Appropriations briefing highlights nursing‑home instability, workforce pressure and BAA requests for direct‑care bonuses and emergency aid

The appropriations committee heard a Budget Adjustment Act (BAA) briefing from the Department of Disabilities, Aging and Independent Living (DAIL) that detailed a package of adjustments including $2,396,001 in appropriations for direct‑care worker bonuses and an emergency financial relief (EFR) ask for nursing homes of $14,500,000. Commissioner Bridal, presenting for the department, said the department is starting a planning year to project long‑term needs and emphasized workforce pressures as the central problem.

"But the biggest one is still the workforce," Commissioner Bridal said, citing Vermont’s unusually high reliance on traveler and contract nursing staff. "In Vermont, it's now about 25%, and it came down from 30%," Bridal added, contrasting those shares with a national average of roughly 5 percent.

The presentation mapped the BAA line items across DAIL’s divisions and noted an internal service fund increase of $312,378 for the Agency of Digital Services (ADS). Commissioner Bridal said most nursing‑home costs shown in the submission were already reflected in the base budget; the additional uncovered difference for Choices for Care was identified at $963,267. The department also described other pressure items, including utilization and Medicaid day pressures.

Commissioner Bridal provided a five‑year history of EFR requests to illustrate recurring need: "In '22, it was 0. In '23, it was $9,300,000. In '24, it was $17,000,000. In '25, it was $21,000,000. Now this year, it's $14,500,000," she said, noting the current ask is lower than last year’s.

Beyond emergency aid, the department highlighted short‑term workforce supports and recruitment initiatives. A grant program focused on licensed nursing assistants (LNAs) reached 11 facilities in an initial round and impacted about 200 LNAs; 17 facilities received grants in state fiscal year 2026 and a formal report is expected in June. Commissioner Bridal also described a proposed use of civil monetary penalty funds, paired with federal matching under CMS, to support recruitment of LPNs and RNs—particularly in rural areas.

The presentation addressed rate‑setting mechanics and rebasing. DAIL staff said some cost categories are rebased on a two‑year cycle and others on a four‑year cycle; the pandemic affected prior rebases and the current rebase better aligns rates with recent costs. Division officials described the timing of cost reports and settlements as the reason some payments are recognized retroactively to FY2024.

Tracy O'Connell of the Department for Children and Families/Department of Human Services (DHS) explained a roughly $13.8 million ADS invoice will be parsed across departments as a net‑neutral adjustment; DAIL did not know its share when the base budget was originally built.

Committee members thanked presenters for a concise, four‑page summary and asked for continued focus on recruitment and the initiatives started this session; no formal vote or motion was recorded in the transcript. DAIL said it will continue stakeholder engagement as it develops a multi‑year plan and will report further in June.

The committee did not record a formal vote on the BAA in the provided transcript; next steps described were continued planning, stakeholder engagement and the June report on grants and program outcomes.