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AHS: corrections increasingly a healthcare site; Medicaid reentry authority cleared under waiver
Summary
Agency of Human Services Secretary Jenny Samuelson and Medicaid Director Monica Ogilby told legislators on Jan. 29 that corrections functions in Vermont now include significant healthcare delivery and that the state secured Section 1115 waiver authority to expand reentry planning.
Agency of Human Services leaders told legislators on Jan. 29 that Vermont’s Department of Corrections is a significant healthcare provider and that recent federal waiver authority will let the state do more to coordinate care for people reentering the community.
"The Department of Corrections actually is a significant healthcare provider," Secretary Jenny Samuelson said, noting corrections contracts with outside vendors as well as the use of local hospitals for care. Samuelson and Medicaid Director Monica Ogilby described programs to link incarcerated people to community providers, including medication‑assisted treatment and other chronic‑care supports.
Ogilby said the state received federal permission in its Section 1115 Medicaid waiver to expand outreach to people expected to reenter the community—allowing case management and connections to housing, medical care and other supports in advance of release. Ogilby described this as a reentry authority that the state plans to operationalize in 2026: "we just got authority to do it…we're really hoping that we'll see this take shape more in 2026," she said.
Samuelson described prior work under the Vermont Chronic Care Initiative (VCCI) that targeted patients with complex health and psychosocial needs; that program, she said, provided a basis to expand reentry planning to additional populations. Officials emphasized the goal of ensuring continuity—making sure individuals on medication‑assisted treatment, for example, are connected to community providers before release.
Asked about the private correctional health vendor, Samuelson said Vermont has not seen service disruptions in the state despite Wellpath’s national reorganization under Chapter 11. "We have not seen any disruption in healthcare services here in Vermont," she said, adding that AHS has not observed operational interruptions and that the vendor has cooperated with the state to address issues as they arise.
No formal action or vote was taken during the briefing. Staff said operational plans and timelines for the new reentry uses of Medicaid will be developed and reported back; Ogilby indicated the program would be phased in after federal approval and operational planning.
Less critical details: officials described that many people who enter corrections have short stays, creating both opportunities and logistical challenges for arranging community care; they cited examples of long hospitalizations for a small number of patients (more than a year in some cases) that underline the complexity of transitions between hospitals, skilled nursing and corrections settings.
