Vermont Legislature SmartTranscripts:

[Rep. Theresa Wood (Chair)]: Okay, good morning, folks. Welcome back to House Human Services. This morning, we are going be

[Alison Lamagna]: hearing in quick succession from

[Rep. Theresa Wood (Chair)]: a number of organizations and associations that have requests for us to consider in our budget recommendations for the Budget Adjustment Act that we will be making later this week, meaning tomorrow. So we're

[Rep. Brenda Steady (Member)]: going

[Rep. Theresa Wood (Chair)]: to start off with Helen Levin, who is the Executive Director of the Vermont Healthcare Association, and appreciate everybody's attention. Since we're going to have sort of a cadre of people coming in and out, and most of these people we've seen, although not all, Helen, you've been here before, so we won't do any introductions right away. So welcome, and

[Helen Laban]: the floor is yours. Great, thank you. So I'm Helen Laban. I'm executive director of the Vermont Health Care Association. We're the trade association that represents nursing homes, assisted living residences, and residential care homes. I am also part of the long term crisis coalition long term care crisis coalition. Long term crisis, that's what it feels like sometimes. And I believe that you should have received a one pager the LTCC wrote in support of what we'll be talking about today. And I'm here to talk about, in particular, the funding for Medicaid rates for assisted living residences and residential care homes. To be concise, I will give you the bare bones of what's in that letter and then take any questions that you have. It's on our website, members. Yeah. So the central concern that we have for the BAA is that So it stems from good news and good work that you all did last year. So there is a Medicaid rate that is called enhanced residential care. And this is what you start to collect when a resident reaches what we call nursing home level of care, and that's defined in regulations. At that point, there are additional services and also a more clinically intense set of services that are required. And so ERC starts to pay for those services. And there are three tiers, one, two and three. And the first is the lowest level of care. And that's an important one because that is when you first cross that threshold. And additionally, if you're a residential care home, that's when you need to begin to apply for waivers to continue to serve that individual in your residence. So last year, we've been working with the legislature for several years now to begin to bring those rates closer to the actual cost of delivering the services. And last year, as part of that progression, there was $2,790,000 allocated to increase rates that were not yet fully funded according to a measure from 2022 data. And we did not anticipate some of the ways that guidance was interpreted when implementing rates. So on July 1, happened was ERC tier three received a very large increase and ERC tier one received a decrease of, depending on what type of provider you were, 33% to 35%. So it did even out to more money, at least in the residential care home space. Assisted living was net down a little bit, But it was not what was anticipated. And so we saw a dramatic cut to those ERC tier one rates. And it was additionally a surprise. So folks learned about it about a week before it happened.

[Rep. Theresa Wood (Chair)]: It was a surprise to us, too.

[Helen Laban]: It was an unpleasant surprise. So we are asking in the budget adjustment to restore that funding to ERC tier one back to what it had been previously. And that's the essential ask here.

[Rep. Theresa Wood (Chair)]: And I see in the documentation that came from Long Term Care Coalition, Long Term Care Crisis Coalition, It references the $72.37 per day for the tier one. It doesn't say how much the total would be. What is the total? Don't know if that the ask would be.

[Helen Laban]: Oh, so we could That is a good question. We can do that. We only have utilization data up to 2024. But we can do the amounts off of that. I believe I don't want to misspeak numbers when talking. Actually, I'm not going to say it from memory. I'm going to get it for you and send it to you in an email.

[Rep. Theresa Wood (Chair)]: Okay. Well, actually, can communicate with Nolan. That would be very helpful. And he will also be checking, or maybe already has, I don't know, with the department. My understanding is it was roughly around $1,000,000 or so, give or take.

[Helen Laban]: That's what I was about to say from memory before I stopped myself.

[Rep. Theresa Wood (Chair)]: So our memories match. I'm remembering from the conversation this So just for committee members. So last year, one of the recommendations that came from Representative Nielsen and Representative Noyes when we were doing our budget work for '27 was to fully fund the rate study that the legislature had asked for. And we had funded one year and had provided substantial increases. Then we took a year off and then this was to fully fund the rate study. Well, so that was the action. And during the summer, I was contacted by Commissioner Bowen and said, you probably were not expecting this, but this is going to result in a decrease to the tier one as the witness is saying. Certainly wasn't legislative intent. It wasn't the appropriations committee intent. It wasn't the full body's intent. And we'll hear a little bit more from JFO about that in a minute. So I just wanted to give you some background about what happened after we went home, after the session ended, when the Department of Disabilities Aging and Independent Living went to implement the budget. So, yes, questions for the witness?

[Rep. Zon Eastes (Member)]: A question for the witness, maybe the chair.

[Rep. Brenda Steady (Member)]: I'm trying

[Rep. Zon Eastes (Member)]: to get clarification on this. So DOC tiers one and three, we saw an increase. One went down, but you're asking for one to come back up. If they're using the total pool of the 2,790,000.00 that was appropriated, if we bring one up and don't change the other, is that the million dollar delta that you're referencing?

[Rep. Theresa Wood (Chair)]: It would not be changing anything in tier three.

[Rep. Zon Eastes (Member)]: Right. But if

[Rep. Theresa Wood (Chair)]: So in other words, it would have been 3.79 roughly.

[Rep. Daniel Noyes (Clerk)]: Okay. That's

[Alison Lamagna]: fine. Yes. Thank you.

[Rep. Theresa Wood (Chair)]: Other questions? Yes. Representative Could you repeat

[Rep. Daniel Noyes (Clerk)]: the amount that tier one was reduced, or what is the reimbursement rate for

[Rep. Theresa Wood (Chair)]: tier one? Currently,

[Helen Laban]: it is 35% less than $72.37 around $40. So it went down by 35%.

[Rep. Daniel Noyes (Clerk)]: Okay, so it's around $40 a day reimbursement rate for tier one. Is that what it costs to be in a tier one placement or is that what it was reduced?

[Helen Laban]: So around $40 is what it currently reimburses. I would not say that's what it costs. We would maintain that it costs more.

[Rep. Brenda Steady (Member)]: So the

[Rep. Daniel Noyes (Clerk)]: current reimbursement rate is $40.

[Rep. Brenda Steady (Member)]: Yeah. Okay. Thank you.

[Rep. Daniel Noyes (Clerk)]: Go ahead. I just wanna point out that to board your dog is more than that.

[Rep. Theresa Wood (Chair)]: Any other questions for the witness? Okay, thank you, Helen. Appreciate Thank you so much for your time. And now we're gonna hear from Nolan because he was involved in all these conversations.

[Alison Lamagna]: Thank you.

[Nolan Langweil (Joint Fiscal Office)]: For the record, Nolan Langwell, Joint Fiscal Office, to answer the question of how much it's gonna cost, according to Dale, it is going to be $1,071,550 to hold them harmless, basically to bring that rate back up.

[Rep. Theresa Wood (Chair)]: And is that for the full fiscal year? Is that retroactive to July 1?

[Rep. Daniel Noyes (Clerk)]: Bias. No assumptions.

[Nolan Langweil (Joint Fiscal Office)]: Yeah, yeah, no. Will find out, given the What I'm gonna share with you is, I will find out.

[Rep. Theresa Wood (Chair)]: Well, the only reason I say that is because That's we how into we this problem to begin with. The

[Nolan Langweil (Joint Fiscal Office)]: other thing I would just echo is, so every year for the last, I can't remember how many years, we've asked for, I've asked for the chart in anticipation of how much would every 1% increase be. And every year there's always some dispute about what's in each category, who's included, who's not included. There's always been a lot of conversations with with home health. They were saying, well, no, that's this and not this. And are you catching everybody SSA PAs? We thought we had kind of solved that problem, but what we did not anticipate was based built into those assumptions with a decrease to the ERC. And so again, I would just say another lesson learned in terms of questions that need to be asked, and also for AHS to be a little bit more straightforward. So there's blame on both sides In terms of legislative intent, usually is no decreases, it's usually an increase. But I don't know that that was clear. So going forward, the lesson for us is we need to ask more questions like, are there any decreases in there? Is anybody harmed? Not harmed, but any reduction.

[Rep. Theresa Wood (Chair)]: And maybe asking for background detail. So we got a summary for residential, breaking out by all the different tiers and things like that. And also for us

[Nolan Langweil (Joint Fiscal Office)]: to articulate to them that when you say legislative intent, I think they assumed legislative intent was to do the study, not understanding that legislative intent was not decreases. So there needs to be better communication on our end as well to be a little clearer, and on their end to be more and more. So lesson learned on that.

[Rep. Theresa Wood (Chair)]: Are there any additional questions for Nolan? This appears to me to be what I would call a technical fix that wasn't intended. And so sometimes we have to correct errors, this is what I would call correcting an error. Would you Is that

[Nolan Langweil (Joint Fiscal Office)]: I would say my understanding of legislative intent was for there not to be a decrease.

[Rep. Theresa Wood (Chair)]: Yeah. Okay. All right. Thank you very much. Okay.

[Rep. Brenda Steady (Member)]: We're ahead of schedule. Yeah.

[Rep. Theresa Wood (Chair)]: Okay. Next, and I'm not Alison? Alison? Alison. Alright. We're running a little ahead of time on that. Meg? No Meg yet. Okay. Okay, why don't just talk among yourselves? Just

[Rep. Daniel Noyes (Clerk)]: quickly, Nolan or Katie, to get the language for the BAA to put in, I wanna just If you wanna put in language? Yeah, to bring it back up to what it was. So, I'm just gonna make sure you know I'm gonna get that language so that it will be working.

[Rep. Theresa Wood (Chair)]: I'll be working with Katie.

[Rep. Daniel Noyes (Clerk)]: Okay, you'll be working

[Rep. Brenda Steady (Member)]: with Katie.

[Rep. Daniel Noyes (Clerk)]: Yes. That makes that easy.

[Rep. Theresa Wood (Chair)]: Yes. You. That's after hour. We we will need to have recommendations from the Correct.

[Rep. Daniel Noyes (Clerk)]: I didn't know if you wanted me to get the language.

[Rep. Theresa Wood (Chair)]: In anticipation of that?

[Rep. Daniel Noyes (Clerk)]: Correct.

[Rep. Brenda Steady (Member)]: Oh, sure. Go ahead.

[Nolan Langweil (Joint Fiscal Office)]: I will take care of it.

[Rep. Theresa Wood (Chair)]: Thank you. And we haven't heard from we haven't heard from number two, Dan. We haven't heard from number two, but you can include that in your language request too yet. So I started to provide some background. So before our next witness gets here, I will do. And do we know if Alison is going to be here via Zoom or person? She's here. Oh, I don't know what she looks like.

[Rep. Brenda Steady (Member)]: Oh, she's here. Okay. Having lunch with her today. Okay.

[Rep. Theresa Wood (Chair)]: So if you look at the Long Term Care Crisis Coalition's document, you'll see the second item is an inflationary adjustment of 2% to the Area Agencies on Aging. So last year, the legislature provided a 2% cost of living increase for all Medicaid providers and Medicaid services that were in our jurisdiction, as well as some in the healthcare committee's jurisdiction. So that included designated agencies, specialized service agencies, it included choices for care services, it included the rate adjustments for ResCare that we were just talking about. And for some reason, I'm not really sure why, but I think it has to do with the fact that there was a transition. You'll remember about conflict free case management. There was a transition last year and the area agencies on aging now have 100% of the case management for choices for care. That's the state's long term care service that they do on the home and community based side. And so they were left out of the 2% increase. It wasn't intended. And we had hoped that this would be rectified through these two technical amendments. They should not have been omitted. Every other provider got one, and every other service that we have got that 2%. And so that is a significantly smaller amount. They have estimated 140,904 for that. So that's what we'll be hearing from the representatives from the AAAs about that in a little bit. So maybe we should talk a little bit since we have fifteen minutes about how we will be making recommendations to the Appropriations Committee about this and anything else that comes up during the course of today. And we'll have some Our schedule has us having committee discussion on this afternoon just before the House floor. And then we will also have some discussion about that tomorrow and reach our conclusions on our recommendations. So we're trying to make this relatively quick, because there's a quick turnaround time on the BAA. So, do people have any questions about, particularly people who maybe haven't been through this BAA process before, do people have any questions? Last year was very different. We never had a BAA last year. We passed BAA twice, but it was VJO twice. And so what we are looking for is to not repeat that. So it's a bit of a different process than has happened last year. So happy to answer any questions if you have any about BAA in general and what that is intended to do.

[Rep. Zon Eastes (Member)]: It's watching. And

[Rep. Theresa Wood (Chair)]: there are documents both on if you are more than welcome to look on the joint fiscal website. If you search for Budget Adjustment Act, documents will come up, you can also find them on the House Appropriations website. So if there Oh, go ahead. I was just gonna say, if there's no questions, we can go offline for ten minutes before our next Wednesday comes.

[Rep. Zon Eastes (Member)]: Just on the issue we just heard about, it sounds like conversations started over the summer, and I apologize if this came up yesterday. Is there a reason that Dale did not include this in there or the governor did not include this?

[Rep. Theresa Wood (Chair)]: No. I don't know the answer to I that think that there is probably difference in understanding when you heard Nolan say that AHS was less than forthcoming, I'm just going to say. They've had a change in management of their CFO and working very well with the new CFO, AHS. So it never disclosed to the legislature that this would result in a decrease. And we didn't specifically ask that question. And so we certainly did not intend for a 35% decrease in the reimbursement rate for the care of vulnerable Vermonters. And we are talking residential care providers are relatively small providers. They are in some cases privately owned well, in all cases privately owned, but we're not talking nursing homes. We're not talking the kind of rates that nursing homes are paid. And so a rate decrease like that, substantial impact to the business and the availability of residential care beds. And probably has this number off the top of his head, but we have lost a number of residential care homes beds over the last five years. And precisely because Medicaid was paying insufficient rates for the care that was being required. And at the same time, Dale is increasing the requirements for residential care providers. So it's kind of a double whammy when you look at this. Would be like, we heard testimony yesterday about from the commissioner around the impact of not getting $14,000,000 in financial relief for nursing homes. This million dollars is just as dramatic for residential care homes.

[Rep. Zon Eastes (Member)]: And could have a ripple effect at that next level of care if this isn't available.

[Rep. Theresa Wood (Chair)]: It already has. So that's just a little history behind.

[Rep. Zon Eastes (Member)]: I guess I do have a question then. So when we requested that the rate study be done, so that was completed. Yes. And so then it sounds like there was some interpretation though about how those rates were applied or what the amounts would be inside the rate study. I just don't quite understand where the

[Rep. Theresa Wood (Chair)]: You can actually see the rate study if you go into FY23, the '23 session, and look at reports in our committee. You can see the rate study. The state so we said you have to do a rate study. And it wasn't just for these services. There were other services as well. And when we received the rate study in FY24, we implemented it partially. We did not implement the whole thing because it was more money than we were able to do, frankly, in one fell swoop. Here we go. That didn't mean that we didn't want to have a plan to. So we had planned to do it over three years. We a big chunk in '24, '25. So '26, we said, okay, we have to finish up. We have planned to do it over three years. So we did do it over three years, but big chunk in the beginning and big chunk at the end. That's what ended up happening. So if you could look at the rate study, the report, I shouldn't say the rate study. If you look at the report that was issued, you don't see a reduction in residential care. That was not transparent. Was going say it wasn't transparent. It wasn't evident from the report. Wasn't evident from any of testimony that we took on ResCare. It wasn't even evident to the ResCare providers and their associations.

[Rep. Daniel Noyes (Clerk)]: Until last

[Rep. Theresa Wood (Chair)]: July. JFO got involved. The commissioner notified us that this was going to be happening. So my belief is that they knew it was not our expectation that that was going to result in a decrease. Because otherwise, we don't get notified when rate increases happen. It's just like when the legislature approves rate increases, the administration implements it. Increase it out. The fact that we were notified signals to me that it was understood that this was not legislative intent. So, yeah, Dan.

[Rep. Daniel Noyes (Clerk)]: I have no idea if this data would ever be available, but because of the reduction in the ResCare number of units available, and at each tier, how many people are unable to transition within the res care framework to skilled nursing facilities because there is no beds available in- There's beds available? They're

[Rep. Theresa Wood (Chair)]: just not, you mean nursing homes, they're not making new things?

[Nolan Langweil (Joint Fiscal Office)]: No, no,

[Rep. Daniel Noyes (Clerk)]: in res care. They're in res care and their needs increase, so they need to move up the scale. And if there's no beds available in residential care with the increased support, then they end up transitioning to nursing homes or skilled nursing facilities where we know that the cost is It would just be interesting that I have no idea if that's even trackable, but Well,

[Rep. Theresa Wood (Chair)]: I do know that they also can apply for exceptions, depending upon a lot of different things, depending upon staffing, depending upon evacuation, and it involves the Division of Fire Safety and the Division of License and Protection. And the only reason I know about it is because I help people to do it.

[Rep. Daniel Noyes (Clerk)]: They're also businesses. There if might they this is like big loss to be able to provide a higher level of care to an individual. They're going to close a business. They're either going to say this person can't be here anymore,

[Nolan Langweil (Joint Fiscal Office)]: or they can't provide for them, and then they end

[Rep. Daniel Noyes (Clerk)]: up in a higher cost

[Rep. Theresa Wood (Chair)]: facility. If they'll admit them. Okay. Welcome, you must be Alison. Yes. Okay. The only reason I know is who you came in with. So Welcome. We finished up a little early. Our two previous witnesses were very succinct. So, welcome, welcome to the table.

[Rep. Brenda Steady (Member)]: And

[Rep. Theresa Wood (Chair)]: you haven't been here in our committee before, so we will do a round of introductions for you. So welcome. My name is Theresa Wood. I'm from Waterbury, and I also serve Bolton Buellscore in Huntington. Hi, Allison. I'm Rey Garofano. I represent Essex and Essex Junction. Thanks. Welcome. I'm Jubilee McGill, I represent Birdport, Middlebury, New Haven, and Weybridge.

[Rep. Esme Cole (Member)]: I am Esme Cole. Represent Hartford.

[Rep. Zon Eastes (Member)]: My name is Zon Eastes. I represent Guilford and Vernon.

[Rep. Todd Nielsen (Member)]: I represent Nielsen. I represent Brandon and Garofano.

[Rep. Doug Bishop (Member)]: Good morning. This Doug Bishop. I'm one of Golrang Rey Garofano's representatives.

[Rep. Brenda Steady (Member)]: Brenda Steady. I represent Westburg and East Melbourne.

[Rep. Eric Maguire (Member)]: Hi. Good morning, Eric Maguire. I represent Rutland City.

[Rep. Daniel Noyes (Clerk)]: Hi. Dan Noyes represent Wilkett, Hyde Park, Johnson and Belvedere.

[Rep. Theresa Wood (Chair)]: And

[Rep. Brenda Steady (Member)]: Donahue, Northfield and Berlin.

[Rep. Theresa Wood (Chair)]: And Sandy. We'll start going all the way around the outside.

[Alison Lamagna]: Thank

[Rep. Theresa Wood (Chair)]: Thank you you for being here. Welcome to your new position at two eleven. Thank you. So do

[Alison Lamagna]: you have written material? I don't see anything on our website. I do. I just sent some written materials and slides. Refresh. I'll refresh.

[Rep. Theresa Wood (Chair)]: There it is, right at the top. Okay. The floor is yours. Great. Well, thank you for

[Alison Lamagna]: all the lovely introductions. And Chair Wood and committee members, thanks for the opportunity to speak with you this morning. So as you know, I'm Alison Lamagna, I'm the new Executive Director of the United Ways of Vermont and Vermont two eleven. I started back in May 2025, about eight months ago. And I know many of you are familiar with Vermont two eleven. Our mission is to promote the health and well-being of all people in Vermont through a statewide information and referral system for streamlined access to community resources. And at this particular moment in time where there is increasing need shifting federal policies and continued strain on state and local services, it's critical that Vermont two eleven system is fully functional, visible and prepared to respond. So I'm here today to follow-up on my ask to the committee to include $20,000 for Vermont two eleven in your budget adjustment memo to the House Appropriations Committee for fiscal year twenty six that would allow Vermont two eleven to recruit and hire an outreach and communications manager at the start of our fiscal year on April 1. And this will allow us to reestablish a robust intentional outreach program for two eleven. Just for a very quick refresher and a bit of background, I know most of you are familiar with two eleven, but I wanted to share a few important pieces of our background. So we're housed at United Way of Vermont, which is an independent 501c3 organization. And in 2004, we were officially designated by the state as the agency for two eleven services in Vermont, which solidified our important role in the state's infrastructure for ensuring that Vermonters across the state can connect to critical health and human services and to assist us response and recovery in times of disaster. And additionally, we represent Vermont in the National two eleven Infrastructure and Network. We are also a nationally accredited information and referral service, which means that our database must adhere to national standards and best practices and is reviewed for reaccreditation every five years. And our staff are certified resource specialists and certified database curators upholding national standards for providing resources to the public. A quick data snapshot, Vermont two eleven receives an average of 52,000 contacts from Vermonters every year through phone, text and email. And in 2025, we exceeded that receiving 61,654 contacts. Our database currently contains more than 1,100 agencies, which represents more than 3,100 programs across the state. Many know us for our work supporting the state with the emergency housing program and for disaster response. However, our work is broader than this and includes helping Vermonters connect to resources for other basic needs and some that are less visible. In 2025, our top requests for referrals besides housing were for utilities, transportation, tax preparation services, public assistance, food, legal services, health services, mental health, and other specialized services for children and families, older adults, and individuals with disabilities. So the reason for this request. As many of you know, Vermont two eleven has been under resourced for many years, and we've had to meet growing demand with limited capacity. Thanks to the support of this committee, we are beginning to move toward greater stability. We have taken some important steps to modernize our services, including refreshing and updating our online searchable database, which helps to keep Vermonters where they are and reduces barriers to accessing information. And with some new capacity, it is essential to invest in the infrastructure that allows us to function as a reliable statewide system so Vermonters can consistently access accurate information and so the state can depend on us during both day to day needs and emergencies. And things are changing quickly, as you're well aware, in terms of what services are needed, what is available amid federal cuts, changes to benefits, and competing priorities. So this funding will particularly ensure that we have systems and infrastructures in place so that, firstly, Vermonters and community service providers in every corner of the state know that two eleven exists, we are here for them, and how to use the service and refer people to it. It will strengthen the overall infrastructure by ensuring that Vermonters can reliably find and understand and access services that already exist so that the state's investments in services are actually reachable by the people they are intended to serve. And it will help ensure that community partners consistently use two eleven as the front door to assistance, reducing duplication, improving coordination and helping people get connected faster. So what this means practically, what we could do with this capacity is allow us to regularly attend resource fairs across the state, community meetings, other events, and support some hyper local grassroots initiatives around the state by being a resource supporter and collaborator. Secondly, this capacity will ensure that Vermont two eleven maintains the most inclusive, accurate resources in our database as things are changing rapidly, wherever they live in the state. New resources are coming online and some are closing their doors. And we want to be able to capture every resource no matter how small or localized it may be. And that makes us a trusted source for policymakers, agencies, and providers about what's available across the state. For example, there are many small rural hyper local resources that lack a staff or budget to do their own outreach to Route 211. For example, a small basement food shelf that's staffed by a volunteer. A good example of this is an initiative we're currently working on in Bethel, Vermont, helping local providers there to understand how to best utilize our online database to create lists and avoid duplication, and also troubleshooting with that community around how community liaisons there can work with two eleven to ensure that all of the teeny tiny resources that they have in their area are represented and are accurate in our database. So with this added capacity, we could duplicate that in other communities across the state. Finally, this will also allow us to focus more on data, supporting agencies, service providers, and lawmakers with sharing actionable, reliable data, and to serve as a statewide barometer of need during these current periods of disruption and policy change. For example, we have the capabilities to be able to provide a statewide snapshot, as well as regional data and collated data around specific issues such as housing, transportation and utilities. As the new executive director, I've spent the past several months listening closely to our staff, partners and community organizations across the state. And what I hear consistently is that although Vermont two eleven is trusted, relied upon and essential, some longstanding capacity gaps have been limiting. So this request is about ensuring that Vermont has a strong, stable and responsive two eleven system to respond to the current changing and dynamic environment. I respectfully ask for your support and including the adjustment in your committee's recommendation, and I will be happy to answer any questions that you have. Thank you for your continued support of Vermont two eleven for your commitment to ensuring that Vermonters can access the services they need.

[Rep. Theresa Wood (Chair)]: Thank you, Alison. That's interesting. I'm just wondering if you want to briefly go through the other documents that you've sent to us.

[Alison Lamagna]: I did include a brief one page overview of two eleven, just some of the important information about who we are and what we do. We don't probably have to go over it in-depth because I touched upon some of it in my testimony. Yeah, Okay. And then I did include a few slides, but they were just highlights of, again, the talking points. I just opened it up and realized that now. I

[Rep. Jubilee McGill (Member)]: was looking at it while she was So talking and they appeared

[Rep. Theresa Wood (Chair)]: I guess it's a question that I have for you, and we'll open it up to other folks, is your fiscal year starts in April 1, and you're asking for $20,000. So I'm presuming that that's one quarter of the actual amount that you need for a full year.

[Alison Lamagna]: Yes. Is that accurate? That's accurate.

[Rep. Theresa Wood (Chair)]: Yes. Okay. So so I'm presuming you'll be back asking for the remaining three quarters of that. Budget adjustment isn't generally a base well, sometimes it's a base increase. Okay. So you're really looking for $80,000 Yeah.

[Alison Lamagna]: And yes. The idea would be they would roll us into our contract funding for the next fiscal year. And have you had any discussions with the agency of human services about this expansion?

[Rep. Theresa Wood (Chair)]: Would this be a surprise to them?

[Alison Lamagna]: I have had an initial conversation with Nicole Tousignant at ESD, which is our contract there, about our new contract. In fact, we are in the final year of allowable amendments. So we are going to have to start over with a new contract this year. So we discussed that a bit, as well as some of the changes and growth that we're on the precipice of. And it sounds like the plan is level funding from ESD based on that initial conversation. And we're in the budgeting process now internally for our year. So I think there need to be some follow-up discussions. And do you have so what's your funding construct? So how much of your funding is state dependent? You have other funding sources. We have some very small limited other funding sources. We are primarily funded by our state contract.

[Rep. Theresa Wood (Chair)]: Questions from committees. Yes, go ahead, Representative McGill.

[Rep. Jubilee McGill (Member)]: Mine's not so much a question, just a follow-up. You touched on data available to legislators. And I just want you to all know, if you go to the two eleven website, there's a dropdown. And you go to statistical reports, you can see reports on the kinds of needs people in your community have been requesting. I check it. It also was super useful to me this summer when I had a sudden need in my work outside the legislature to do a needs assessment with a quick turnaround. So we were able to pull a lot of information from that. So I just wanted to point it out because it's a helpful resource that I just discovered this summer.

[Rep. Theresa Wood (Chair)]: And we do get a summary quarterly, I think. Yes, yes, in our inboxes. Yeah, go ahead, representative. Do you still I know I've

[Rep. Brenda Steady (Member)]: taken classes at 02:11 for emergency because I work in DCF at one time, and emergency housing. And you used to offer like, I went and took a class on how to help people if there was an emergency. Do you still do that? We are not aware of that.

[Alison Lamagna]: That's actually a piece of our history I wasn't aware of.

[Rep. Brenda Steady (Member)]: We used to teach classes. Oh, okay. So yeah, they offered classes. So if there was a Vermont emergency, we could help or they trained us or tried. I never had to use it. But I did go. So do you do that anymore? Because that was No,

[Alison Lamagna]: I'm not currently doing that. No, our staff are trained by Vermont Emergency Management and AHS on response and being part of the state emergency operations center. So we get trained. But that was a nice way to get volunteers.

[Rep. Brenda Steady (Member)]: I guess that's what I'm throwing out there.

[Alison Lamagna]: Okay, great.

[Rep. Theresa Wood (Chair)]: Other questions for Alison? You've taken on a big job. And really just before the legislative session started. How long have you been?

[Alison Lamagna]: I've been here there about eight months, just under eight months. And so the first six months, I felt like I was just trying to keep my head above water. But I do feel now that there's some excitement and momentum for just a lot of opportunity for us to innovate and grow in ways that we have not had the opportunity to do in the past. So that's the exciting part about this new venture. Yeah, go ahead, Bishop.

[Rep. Zon Eastes (Member)]: Thank you. I'll start with appreciation. My past work has included that disaster recovery in Vermont 201 has been an important partner. So if you received this request and came back and in the regular budget process did not receive balance of funds needed for this position, would the position go away? Or has there been a way within your other funds to identify how you can move forward with it?

[Alison Lamagna]: That's a great question. And we're working on some other funding opportunities. In fact, we're working on getting an official contract with Vermont Emergency Management for the work that we do to support them. We're identifying our strategic priorities right now, and one of them is flexible funding. And as I mentioned, we're almost entirely reliant on our state contract at the moment, but we know that for long term sustainability, we do need to be thinking of other opportunities and ways to fill the gaps. So we have some irons in the fire and initiatives that we're thinking about to enable this to be sustainable. One

[Rep. Theresa Wood (Chair)]: of the things that we have coming down the pike is many changes to Medicaid eligibility. I guess I'm curious as to how you're preparing for that. Because I would imagine, all the things that you've talked about that you get referrals for, I'm sure healthcare is one of them. And in thinking about the sometimes complicated notices that people get from our state and federal government that are difficult to understand, They will be starting to get even more of those. Is that something that you assist people with? And what do you think the impact of that is going to be on your organization?

[Alison Lamagna]: Yeah, so I'm kind of feeling Amy's eyes over here on the side of my head because we are joining a coalition of service providers around the state that are looking at this right now and thinking of ways that we can rise to the moment and be prepared and available to assist Vermonters with those confusing letters or other questions, or to be able to find out how they can navigate the benefits that are available to them or that are becoming unavailable to them. So that's one way that we're getting prepared is by working with this coalition that Yumi has pulled together, I'm sure you'll be hearing a lot more about throughout the session, to have some training and resources available to be able to assist callers. So some of the other organizations that are participating have direct benefits assisters on staff to help folks navigate. And 211 will be like a wraparound support for all of them So that when people call, we know exactly how to direct them based on their relationships and where they live and things like that. So I think we're anticipating it being a massive need and trying to work collaboratively across the state to build a support system. Represents Noyes and that's Steady.

[Rep. Daniel Noyes (Clerk)]: Just thinking about future requirements for Medicaid enrollment and around volunteerism as one of the things that people can do. Do you see two more in one playing a role in volunteer opportunities to be able to help people find different volunteer or even figure out how to help track that type of work, because I think that's gonna be, that will be a requirement moving forward that people have to either work or volunteer in the community.

[Alison Lamagna]: Yeah, I do think we have the capabilities to connect people to volunteer opportunities if they're seeking, if they're calling us looking for how to get connected. And we also, because we're also the United Way of Vermont, we are the state association for all of the regional and local United Way's across the state. So we have that network wide perspective as well. A lot of our local and regional partners have those hands on volunteer opportunities with the work they're doing boots on the ground in communities. So I think we'll give you a connector in that way as well.

[Rep. Theresa Wood (Chair)]: I'm all set. Okay. Go ahead, representative.

[Rep. Zon Eastes (Member)]: Just quickly, thank you. How many people do you have that'll work in the phones after hours or on the weekends?

[Alison Lamagna]: So we have eight, I believe, staff in our contact center. And they split different shifts between 8AM and midnight. And then after 12AM, we have an outside call center that takes calls from 12AM to 8AM. And they also take our calls on weekends and holidays. So our staff are eight to midnight, and there are eight of them.

[Rep. Zon Eastes (Member)]: So it's a call center, which means it's pretty much we'll get back to you later to an exciting

[Alison Lamagna]: No, they actually do have access to our database. So they can provide the service for information referral. They also have access to the state's emergency housing systems. So they can basically act almost exactly how two eleven could. There are some limitations. I mean, they're not intimately involved with state partners and things. Sometimes, in fact, we often have to have, we always have to have one of our staff on call to respond to the call center's questions that they might have after hours or on weekends when they're just not quite sure how to handle a situation or not quite sure how to direct somebody, then we always have someone available that they can contact for guidance.

[Rep. Zon Eastes (Member)]: Okay, thank you.

[Rep. Theresa Wood (Chair)]: Yeah, I'm not sure that the general public and maybe even some of our colleagues understand the role that two eleven plays in emergency housing on nights and weekends in particular, but any time of the day, real

[Alison Lamagna]: beach. And housing, this will be no surprise to you, is the number one requested resource that we see overwhelmingly in every region and across the state.

[Rep. Theresa Wood (Chair)]: Any other questions? Yeah, go ahead. And food, I remember seeing in the email updates, that's pretty high up on that list as well. Is. That number two.

[Alison Lamagna]: Housing was our top requested resource in 2025 and utilities is actually next, which might be a little bit of a surprise. But we did see a spike in calls about food resources in November with the shutdown and the crisis. Yeah.

[Rep. Theresa Wood (Chair)]: Okay, all right. Can we

[Rep. Zon Eastes (Member)]: speak a little more about utilities? I mean, the kinds of questions? Is it that people's service just goes out and they need help at that moment?

[Alison Lamagna]: I think that the majority of the calls are seeking assistance to pay for utilities. Yes.

[Rep. Theresa Wood (Chair)]: So the interesting thing, tried to think about what Vermont was like before we had two eleven. And I was in state government at that time, and it was hard. When two eleven came on, made a significant difference in the ability of people to respond and the ability of just every day, Vermonters, to be able to get information and connections. One final question, because it made me think of it. Information referral sometimes feels like just another we get information, just another number to call kind of thing. Do you do warm handoffs? Do you do warm transfers to other organizations? We will do

[Alison Lamagna]: a warm transfer to a crisis line. Certainly, we sometimes transfer to DV hotlines or 988 while the caller is on the phone with us and make that connection. We don't do a warm handoff usually, for example, to a CAP agency or something like that. But we do some follow-up in certain cases. It's not just a phone call for information. The community resource specialists who are answering the phone are trained and they are certified with the National Accrediting Agency. And they are skilled in asking the right questions, troubleshooting, finding out what has the caller tried already. They often uncover other underlying needs. And so it is more than just a call for info. What is that national accreditation process? I mean, how long does it take for somebody to receive that national accreditation? What's the The agency that provides it is called Inform USA. And for our database, we get reaccredited every five years. And they do a thorough review of contacts. They reach out to agencies who are listed and do a survey, get input and feedback about their inclusion in the database and their experience with us. They ask for policies and all that kind of thing. We're actually in the middle of that right now. So we'll be reaccredited in April. And then for the individuals, it sort of depends. Inform USA has different guidelines based on the individual's education level. And so once they're on staff with us for a year, they're normally eligible to become certified. Some people, it might be two years. It depends on their personal education level, which is a policy of Inform USA. And then they have some preparation courses and materials they can go through and then they sit for their exam and become certified. So they actually have an exam they have to test. Okay. Thank you so much for

[Rep. Theresa Wood (Chair)]: being here, Alison. Nice to meet you as well. It was nice to meet

[Alison Lamagna]: all of you. Appreciate the opportunity and I welcome any questions or comments if anyone wants to connect afterwards. Yeah. Thank you. Thank you so much.

[Rep. Brenda Steady (Member)]: Okay.

[Rep. Theresa Wood (Chair)]: Meg, yeah. Meg? Meg Dash. Okay. Alright. So,