Last week, Governor Phil Scott made his annual budget address. The address was delayed because the State’s revenues were upgraded by more than $116 million just days before the scheduled address, thanks to an infusion of federal coronavirus relief dollars. While most of the revenue doesn’t go directly into state coffers, it improves the forecast for tax revenue that Vermont can expect.
While this was a positive development, the governor was careful to distinguish revenue available for one-time spending from increases that require ongoing funding. Setting aside the one-time spending proposals, the underlying base budget across all agencies and departments increased by only about one percent.
Given the austerity of the underlying budget, it’s no surprise that the budget does not include a reimbursement increase for the home- and community-based portion of the Choices for Care program. At the same time, the administration is projecting higher demand for at-home long-term care services, evidenced by a $4 million “caseload” increase and a $6 million nursing home utilization reduction. This is deeply worrisome. The program is already experiencing a staffing crisis and home health and hospice agencies are already providing the services at a substantial loss, with expenses exceeding revenue by 25 percent or more.
The budget also includes some good news. The governor proposed a nurse income tax incentive of $1.25 million that we strongly support. Under the proposal, new graduates of Vermont-based nursing programs will quality for a three-year incentive if they work in the state following graduation as follows: 100 percent waiver of income tax in year one; 70 percent waiver of income tax in year two; and 50 percent waiver of income tax in year three. The Department of Health re-introduced a $1.9 million proposal to expand maternal-child health home visiting that was deferred in SFY’21.
Over the last several weeks, key policy committees have also outlined their priorities for the legislative session. Many align with the top policy priorities of the VNAs of Vermont and other health care providers. These include:
- Extension of pandemic-related emergency legislation passed in 2020
- Distribution of new federal coronavirus relief funding
- Broadband deployment for telehealth and telemedicine
- Measures to address the health care workforce shortages, including passage of the Interstate Nurse Compact
More recently, the House Health Care Committee heard from the Department of Financial Regulation working group's recommendations on audio-only telehealth. The VNAs of Vermont supports extending reimbursement for audio-only telehealth beyond the public health emergency.
Throughout the legislative session, the VNAs of Vermont will work closely with other provider groups to advance our mutual top priorities: Medicaid reimbursement, workforce, and COVID-19 response and recovery.