time of the hearing. Members also discussed the contractor the state uses for rate reviews (named in testimony as Burns and Associates, under a replaced name), whether other Medicaid provider types should receive the same periodic review, and whether substance use providers who bill Medicaid should be included in any review established by H13.
Witnesses described prior practice in which nursing home payment rates were adjusted annually after cost studies, and they urged that community-based Medicaid providers receive a comparable cycle of review so agencies can budget, raise wages and retain staff. No formal votes were taken; committee members scheduled follow-up hearings with designated agencies, legal-aid representatives and other stakeholders and said they plan to mark up H13 in committee in the coming days.
