Brian Guy

This document outlines the Vermont Pathways to Partnerships (VT P2P) initiative, a five-year, $10 million grant program awarded to Vermont DAIL/DBVI by the U.S. Department of Education, Rehabilitation Services Administration. The strategic plan details a phased implementation from October 2023 to September 2028, encompassing planning, pilot programs, and statewide scale-up. Its core objectives are to establish robust partnerships and support systems, prioritize the leadership and engagement of individuals with disabilities and their families, and enhance transitional plans to improve outcomes for youth with disabilities.

Key discussion points included the recent bankruptcy filing by Genesis and assurances of continued operations for its Vermont nursing homes. Updates covered potential impacts from a new federal bill requiring infrastructure development, changes to Medicaid eligibility affecting non-citizens and the adult expansion population, and the elimination of Medicaid reimbursement to Planned Parenthood. Further discussions addressed potential Medicaid waiver opportunities, the extension of the GA Hotel Motel Program, proposed Medicare rate increases, concerns regarding communication and funding for transition services, support needed for therapeutic schools, and inconsistencies in Residential Care Home regulations. The presentation on Assisted Living and Residential Care highlighted issues with criminal record checks and increased complaint reporting transparency. Updates on Payment Reform noted changes to the respite services payment model and potential service reductions for individuals served by UVS.

The meeting included an approval of the July minutes, which involved an abstention from one member. Updates from senior leadership detailed personnel changes at AHS, including a new Commissioner of Corrections and Medicaid Director, and the departure of the Healthcare Reform Director. Discussions covered budget planning for SFY 2027, opportunities related to the Rural Health Transformation Fund, and progress on conflict-free case management and DS payment reform slated for an October 1st start date. The board also reviewed participation in the National Direct Care Workforce Collaborative and ongoing focus areas for long-term care system support, including financial stability and workforce retention. A segment dedicated to the Rural Healthcare Transformation Group identified unmet needs such as the lack of primary care providers, general staff shortages, mental health services, transportation, and housing, with suggestions for remote health monitoring and community partnerships. Further updates included compliance benchmarks for case management and payment reform, a presentation on federal and state statutes guiding DAIL's work, and several data briefs released under the Age Strong VT initiative addressing topics like heat-related illness and housing insecurity among older adults.

The meeting included updates on various initiatives such as the 'Back to Office' discussion, positive feedback on Cap4a Day, and updates concerning the Rural Health Transformation Grant and ongoing budget planning with legislators. A significant portion of the discussion focused on the 'Question of the month' regarding program and service prioritization given limited resources, with emphasis placed on affordable housing, direct care, workforce stabilization (including pay enhancements), and healthcare transformation. Board members also provided input for potential 2026 agenda topics, including policy changes, updates on payment reform, and considerations for increased board input. Other agenda items covered the creation of a subcommittee to review the UHC AARP Medicare Supplement Increase, updates on payment reform following a staff resignation, a presentation on the Certification and Recertification Process for CMOs, and general public discussion regarding agency financial concerns and maintaining choice in the system.

The meeting commenced with the approval of the December minutes. Key discussions focused on updates from the DAIL Commissioner regarding the Rural Healthcare Transformation Grant and sustainability planning. Significant attention was given to the challenges in nursing homes, where demand for ventilator units exceeds supply, emphasizing the need to expand Home and Community-Based Services (HCBS) and Adult Foster Care (AFC) statewide. Discussions also covered inclusive planning for aging and disability services, addressing social isolation in Long Term Care (LTC) facilities, and soliciting input for 2026 discussion topics, including medical care in rural areas and transportation. A presentation on SPA Goals FF27 involved mitigating implementation risks and exploring sustainable funding mechanisms. Furthermore, the Vermont Department of Health presented on the BOLD initiative concerning dementia infrastructure. The Board endorsed a Rate Increase Memo and assigned volunteers to review the draft Alzheimer's Disease and Related Disorders and Healthy Aging Plan.