DAIL tells appropriations committee nursing-home costs and settlements drive most of its budget adjustment request

Department of Disabilities, Aging and Independent Living officials told the House Appropriations Committee on Jan. 18 that most of their budget adjustment request addresses rising Medicaid nursing-home bed-day costs, a request for extraordinary financial relief for several facilities, and a delayed cost settlement with the Vermont Veterans’ Home.

"Our mission is to make Vermont the best state in the nation in which to grow older, live with a disability with dignity, respect, and independence," Commissioner Dr. Rowan Jill Bowen said in opening remarks.

Bowen and agency staff summarized the department’s divisions and then walked the committee through the Budget Adjustment Act (BAA) items for the department. Agency witnesses described three large categories driving the request: (1) higher nursing-home Medicaid bed-day costs tied to rising utilization and higher acuity; (2) requests for extraordinary financial relief (EFR) to keep some nursing facilities solvent this fiscal year; and (3) a cost-settlement payment the state must make to the Vermont Veterans’ Home for a prior fiscal year.

DAIL officials told legislators the single-largest line in the department’s BAA related to nursing-home Medicaid bed-day pressures, which they quantified as roughly $24.5 million to address inflationary and utilization-related costs. Agency witnesses said those pressures reflect two trends: a return to pre-pandemic nursing-home utilization levels and higher…