Leaders from the Vermont Agency of Human Services briefed the House Committee on Human Services on Oct. 12, 2025, outlining the agency's structure, budget and the role of Medicaid (the state's Global Commitment) and describing how services are delivered locally through district offices and community partners.

The briefing, presented by Jenny Samuelson, secretary for the Agency of Human Services, and other executive staff, explained that the agency comprises six departments plus a central office that houses health care reform and Medicaid policy.

"The Agency of Human Services' mission is to improve the conditions and well-being of Vermonters," Samuelson said. "Our vision is that Vermont is a place where all people have the opportunity to thrive in inclusive, equitable, and resilient communities." Samuelson also described the agency as the largest in state government by staff and total spending.

Why it matters: AHS administers a large share of the state's publicly funded health and social services. Officials said the agency spends about $1.3 billion in state general funds and approximately $5.2 billion across all funds and employs a little more than 4,000 people. Those resources and programs directly affect services ranging from Medicaid and long-term care to child protection, public health and corrections.

Key facts and programs

- Agency structure and central functions: Samuelson said the central office provides leadership, coordination and health care reform work, including the Office of Health Care Reform and the Medicaid director, which sit in central office to support cross-departmental programs and payment reforms.

- Medicaid / Global Commitment: Officials equated "Global Commitment" with Medicaid funding that the state matches with federal dollars and then distributes across departments. Monica Ogilby, identified as the state Medicaid director, and others described how Medicaid funds touch nearly every department: Department for Vermont Health Access (DVHA) operates enrollment and claims functions, while other departments administer Medicaid-funded programs.

- Department roles: The six departments described were: Department for Vermont Health Access (DVHA), Vermont Department of Health (VDH), Department for Disabilities, Aging and Independent Living (DAIL), Department of Mental Health, Department for Children and Families (DCF), and Department of Corrections. Samuelson and deputies emphasized that many departments wear "two hats": system planning and program delivery plus administering Medicaid-funded services.

- Local delivery and district offices: AHS staff noted there are 12 district offices statewide that provide local services and host public health nurses, case managers and other staff. The district-based teams include a small, flexible caseload model for complex cases (teams that typically manage roughly 25 intensive cases) to coordinate care across housing, mental health, substance use and primary care providers and to transition clients to a long-term care coordinator.

- Long-term care eligibility: Staff explained that eligibility for long-term care Medicaid combines a clinical assessment (handled by DAIL) and a financial eligibility determination (handled by DVHA). Alyssa Mullins described that clinical and financial components together determine long-term care Medicaid eligibility.

- Mental health and crisis services: The Department of Mental Health highlighted 24/7 crisis resources, including the 988 crisis line and mobile crisis teams that can provide in-person response statewide.

- Corrections: The Department of Corrections was described as a unified system with six facilities (five male, one female and one out-of-state facility) and statewide probation and parole supervision. A centralized training academy for correctional officers was noted.

- Department for Children and Families (DCF): DCF was described as the agency's broadest department with both direct child- and family-focused services (family services, child development) and financial programs (Office of Child Support, Economic Services Division, Office of Economic Opportunity, and Disability Determination Services).

Clarifications and follow-ups

- Budget detail: Committee members asked for a departmental breakdown that shows how Global Commitment (Medicaid) dollars flow into department budgets. Samuelson and staff said they would return shortly to walk through the budget in detail and that staff would provide a departmental budget breakdown before that session.

- SSDI/disability application data: In response to questions about constituent experience with Social Security Disability and the General Assistance program, staff agreed to have Commissioner Chris Winters and budget staff pull data on determinations and appeals to share with the committee.

- Service delivery partners: Presenters emphasized that many direct services are delivered by community providers such as designated agencies, visiting nurse associations, home health agencies and a workforce of personal care attendants rather than exclusively by state employees.

Quotes

"The benefits of the Agency of Human Services, within its six departments, is it's efficiently managed the delivery of health and human services," Samuelson said. "By putting the different services together within the Agency of Human Services, it allows us to collaborate across the boundaries of the department so that we are able to serve the whole community, the whole family, and the whole person."

"Global commitment equals Medicaid," Samuelson said when explaining how federal Medicaid funds are matched and distributed across departments.

Meeting outcomes and next steps

No formal committee actions or votes were recorded during the orientation. Staff committed to: (1) return with a detailed departmental budget breakdown and BAA briefing; (2) provide contact information for AHS leadership; and (3) compile and send data about SSDI/disability determinations and appeals at the committee's request.

Ending

Committee members thanked AHS leadership for the overview and were scheduled to receive a Budget Adjustment Act briefing from the Joint Fiscal Office after a short recess. The AHS presenters said they would be available to follow up with additional materials and with specific departmental briefings in coming weeks.