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FQHC leaders tell House they need more primary‑care funding, flexibility in Blueprint under S197
Summary
Leaders from Vermont federally qualified health centers testified in support of S197, urging greater primary‑care investment, alignment of quality metrics across payers and flexibility in the Blueprint for Health to recognize FQHC reporting. Witnesses warned that current funding uncertainty and staffing costs threaten services in rural areas.
Chris Town, CEO of Northern Counties Healthcare, told lawmakers on April 8 that his network of federally qualified health centers serving Vermont’s Northeast Kingdom supports S197 and additional investment in primary care. Town said Northern Counties serves roughly 40% of the region through a mix of primary‑care, dental and behavioral‑health sites, and that “investing in primary care…saves cost” for the wider system. He urged flexibility in eligibility for Vermont’s Blueprint for Health so that FQHC reporting and federal quality metrics can be used alongside NCQA recognition.
Town described ongoing financial pressure: his organization reported negative operating margins, heavy payroll costs (about 75–80% of expenses), and uncertainty created by the dissolution of OneCare Vermont and gaps before a successor payment model is implemented. He said a Medicaid rate adjustment last year provided important relief but that continued, predictable investment is needed to avoid cutting staff or services.
Committee members asked how many sites Northern Counties operates and whether Blueprint payments vary by location. Town said the network includes five patient‑centered medical homes, two walk‑in clinics, three dental sites and a certified home‑health agency; he said some programs pay by improvement or outcome while others provide the same rate across sites, and he pledged to provide detailed site‑level payment data to the committee.
Lawmakers pressed Town on aligning quality metrics across payers to reduce administrative burden. Town and questioners agreed that differing payer requirements — including multiple Medicare ACOs and market plans — increase reporting time and cost for small rural centers. Town recommended work to harmonize metrics so providers “are all rowing in the same direction.”
The testimony included requests that the Legislature preserve flexibility in any Blueprint redesign to account for different community needs (for example, remote areas with limited transportation) and to continue targeted funding that recognizes non‑billable care coordination and community health‑team work that supports patient outcomes.
The panel did not take votes on S197 during this testimony; the committee indicated it will continue deliberations on primary‑care reform and payment design in later sessions.
