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Behavioral‑health agencies cite staffing, paperwork and funding shortfalls and seek a 6.2% Medicaid rate increase
Summary
Vermont Care Partners told legislators agencies have vacancy rates and administrative burdens that hinder care delivery, and leaders asked for a 6.2% Medicaid rate increase to cover an overall 5.2% projected expense rise.
Leaders from Vermont Care Partners told lawmakers at a Jan. 29 State House presentation that workforce shortages, administrative burden and a widening gap between costs and reimbursement threaten behavioral‑health access across the state, and they asked for a 6.2% Medicaid rate increase to cover a projected 5.2% rise in operating expenses.
Simone Rishmeier, executive director of Vermont Care Partners, described the network as a core component of Vermont’s safety net: the agencies served roughly 35,000 clients and up to about 50,000 people in total last year and together employ about 6,000 people, she said. “We have a vacancy rate of up to 12.5%,” Rishmeier said, adding that turnover and burnout remain significant concerns.
Panelists described efforts to reduce clinical no‑show rates and improve access, including same‑day access models, centralized scheduling and expanded urgent‑care programs that cut children’s waitlists from a year to three months in some catchments. But they said these gains are fragile. Agencies presented financial slides showing that agency cost increases have lagged consumer price index movements and other inflation drivers, leaving a shortfall compared with prior fee increases.
Manili (identified at the hearing as chief financial officer at the Howard Center) summarized financial indicators, including days‑cash‑on‑hand figures. He said the system average is about 63 days on hand and that agencies prefer to be nearer 90–100 days. The presenters said cash reserves rose temporarily during the pandemic but are now back toward pre‑COVID levels.
Vermont Care Partners’ CFO group recommended a 6.2% Medicaid rate increase based on an itemized projection that includes a 4.8% salary increase (Bureau of Labor Statistics), a projected 13.5% increase in health insurance, a 6.2% increase in fringe and a 3.3% rise in other operating costs tied to the new annual CPI. The presenters characterized the request as necessary “to keep the lights on.”
Speakers noted payer‑mix challenges: Medicaid covers most of the full continuum, but private insurers and Medicare do not reimburse certain community supports and case management at parity. Presenters urged lawmakers to consider policy or funding changes to stabilize staffing and support nonbillable preventive work.
Ending: The group asked legislators to consider the rate request during the current budget process and to support measures that reduce administrative burden and shore up workforce retention.
