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Committee reviews budget construct to preserve primary care payments, reallocate opioid-settlement funds and boost Meals on Wheels
Summary
Members and staff discussed edits to FY2027 appropriations to protect supplemental primary care payments, consider moving opioid-settlement dollars into one-time funds, and restore a $125,000 Meals on Wheels line, with staff warning CMPM payments could conflict with 'HR 1.'
Committee members and staff on the Governors committee on H 9 51 reviewed a budget construct intended to preserve supplemental payments to primary care providers while shifting some opioid-settlement funding and restoring a small Meals on Wheels appropriation.
The committee discussed a House proposal to reinstate contract cuts that would reduce some line items by $69,000 and proposed placing opioid recovery funding into the one-time '660' settlement area rather than the base budget. Staff said this shift would allow the committee to "buy back the Meals on Wheels for a 125,000," and that moving an appropriation (CVOER) into the homelessness bill freed $234,000 to help offset the cost, leaving about $109,000 of additional unspent one-time funds in the construct.
Staff also raised a legal compliance concern about how supplemental payments are structured. Reading draft language, staff said, "in order to preserve access to primary care services, the Department of Vermont Health Access shall distribute supplemental payments in fiscal year 20 27 to primary care providers who are enrolled in the primary care plus program." The language is intended to limit supplemental payments to providers already enrolled in the Primary Care Plus program so the payments do not run afoul of "HR 1," which staff flagged as a potential statutory conflict.
A committee member warned the draft underestimates the scale of primary care losses, saying, "primary care is losing a lot more than what's in [this draft]." Members discussed whether the primary-care payment should remain in the base budget or be moved into the one-time opioid settlement line where the settlement funds are listed.
Staff described the change from the earlier term "primary care case management" to the simpler "primary care" as a conforming language cleanup intended to align titles across documents, not to change substantive policy.
The meeting produced no recorded formal vote; members asked staff for follow-up information and to confirm technical section numbers and draft language before any final decisions are adopted. The committee thanked lawmakers who worked on the draft and indicated further review would continue.
