Committee hears $56 million FY25 budget adjustment request tied to long-term care, nursing facility utilization and worker wage policy

The committee discussed a fiscal-year-25 budget adjustment request that staff described as one of the largest line items in the current supplement: roughly $56 million tied to long-term care and disability services.

Committee members heard that the package reflects three drivers: increased days of care in skilled nursing facilities, collective-bargaining wage and bonus provisions for direct support professionals, and other utilization changes across developmental and residential services. Committee members said the single-year true-up is largely a response to actual utilization exceeding the amounts budgeted earlier in the fiscal year.

Why it matters: The presenters and members noted that specialty long-term care spending is high and that even small changes in utilization produce large dollar effects. Committee members said that a roughly 77,000-day utilization increase in nursing facilities was a large share of the request and that the high cost of skilled nursing means relatively modest bed changes can drive tens of millions of dollars in budget pressure.

Discussion points and context: Committee members repeatedly raised wage levels for direct support professionals. The presenters referenced a starting wage included in a collective-bargaining agreement of $14.75 per hour and bonuses tied to annual hours worked; members said that low wages contribute to staffing instability, closures of residential-care settings and downstream shifts of people into nursing facilities.

Members also discussed emergency financial relief (EFR) and whether repeated EFRs and nursing-home placements could be reduced by earlier investments in lower-cost residential supports. One member cited a prior estimate that 77,000 additional nursing-home days equate to roughly 213 staffed beds for a year, underscoring the scale of the fiscal impact.

What the committee did: Committee members discussed the matter at length and signaled they will examine the long-term policy steps (bills and the FY26 budget process) to address pay, residential care financing and the mix of community supports. No formal vote or final appropriation decision was recorded in the transcript excerpt.

Ending: Members asked staff for more utilization detail and caseload breakdowns for developmental services. They said they will take up policy options — including potential legislative language in the FY26 process — to reduce future unplanned budget true-ups.