Vermont aging and disability agency outlines services, housing pilots and workforce challenges

Dr. Susan Bowen, commissioner of the Department for Disabilities, Aging, and Independent Living, told the Senate Health & Welfare Committee on Jan. 28 that the department’s mission is “to make Vermont the best state in which to grow old or live with a disability, with dignity, respect, and independence.”

The presentation summarized the department’s five divisions and program volumes, described recent successes including housing pilots funded under Act 186 and the September 2024 opening of Mission Care in Bennington, and flagged persistent workforce shortages across long-term-care and home-and-community services. The session included data on service volumes, licensing and adult-protective-workload increases, and questions from committee members about benefits work incentives and veteran benefit bills.

Dr. Bowen and division leaders said the department is heavily federally and Medicaid funded and complies with multiple federal and state mandates, including the Americans with Disabilities Act, the Older Americans Act, the Olmstead decision and CMS rules. Dr. Bowen described the department’s guiding principles and said the agency seeks to strengthen the continuum of care while enabling Vermonters to “choose where they receive supports and services and to be fully included as members of their communities.”

Angela McMahon, interim director of the Adult Services Division, gave program-level figures: approximately 48,000 people received Older Americans Act services last year, more than 8,000 received home-delivered meals and more than 6,000 received Choices for Care services across settings. McMahon said Older Americans Act services serve residents age 60 and older with no income test and rely heavily on volunteers for meal delivery. She told senators that roughly 12 adult day programs are currently operating statewide and that some sites closed during the COVID-19 pandemic have not yet reopened.

Jennifer Garabedian, director of the Developmental Disability Services Division, presented unduplicated counts for home-and-community-based services (over 3,000 people) and service-specific counts including flexible family funding, family-managed respite, and a guardianship caseload. Garabedian said the Act 186 housing pilot has produced four projects (one already serving residents under the Riverflow model) and that other pilot projects in the Upper Valley, Waterbury and Randolph areas are moving toward completion in the next 18–24 months.

The department described Mission Care in Bennington as Vermont’s first complex-specialty care facility for people with high medical and behavioral needs; officials said Mission Care opened in September 2024 and is admitting residents who had been held in hospital beds while awaiting appropriate placements. Joe Nelsbaum, director of the Division of Licensing and Protection, reported that survey and certification staff conducted 266 on-site investigations in the last year drawn from nearly 500 complaints and self-reports, and that Adult Protective Services received almost 4,000 reports and completed over 400 investigations and assessments in fiscal year 2024.

James Smith, deputy director of HireAbility Vermont, described employment and transition programs: HireAbility served nearly 7,000 individuals in state fiscal year 2024 and runs a pre-employment transition services program for high-school students (federally mandated to receive at least 15% of certain funds). He also highlighted an opioid employment pilot that has received settlement funding to expand work connecting people in recovery with jobs.

Committee members pressed division leaders on workforce shortages—particularly for licensed nursing assistants, nurses, and direct-care staff—and on the financial rules that can limit supplemental earnings for people receiving federal benefits. Officials recommended using certified work-incentive counselors and ABLE accounts where appropriate and offered to provide individualized follow-up for constituents. Senator-level questions also raised pending legislation on veteran income-tax treatment and broader questions about adequacy of benefits when older Vermonters move into long-term care.

The hearing closed with the committee asking staff to circulate reports (including the APS report) and to continue follow-up conversations on workforce and benefit questions. No formal votes or committee actions were recorded during this briefing-style session.