Vermont award: $195 million from federal rural health transformation grant; state and providers press for clear rules and quick next steps

The Senate Health & Welfare committee heard on Jan. 14 from Agency of Human Services officials about Vermont’s award under the federal Rural Health Transformation grant and what comes next.

Jill Mazel Olsen, Medicaid and health systems director at the Agency of Human Services, and Sarah Rosenblum, interim director of health care reform at AHS, told the committee the Centers for Medicare & Medicaid Services set the notice of funding opportunity Sept. 15 and Vermont submitted its application on Nov. 5. "The rural health transformation grant is a $50,000,000,000 initiative from CMS," Olsen said; she reported the state received a $195,000,000 award.

Why it matters: the program is intended to modernize rural care by improving access, quality and sustainability, but it carries strict federal limits and an annual federal redetermination of each state’s award. Rosenblum said states must report yearly on spending and performance, so the $195 million is not guaranteed for the remaining years of the program.

Federal rules and deadlines: AHS told senators that some uses are expressly disallowed — the agency said, "We can't use it to pay for clinician salaries in general" and that the funds cannot be…