Vermont Care Partners, DAs and SSAs tell Human Services committee crisis in IDD residential and crisis supports is acute

At a meeting of the Vermont House Committee on Human Services, representatives of Vermont Care Partners and regional designated agencies (DAs) and specialized service agencies (SSAs) described a strained system for intellectual and developmental disability services and urged careful planning as the state implements payment and case-management reforms.

Vermont Care Partners’ Amy Johnson, Vermont Care Partners director of government affairs, framed the presentation as an overview of DA and SSA roles and the services they provide across Vermont. "We're grounded in the philosophy of home and community based care," Johnson said, adding that agencies offer prevention through crisis services and support people in homes, schools and communities.

The presentation emphasized why the Home and Community Based Medicaid waiver matters. Delaney Nordin, executive director of Champlain Community Services, described the waiver as a federal-state blend created after Vermont closed institutional care: "the waiver is designed to meet all the other needs that no other programs are able to actually meet," Nordin said. Nordin and other presenters explained that eligibility requires clinical assessment, Medicaid financial eligibility and that applicants meet a state funding priority.

Gloria Quinn, executive director of Upper Valley Services, described the range of residential supports and how Vermont currently serves people with IDD. "We are the only county that has a sister agency that provides the mental health substance use. So we are really designated for IDD, serving folks with IDD," Quinn said. Speakers said Vermont serves just under 4,000 people on the waiver systemwide, with about 1,500 receiving some level of home support. The most common model is the shared-living provider model; supervised and staffed living and a small number of group homes also exist.

Committee and agency speakers said system strains have grown acute. Rachelle Schumacher (staff member) and other presenters described escalating need driven by aging shared-living providers and families, housing shortages and workforce gaps. "People work round the clock within these agencies and we all do everything," Schumacher said, adding that agencies have opened additional crisis capacity. Upper Valley Services reported expanding crisis bed capacity from three to five because of demand.

Speakers warned that several system changes are arriving simultaneously: conflict-free case management (a federal mandate) and a redesigned payment system under state reform. Presenters said the timeline for both shifts is aggressive and urged care to avoid destabilizing people who currently have stable housing and supports. "Whoever is doing well in those situations should stay in those situations, because there really isn't anything else," one presenter said.

Committee members asked technical questions about eligibility and financing. A staff speaker who identified herself as Elena O'Rourke summarized eligibility steps: clinical determination of disability, Medicaid financial eligibility, and meeting Vermont’s funding priorities. Agency presenters said the priority process is high; they estimated roughly eight funding-priority categories, with many applicants routed by an unmet health-and-safety need.

Presenters listed gaps in mental-health services for people with IDD and high rates of co-occurring mental-health conditions: the group cited an estimate of about 47% statewide and locally higher rates (about 60% in one agency). They also said trauma and other health conditions are common among people served. Agency representatives said repeated moves, loss of a provider or the collapse of a placement can cause traumatic instability.

No formal votes or motions were taken at the session. Committee staff asked agencies to supply additional data in advance of budget deliberations and legislation; presenters agreed to provide requested figures, including the percentage of authorized and funded services that are actually delivered and additional impact-report data.

The briefing concluded with scheduling notes: agencies will be asked to testify on H.13 (the Medicaid rate bill) and will be invited back for budget hearings. Presenters said they are willing to return for follow-up sessions.

Ending: Committee staff said they will circulate further materials before budget work begins and thanked Vermont Care Partners and the agencies for presenting.