Bill > H0013

This bill establishes new guidelines for calculating Medicaid payment rates for community-based service providers in Vermont, defining community-based services as long-term support services for older adults, people with disabilities, mental health conditions, substance use disorders, developmental disabilities, and brain injuries, provided outside of nursing homes or clinical residential settings. The Secretary of Human Services is now required to calculate payment rates that are reasonable and adequate, taking into account factors such as governmental mandate costs, inflation, labor market dynamics, and regional variations in wages and living expenses. The bill mandates a comprehensive methodology for rate calculations, including conducting service-specific rate studies at least every five years, establishing a predictable timeline for rate adjustments, creating an annual inflationary rate adjustment process, and considering provider financial needs during client absences. Additionally, the bill creates a process for providers at risk of closure to request stabilization support and requires the Secretary to report annually to legislative committees on the calculated rates and funding requirements. The legislation aims to ensure that community-based service providers receive fair and sustainable compensation that reflects the actual costs of delivering essential services across Vermont.

Budget and Finance, Health and Social Services

https://legislature.vermont.gov/bill/status/2026/H.13