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Providers urge Senate to fund study and adjust payment methodology for community‑based services
Summary
Designated and specialized service agencies told the Senate committee that payment rates do not cover transportation, benefits and residential supports, destabilizing capacity; witnesses urged a formal study and a targeted work group to address high‑acuity populations and staffing shortages.
Witnesses representing Vermont Care Partners and regional designated agencies told the Senate Health & Welfare Committee on March 12 that S194 should be amended to direct a formal study of payment methodologies and to ensure AHS sets rates that reflect the full cost of community‑based services.
Kelsey Stavsth, executive director of Northeast Kingdom Human Services and co‑president of Vermont Care Partners, said agencies in rural areas “drove over a million miles” last year to transport clients to jobs and appointments and that those transportation and benefit costs must be included when setting rates. She said recent reforms—CCBHC designation work, developmental services (DS) payment reform, and new conflict‑free case management federal requirements—have compounded revenue pressure and, for some providers, created bottlenecks and potential destabilization.
“We often get referrals from primary care, hospitals, first responders, including law enforcement, and we can be the last stop before inpatient or higher levels of care,” Stavsth said, describing community agencies’ role in preventing higher‑cost interventions.
Amy Johnson of Vermont Care Partners said the coalition will submit suggested study language and called for a work group that includes AHS/DMH, the Developmental Disabilities Council, people receiving services and family members. The proposed study would inventory services provided by DAS and SSAs, review statutory and contractual frameworks, analyze workforce capacity and administrative burden, and identify essential services and sustainability gaps.
Committee members asked whether draft language could jeopardize Medicaid eligibility; staff said the administration had submitted a memo identifying concerns and the committee should consider study language before enacting program changes. The committee did not vote on S194 and planned to consider amendments and written agency comments at the next meeting.
Next steps: providers will submit written language suggestions and the committee will reconvene the following day to consider amendments.
