Vermont Legislature SmartTranscripts:

[Executive Director, Addison County Home Health & Hospice]: And we are now supporting that. When the medicine chest chose to walk away and leave Addison County without its only oxygen vendor, and bed vendor, and leaving people abandoned without their care, this team demanded that we step up and do something. So this team has a long history of thinking what needs to be done for its community and doing that. And one of the challenges that we've seen over the years is that we have so many medically frail aging in place. They are housing vulnerable, be it that they don't have a home or they have a home and they don't have the support systems in that to maintain optimal health. Couple that with really a lack of healthcare resources in terms of patients don't have support systems at home, so their typical cycle is to go to the ER. Our hospitals are inundated and overwhelmed. Our Medicaid dollars are spent on people sitting in beds because they don't need to be there, but they can't go home. This impacts our ability to keep our residents in Addison County well and to keep them healthy, and it has driven our team to find a way out. So what our team did was we searched for over a year and found a large home in East Middlebury, to stay within the regulations, or within the zoning. And again, we are a group of clinicians, nurses, and office people that are driven to support, so I don't speak from a lot of building experience. It is going to be an eight person care home that because we are finding that our patients are no longer able to stay home, they are unable to return home. We have many patients that we've tried to care for in our community that can't even get to the shelters because they have overwhelming medical conditions. They can't take them when they're medically frail. So we have a large population of medically frail individuals that can't get to a degree of wellness to be able to move to wherever the next place is. There aren't any regulations currently that support that. So we've been working very closely with the licensing divisioning. We've talked to them about how do we begin this? And everybody said, we'll get a place first. So we were able to scrape up some reserve funds, we bought the home and we're in our fundraising so that we can renovate it with stair lifts and sprinklers and all those fire safety things that we need to do. Because the next step is we need to figure out how to support our community to keep people out of the ER, and be that, that it is somebody that has a landing spot for two to three weeks post hospital stay because they can't go home. Imagine being 75 or 80 and being able to go home and you're on congestive heart failure and you're on a low salt diet and the only thing you can do is make mac and cheese or open a TV dinner. Open some canned beans, the highest salt foods in the world. Why don't we just take the salt shaker and give it to them? What happens three days after their admission? We're back in the ER. These statistics are overwhelming us. Our patients don't have the resources to take their meds. Do the basic things for self care because they don't either have the housing, the resources, or the ability to navigate this. Having a place for them to land with support and supervision. Home health has the resources to provide the skilled nursing services, to provide the physical therapy. To have to go home to year two, we have many people that end up sitting in a hospital bed waiting to get to a nursing home because they've had surgery or a medical condition, and they now can't get to the 2nd Floor of their house where their bathroom is and their bedroom are. So they're sleeping and a La Z Boy are on a sofa, and it impedes their wellness, and within weeks they're back in the ER. So this is our way of finding a way to reduce rehospitalizations, to take our small part of taking that tax off the hospital system, of having people in beds that don't need to be there. So our goal is to use this building and to navigate it in such a way, or to, you know, figuring out how that fits is our next challenge. But that could not happen until we got the building. We have a wonderful construction company that is reconstructing it with the fire safety people to meet all the needs of the highest level of a level three care home should we need to go there. And that is really our goal. We need to have a place that when someone lands at 5PM in the emergency room and can't go home because A, don't have a place to go, they don't have heat, they don't have food, or they don't have someone to support them through their medical journey, we have a landing spot. We have clinical staff and paraprofessional staff that can navigate them through. And as we see this, we will also be adding a level of case management because nobody is successful unless care is navigated through the continuum. And that's what we lack. So having a care management connect to this person from the beginning of time, as they are tagged with a chronic disease, to find the right level of care, to find the right healthcare physician practices, to advocate for them to see the physicians, to advocate for them to get to the appointments, to coordinate that care. These are the things that are missing that our team has seen that has failed so many times on the front lines. And we have the privilege of servicing almost over three fifty residents on any given day. Hospice, home health, we see this. We have many patients that end up leaving their homes and their community at end of life. All they want to do is be in Addison County, and now they have to leave the state because they don't have the personal resources or the resources they need to support them. This has really empowered and driven this team to find this house and to rebuild this house and then take on the next adventure. Shaping and forming that is where we're going next. But as I said, a level three care home really doesn't meet those because that's longer term housing. And if that's what we have to do, then that's where we start. But our goal is we really need, in our small way, find a way to stop the cycle. We can't fix everybody. These will be for medically frail, be it those patients that we've worked very closely with the John Graham Shelter and the Charterhouse dozens of patients that just don't, they leave the ER, they can't come back because of their medications, because of their medical frailty or their advanced disease. Many are fighting cancer diseases. And we've had to service them in a car. That is not the way to enter life in a car. We've had to deliver oxygen tanks to cars in storage areas so that they had what they need. And so these are the limitations that have empowered this team to And it is, it's completely driven by employees. I just have the privilege of being the biggest maid for them in the room, and to be their advocate. But this is our drive to find a way to break that cycle. Nobody wants to live in the hospital. Nobody wants to live in an emergency room. And nobody really needs to. There's so many patients that just don't need to go there. But where else do they get to go?

[Rep. Theresa Wood (Chair)]: Thank you so much for your passion for this and for seeing a need in your community and empowering your staff to think about what a solution might look like. So it sounds like what you're doing is a little bit different than what I hear other people thinking about. I'll ask a question that relates to because it sounds a little bit like what you're doing. We think about rehab arms or rehab rooms at nursing facilities, where people come in, they manage through whatever health crisis has gotten them there, and then ultimately they go home. Because you're not talking about this being a long term care facility necessarily. So talk a little bit about why you think this is necessary versus a nursing facility. Well, living in Addison County, we have one nursing home.

[Executive Director, Addison County Home Health & Hospice]: We have limited resources, and that nursing home has a long wait. If you're a Medicaid patient, your wait is longer. So these patients end up sitting and waiting in the hospital, or what's happening now is they're moving out of state or moving out of campus. They They're losing the connections with their families, and they're not always getting back.

[Rep. Theresa Wood (Chair)]: And so your plan is, would this be 100% Medicaid patients or? Our goal is to have that as a mix.

[Executive Director, Addison County Home Health & Hospice]: But yes, was our goal, and our goal is to meet the needs of whoever presents that issue and that problem. So the largest and most vulnerable population we see right now is our Medicaid population, our seniors that are so dependent on their Medicaid services to sustain at home. We understand that there's not always enough. There's not enough caregivers and PCA hours and caregiver and homemaker hours to fill the needs of those families. And there's so much social isolation that has impacted these individuals. The inability to understand simply to take your Lasix once a day and take it in the morning is a difference between being able to stay at home or in a home like setting and getting well enough and having the support education and case management to possibly return home. And to have that time from a launch from the hospital, which doesn't have to be a nursing home level of care, would certainly be far less expensive, to have that level of care and support to get home. Would envision braiding, because you were

[Rep. Theresa Wood (Chair)]: just referencing some choices for care services, some home community based services through Medicaid, would you envision sort of braiding this funding in order both I recognize most places, like what you're talking about, have to have some form of private pay in order to make it work financially. And you're even talking about, I think, a bit higher level of care than what some of the folks that we see. So would you envision trying to figure out a way to draw down some of the choices for care funding? Does Dale consider this a community based option? Dale, right now, the

[Executive Director, Addison County Home Health & Hospice]: only regulations that sit in speaking with the license of division, and they have been wonderful walking us through, they met with us a couple of times. This lands at a level three care home. The challenge is to level three care homes is that's a permanent home. And yes, if that's how we have to get there to service our patients, we will do that. We are trying to find the method and the solution. The challenge we have to that is that's not always the population. And we we are trying to find the way to meet the population that is truly falling through the cracks, that is sitting in those beds in the ER right now, in an OBS bed that Medicaid is paying for, that don't need to be there. That is not the place to get well. Other questions from Ross? Go ahead, Rutland Noyes.

[Rep. Daniel Noyes (Clerk)]: Yeah, I was just talking. Thank you so much. Let me start with that. I have gone out with a home health nurse in Lemoyne County, and very, very good experience and seeing the work that they're doing in my community. And I also just met with someone who works in Lamoille County at Res Care, I think it's Res Care. And she was talking about a gentleman who was living in an apartment, ended up in the ER because of not able to care for himself. The food, like you were talking about, the salt shaker, ends up not eating properly, not taking care of himself, ends up in the ER, ends up back in the nursing home, moves to ResCare. They finally get him up on his feet, he's doing great. They discharge him back to his house where he shows up in the ER, in the nursing home and back to where, and she's like, it just keeps happening.

[Executive Director, Addison County Home Health & Hospice]: This is the cycle we

[Rep. Jubilee McGill (Member)]: need to break

[Executive Director, Addison County Home Health & Hospice]: because what happens is our current funding, Medicare does not allow us in home health to care for people that aren't acute. You have to have an acute health condition. So we are then forced to discharge them and we revisit that cycle. By developing this with some case management to allow those patients to eternally have someone to navigate them so that when someone is falling down, we can preempt that and try to get those resources because you don't have to go to the hospital to get home health services. But nobody knows when you're home alone and you don't have any support systems. So they're back in the ER, the first call we get. And we work very closely with our local hospital, and we know when they're getting full because we've got six coming, we've got beds, we've got people in the hall. How many can you say? And our team is driven to do what we can. But our goal is to really reduce the burden and the costs of health care by having this impact, trying to break the cycle of these repetitive, unnecessary ER stays because of either lack of housing, lack of medical support, and the frailty. We just call it medically and housing frail. And it's the social isolation that is really also impacting this. To bring them together in a setting can really enhance some of their quality of life.

[Rep. Theresa Wood (Chair)]: So are aware of any other home health agency that is creating this kind of innovation? No, we are I don't think so, but I

[Executive Director, Addison County Home Health & Hospice]: just Yeah, no. And again, we have the privilege in Addison County of having We're not as large as some of the other places. And we understand And this is what is driven by this team, and this is a very unique team in healthcare. I've been in healthcare for over thirty five years across most of the country, And my job was to fix a place and move on. And I arrived here and that was my goal. And this has been such a unicorn and a privilege that I am humbled every day to work for people that are so driven. So this is really a mission. Is it replicable? Yes. Could I repeat this in four more homes? Yes. If I had the funding, this would be so easy with a heartbeat. Would be done these things in the past. It's not a hard thing. The challenge is, you know, we have a team that's driven to do that. We have the privilege of being able to hire and acquire staff and to retain those staff and to move those into the setting and to be able to support that.

[Rep. Theresa Wood (Chair)]: And I'm presuming that you're also gonna be in a position to be able to you figured out the financial side of things to be able to hopefully offer benefits and a career ladder, if you will, to be able to keep people on. But we have a couple of final questions. Go ahead. Yeah. I used

[Rep. Jubilee McGill (Member)]: to work for one of the shelters you mentioned. And so

[Executive Director, Addison County Home Health & Hospice]: we did a lot of partnership with

[Rep. Jubilee McGill (Member)]: you all. All got vaccinated during COVID, and we were able to our shelter guests and community members. I know one thing that came up frequently was hospice options for people experiencing homelessness. And often it took time and they were less than ideal situations. We would find places in the community. I'm just wondering if this would also be a way to kind of address that. That would absolutely be our goal. And again, it depends on

[Executive Director, Addison County Home Health & Hospice]: the regulations that we need to fit to land into, but it is ultimately our goal because when people want that, that people don't want to. We have many patients that end up dying in the emergency room because when it comes to the final hour, family goes, I'm not doing this. And that's not what we want. Actually participated. State of Vermont had a grant, and we participated for that career ladder and the shadowing. So we have wonderful examples of that career ladder throughout our organization. So all of that is already set and established.

[Rep. Theresa Wood (Chair)]: Thank you so much. Just so I have, Ripson, please.

[Rep. Daniel Noyes (Clerk)]: This is just quick. As you're moving through your process to get this up and going, drop us emails. Tell us what's going on. Wanna hear as it progresses. But also, could you talk a little bit about just quickly the case management? When you first start interacting with somebody, what barriers do you see and what could we do here to help you with that?

[Executive Director, Addison County Home Health & Hospice]: I think there are so many barriers and there's so many organizations, and I wanna be really clear, our goal is to stay in our lane. This will not be someone who's going through drug rehab. It will not be someone in acute mental health crisis. That is not our specialty. We appreciate C SAC and all of the great care that that does, as well as this will not be geared initially for anybody with advanced dementia because we wouldn't be able to create that housing. That's something if that's important to the team, we'll figure that one out later. Is Case management is critical because we really need to have someone A lot of these people come to the table with the inability to navigate the care system, and those impediments often are what are the failings of their healthcare. Not having the correct resources or somebody Even we've had calls, I can't get my lights on. I can't figure out how to get my power back on. I can't figure out my groceries won't come. There are so many challenges to, I don't have internet, I can't do this, to navigate a disease, to make an appointment, to really look at a disease process and to have it managed through the continuum has been proven over and over to really reduce the incidence of hospitalizations and to remote health and wellness. So we have case managers, we have social workers, but we also have some case managers left over for when choices went away that we've actually retained. And we have those connected to some of our patients so that when they stop their home health services, we've not lost track of them because we know they're going to go back in the ER. And we're trying everything we can. If we can get a call to a doctor and get them back on home care before they end up back in the ER, we've prevented an unnecessary hospital stay. We've promoted wellness. And our goal will be to work with those individuals to really connect with them upon arrival, screen them for entry, and work from the day they arrive to the day they exit to ensure that they are successful, that they've landed in the right place, be it that they don't have housing or have housing, and that they have the resources to be successful from a health And that when they're not, instead of waiting and going to the ER, they have someone to call to help navigate that system, because that's really what health prevention is. You can't do that alone.

[Rep. Theresa Wood (Chair)]: Thank you. Just a quick inquiry. Are you familiar with the organization of res care providers and facilities? Just making sure that you can connect if you need to because they provide advocacy here in the state house and understanding that what you're creating is something unique, which is cool. I'm really inspired by listening to you and listening to the passion with which you and your organization have undertaken, identifying a community issue and figuring out how to do your best to solve it. It's wonderful.

[Executive Director, Addison County Home Health & Hospice]: We continue to navigate that and figuring out the best way to get this care covered and how, because it isn't regulated right now, how do we navigate that? Any thoughts on that? I would appreciate anybody reaching out. We're very fluid.

[Rep. Theresa Wood (Chair)]: We move as the needs. I was talking about choices for care. I think there's ways to figure that out in choices for care.

[Executive Director, Addison County Home Health & Hospice]: Yeah, with the different levels of care. And we have all of that built in if we need to get and become a level three care home. We just then, at that step, have to figure out how do we then meet the needs of those that aren't going to live there forever. And that's the group of individuals that are truly lost right now. They are the group that are ending up in the ER, that are ending up at the shelters, that just don't they're the forgotten ones. They're the medically frail. And that's what's really driving this team. Thank you so much.

[Rep. Theresa Wood (Chair)]: You for having I appreciate it. Thank you. And thank you, representative Lutres, for bringing this witness here. We wish you all the best in getting this all put together. And let us know. I was gonna say, let us know when that happens. You never know. We may wanna make a- If

[Executive Director, Addison County Home Health & Hospice]: you're in Aspen County, let us know. We can fight you in the Biden. Okay.

[Rep. Theresa Wood (Chair)]: Thank you so much. We really appreciate it. Okay, committee. So were fortunate enough to be able to get DCF back this afternoon for a bit of time. Hopefully we can Excuse me,

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: last season happened here. We

[Rep. Esme Cole (Member)]: have enough?

[Rep. Theresa Wood (Chair)]: Yeah. I see it there. I see Megan is online. I don't know if Hello friends, I believe that means that they're outside.

[Rep. Eric Maguire (Member)]: Hello neighbors, you're welcome.

[Rep. Esme Cole (Member)]: Here. She feels like

[Rep. Theresa Wood (Chair)]: Thank you for letting me know. I know where she is. I know she's cross the hall to a meeting in the pavilion. I think she'll be back. Yeah. Okay. I don't know exactly. It would be great if you took the other folding chair and sat up there beside your comrade. Okay. First off, thank you so much for coming back. I hope we were I hope you were able to get some lunch and I hope we caught you before you headed out. I don't know if we did or not, but thank you in any event because we have a lot of budget work ahead of us and a lot of work to decipher what we're going do on homelessness bill. And I just wanted to make sure that we had all of your information and explanations, and we had the opportunity to ask the questions. So thank you very much for coming back. I really appreciate it. And thank you to Megan for being there and available. Appreciate it. And we'll wait for Nayeli to get the PowerPoint back up on the screen.

[Rep. Jubilee McGill (Member)]: Yeah. Thank you so much. I do need to

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: be downstairs at 02:30, so I may just leave a few minutes depending on where

[Rep. Theresa Wood (Chair)]: That's it's all good. And if we're done by 02:30, then we're done by 02:30. That's great.

[DCF Representative (GA/OEO lead) [name unknown]]: Thank you.

[Rep. Theresa Wood (Chair)]: Just before you came in, while we're waiting for the PowerPoint to come back up, we were just hearing from an innovative approach to housing, health care, and homelessness all in one fell swoop in Addison County. The home health agency there is developing a new residential situation for people who have significant health care needs that might not necessarily need to have a permanent place, but potentially a permanent place. They haven't quite got all the irons worked out, but I just thought it was nice to hear innovation for people. She was talking about having to deliver care in a car because that's where somebody was living and how that for anybody, but particularly for older Vermonters who have significant health issues, it's really, really difficult. And so her staff just said, we have to do something in Addison County. And they had figured a lot of things out. They haven't gotten it all yet, but they figured a lot of things out. And so it'll be something for all of us to watch in AHS because it's a new model that we don't It's very innovative. How

[Rep. Jubilee McGill (Member)]: many beds?

[Rep. Theresa Wood (Chair)]: How many did they say? Eight beds, I think. Yeah. And it's an older home. It's under renovation now. They're doing some fundraising and they took some of their reserve money to buy the place. Right So in Middlebury. So yeah, it's- Very cool. Yeah. Okay, welcome back. Thank you, Nelly, for getting that back up. Yeah, I think where we left off was talking about the role of the 21 positions and their connection to the, I guess I would call it, specialized use of hotels and other functions. So I think one of the things we're curious about is, so the way we understand the proposal is to significantly transition out of using hotels, even in that transition, even for those specialized populations. And so then sort of on an ongoing basis, what would then these 21 positions be doing? And I'm just curious about the decision to have them in house versus contracting or providing funding to community partners who are out there through the local housing coalitions or other providers, how that decision was made.

[DCF Representative (GA/OEO lead) [name unknown]]: So I just want to make sure I understand the question. You're asking after the transition from hotels, so three years from now, what do we plan on doing with the position?

[Rep. Theresa Wood (Chair)]: Yeah, mean, what I'm understanding, or at least what I understood prior to us breaking up, was that these are going to be kind of liaisons to hotels and be there to problem solve and to assure that the things that are happening need to happen and all of that stuff. Sorry, it's a tight I'm sorry. And so are they limited service positions? So are you anticipating only needing them for three years? Or what's the goal?

[DCF Representative (GA/OEO lead) [name unknown]]: If you have something you want to add. It depends on how the program evolves. We're not sure right now, but they are limited services. So they could end if we didn't need them anymore.

[Rep. Theresa Wood (Chair)]: But do you have some

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: Yeah. That is how we have been functioning for the last five years is with limited service positions. And predominantly right now in economic services, they are people who are answering the phones, making a hotel. Sorry, reservations, thank you. I'm like Yeah, refocusing after lunch here. And and I think it is trying to be as nimble as we can, not knowing, like, is this model that will work? I'm hearing that it is a need, it is a request from communities and for folks that feel like they haven't been able to navigate the different systems. So I think, yes. But I do think we all desire to not We're using hotel because there isn't another we don't have enough in the shelter options to be able to move folks into immediately.

[Rep. Theresa Wood (Chair)]: So I'm aware that, particularly in ESD, you've been living on limited service positions for a while, since several years anyways. And those have already been included in your budget. So those have been in your budget, haven't they?

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: These are one and the same. We would be carving out from the existing 21 and sorry, I guess I wasn't doing a good job of explaining that this morning. We would take these 12 to be in hotels. That would leave us nine to still be able to operate the program, to pay the bills, to do the fair hearing as needed. I know there's other positions in here. That would be what we would be doing. And it isn't pulled out necessarily in that way in the budget, but I think it's just because we need to know, is 12 the right number? To be honest, I might have some hotel that will tell me, we are not interested in doing this if you're going to have someone who's in because I have had some hotels who have asked about doing family only who said, I can't have families here, and for varying reasons. So it's wanting to be able to be nimble in that way and have the positions where they need to be.

[Rep. Theresa Wood (Chair)]: Just a second. Okay. So then I'm I'm so this isn't new money. This is this is resources that have been in the budget that would be utilized in a slightly different way, and you were just trying to sort of, like, highlight how they would be part of this project or whatever.

[Megan [last name unknown], DCF Budget/Finance]: Can I can I clarify on that that it's they've been funded with one time appropriations the last three years? So the positions exist, but the money is new in the base budget.

[Rep. Theresa Wood (Chair)]: Okay, so this is base budget funding. Okay,

[Rep. Rey Garofano (Vice Chair)]: go ahead. I'm sorry, I had to step out in case I missed this. I can go back. But can you just talk a little bit about how you came to the calculation of the because you just mentioned that something it's hard to estimate because you don't know what's going to be needed at the hotels depending on So I'm just curious, what did you base this number on for 21 positions?

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: How did you calculate, get to that number? So the 21 positions have been in existence, that's what Megan was just saying, that's what we've had the last three years. Is just moving. Okay. Yes. Thank you. You're welcome.

[Rep. Theresa Wood (Chair)]: Do people have any other questions about the positions or anything up here on this slide with regard to family shelters. Yeah, go ahead.

[Rep. Eric Maguire (Member)]: This is the authorization stays based on need and case plan. Is the need expressing the assessment?

[DCF Representative (GA/OEO lead) [name unknown]]: It's based on, yeah, an assessment. Okay. Yes.

[Rep. Theresa Wood (Chair)]: Not the assessment. No,

[Rep. Eric Maguire (Member)]: no, no,

[Rep. Theresa Wood (Chair)]: but Just want be clear.

[Rep. Eric Maguire (Member)]: Well, how do we just how do we define the need without an assessment decide what the need is that helps patients. And

[Rep. Theresa Wood (Chair)]: we're, I'm trying to understand. I appreciate the difference in the heading that says family sheltering, not family shelters. And I'm just wondering, would it be, if you're not expecting to do this on a permanent basis, then what would be, what is going to be your option for the after? What's the option for after?

[DCF Representative (GA/OEO lead) [name unknown]]: For these families? Ultimately, they would be receiving services and be out of homelessness. There would be units available. They would be able to afford them with maybe vouchers or something. So it's not a lifelong plan. This is like a transit.

[Rep. Theresa Wood (Chair)]: Yeah. No, I I get that those two forty rooms wouldn't be occupied by the same two forty. Yeah, I'm just saying, what is your option for family sheltering? At least I'm understanding you to say this, maybe I've got it wrong, that this is a transitional piece. Or is this 7,900,000.0 in base, and you would expect to do this on an ongoing basis

[DCF Representative (GA/OEO lead) [name unknown]]: as if there was need, of course. Waiting for Megan to answer. Okay. She has

[Megan [last name unknown], DCF Budget/Finance]: this is in the base budget. So we're we're planning on continuing to provide services for families, just the manner in which the services are provided, whether that be in these transitional shelters or in actual family shelters, would may differ in the future, but the funding is in the base budget and would remain.

[Rep. Theresa Wood (Chair)]: Is that the question? Yep. That's the answer to that question about whether it's in the base or one time. So are you proposing sufficient family in your $6,000,000 the first one that we started with, which was for shelter development? I'm trying to remember now if that included family shelter or not. You have something specifically called out for family shelter other than this hotel use, I guess. Moving forward, no. Right. What would you then So be doing with that 7,900,000.0 in the future if you're going to only use the hotels as transition? Right. Is what I'm trying to get at. If you're going to still have I think

[DCF Representative (GA/OEO lead) [name unknown]]: ultimately it would be shelters. It would be shelters if we could. Given that the shelter, the capacity is what it is, and there are other populations that need it, and we can use these for the family shelters, this is what we're envisioning as being a safe transition as we try to figure out the next step. Would

[Executive Director, Addison County Home Health & Hospice]: that

[DCF Representative (GA/OEO lead) [name unknown]]: be fair to say that as far as the shelters, right now we're not focusing necessarily on building family shelters immediately? I think that

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: recognizing for different populations, there might be different time periods of the buildup that would be needed to move away more totally from hotels, and that for family programming needing a little more time. I mean, I think ideally we would like to use any opportunity that we could aside from family shelters, in terms of investments with things like rental assistance or others, but knowing that that's a longer off ramp compared to some of the other populations that we've discussed. And so as we've prioritized our time, understanding that families may be utilizing motels in some way for a longer period of time than other populations.

[Rep. Theresa Wood (Chair)]: Go ahead, representative Maguire and then represent Bishop.

[Rep. Eric Maguire (Member)]: Would it be a fair example to share you you wanna design these 240 rooms? We have a potential in Rutland of bringing 16 temporary family supportive units online while another roughly 20 permanent family units come online. Would it be a fair example to say that family sheltering in the hotel and then the launching point over once those units come online? Would that be a fair analogy?

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: Yeah, think that's one way, right, that capacity could shift.

[Executive Director, Addison County Home Health & Hospice]: Thank you.

[Rep. Theresa Wood (Chair)]: Representative Bishop, then your final.

[Rep. Doug Bishop (Member)]: So with the intent that we hope that the sheltering in the motels is the short term as possible, But recognizing the limitations of what we have for housing options, etcetera, are you envisioning that there is any time limitation that a family could be in the motel sheltering?

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: No. No, there aren't. I think that would be one of the specific things to call out on this, is that there isn't a limit, a day limit. So as long as we are moving forward, we're engaging, which I think is also part of having those folks that are able to assist in that way, but there isn't like you have eight days as people have now, giving people a longer time to settle and get ready to launch.

[Rep. Rey Garofano (Vice Chair)]: Representative Garofano. Can you talk a little bit about any potential overlap with family supportive housing? And are you anticipating that these families would not be served by family supportive housing?

[Executive Director, Addison County Home Health & Hospice]: If they are, would

[Rep. Rey Garofano (Vice Chair)]: any of the positions that are currently there, are any of those positions, family supportive housing case managers? Is there an overlap? And since this is so family focused, and we already have a family supportive housing program as far as for the case management part of it, right? That's what that program does. So I'm just wondering the overlap.

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: Yeah, thanks. Family supportive housing is a program that the office administers across the state and has grown significantly over the past few years. So we appreciate that support. Currently, the capacity in that program at any given point in time, if it's fully staffed and every position is filled, is four sixty five families at any time can be in that program. That program, as a supportive housing program, works with folks when they're experiencing homelessness, but then stays with them once they're housed and stays for as long as the plan demonstrates the needed support. So for families who are new to the program, we currently get families that might be in GA. They might be in shelters. They might be unsheltered. And that case manager or service coordinator would start working with them. If they are, for instance, in shelter or receiving other case management support, that service coordinator that has a very small case, so 12 to 15 families, would work with the team and say, Okay, how can I maybe take the lead on this? Can you step back? Do you need to lean in with another family? How do we not duplicate? But once that family is housed, they would stay with them. So the churn is just a lot slower. And so if a family was joining the Family Supportive Housing Program, they were receiving their shelter through this program, that service coordinator would be engaged, would be working. Again, they could coordinate as a team around how they're not duplicating services. Hopefully, that would help create space for others because family support housing service coordinator could take things on. But then once that family got into an apartment, Family Support Housing Coordinator goes with them. So you just see a much slower churn in that program. And often a significant part of the case load are folks who are housed. We can really try in that program to maintain tenancy and maintain housing and keep people from reentering homelessness. So that's why you couldn't necessarily rely on FSH for the service coordination for all of these households, because they're going not stay at the hotel. And I think that was something that Deputy Commissioner Gray was trying to highlight with this approach, is recognizing that we need some folks who are not necessarily, or just almost like plate based, as opposed to, oh, we will go with Lily on her journey to working for the next house. Does that answer your question, representative Garofano?

[Rep. Theresa Wood (Chair)]: I'm sorry.

[Rep. Rey Garofano (Vice Chair)]: So I guess I wonder, because in my mind, when we're thinking about just the crisis, what we've heard from, and a lot of testimony and from a lot of people, experts in the field, is that that is a model that works, and it's super effective. And I know firsthand experience that that is a super as we have other organizations that provide that kind of independent practice management, we know that works. So I'm just wondering, was there any consideration given to expand that, like take some of this funding and expand that program so then once these families are housed and they have a person and have a better chance of retaining their housing and hopefully continuing

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: their success, right? Yeah, I think just speaking broadly, a lot of these interventions are scalable, and those are things that folks can reflect on. I think, again, that it is a tricky predictive dynamic with family supportive housing because that caseload is not always available for people experiencing homelessness because they stay with them so long. So that is just something that would have to be factored in terms of a growth of how many people experiencing homelessness would you intend them to serve, knowing that, again, they're going to stay with people for two or three years and for a bulk of that time, the family's not experiencing homelessness. We don't want to create a gap for those people who are.

[Rep. Jubilee McGill (Member)]: Roxanne McGill? Yeah, I'm just looking at your latest housing report, which is probably very out of date. We'll be getting a new one just for December. And then just looking at number of households of families. In this one, there were two ninety two in GA. And just obviously, what you're presenting is going to come up short from the number of beds we would need for folks who are in the GA program. So I'm just wondering, what are your mechanisms in addition to this? Or are you looking at it all to prevent unsheltered homelessness, especially now that we know more about the T

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: HUD bill, I like to call it, where at least for next year,

[Rep. Jubilee McGill (Member)]: it's not as bad as we thought, but it's still bad. We're losing vouchers across the country, which means more families in homelessness. Like you talked about, well, hopefully they'll move on. We're going to have less and less of that. And so I don't think we should be thinking of transition. This is a long term issue that is going to get worse in the very near future. And I just see a lot of families, a lot of Vermonters, a lot folks with disabilities, which again, sixty two percent of the folks in GA have disabilities. And you didn't mention the word once in your housing initiative or in the presentation, which is a problem to me. So, yeah, I guess how are we going to prevent those folks from living in cars, living on our streets? There's beds, more beds, but it's not enough. And we're talking about the people we have deemed the most vulnerable in Vermont, the ones still eligible for hotel rooms.

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: It'd be great if we can

[DCF Representative (GA/OEO lead) [name unknown]]: get through this presentation, and then you'll hear where we're talking about opportunities for overflow for the stuff that's in excess of the $2.40, where we hope to catch them. And also, when you talk about disabilities, we're including substance use disorder. Those things are captured. I don't know if you want us to call out specific conditions. What we were trying to do was respond to the provider's descriptions of what they indicated that they need and were seeing. And then we created options for those populations that they mentioned.

[Rep. Jubilee McGill (Member)]: And I get that, but one of those disabilities is substance use disorder. And I just think 12 beds that are

[Rep. Theresa Wood (Chair)]: The proposal is not matching the need. It's not matching the need. That's what we're trying to get at. I

[DCF Representative (GA/OEO lead) [name unknown]]: hear you saying that, and we haven't gotten to where we talked about the substance use disorder services that would be delivered in shelters. So we're not saying that we're going to pull everyone with a substance use disorder out and put them into some other shelter. We're saying we're going to tap into the programs that are offered through DSU, the Department of Substance Use, sort of VDH, and ask them to come and provide services in the shelters for people. So we're not envisioning creating a bunch of shelters specific to very specific needs and segregating Yes, we're at providing services that they need so that they can sometimes get better and move on potentially. I have

[Rep. Theresa Wood (Chair)]: a question about I'm trying to understand the intersection of $876,000 in the community navigators, these limited service positions in ESD, and the case management enhancements in OEO. And how those all there's 1.275, almost 1,300,000.0 in OEO for case management enhancement. And what I read in that description actually sounds like what Deputy Commissioner Bray talked about when we were talking about the 21 existing positions. And I'm just trying to figure out how these are all woven together. And we do know that we need more sort of global case management capacity within the sort of overall system of trying to support remote workers who are homeless. We get that. And just trying to understand these different layers. And obviously we're trying to not duplicate things, but we wanna put the resources where they're most needed. So could you maybe explain the intersection of these? Yes, Miranda's trying to pull, she wrote something out about what

[DCF Representative (GA/OEO lead) [name unknown]]: Can I just say this question? It's going really slow. We envisioned those positions, those specific limited services positions doing in the family shelters. They're very specific services.

[Rep. Theresa Wood (Chair)]: And so in OEO, those positions? It says case management enhancements. So I didn't know if they were positions or is that money going out to community partners or what's the scoop on that one point?

[DCF Representative (GA/OEO lead) [name unknown]]: That's the case. Yeah. Yeah, we didn't get there yet. Can we help?

[Rep. Theresa Wood (Chair)]: That's sort of what I'm asking. What's the intersection between all these things?

[DCF Representative (GA/OEO lead) [name unknown]]: There are unique services. Housing, do you wanna talk about the

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: Sure. I think so. I think, again, some of the 21 positions and part of this, I think, we're also trying to manage with the and I'm not saying this to throw the finance system under the bus, but managing to a line item where we have to categorize things. So of the 21 positions, there's a subset that are needed to maintain the program, sort of similar operations as what happens now. I think, again, for that family sheltering option, wanting to create a different experience, adjust things like the day limit, and then knowing that we would need more staff on-site, both the ESD staff, to manage some of the more technical aspects of the program, as well as housing navigation capacity from community providers, to really try to, again, wrap around those families, try to create more support there. So those are some of how we see that. In terms of then the enhanced case management, and I think, as we mentioned earlier, potentially similar to Dale coming back, I think the agency could come back to talk a little bit about the way they see their role in organizing this. For instance, right now, one example is some of the outreach that DSU has. DMH has some outreach that's not necessarily equally distributed around the state, that they see this to try to create consistency, both in terms of coordinating current services, but also filling new gaps that may exist as we're able to identify, oh, in this community, they don't have this. So I think, again, due to some of the budget logistics, these things are with us and DCF. But I think AHS is really playing an organizing role with that in terms case management. And I think I know for timing, we couldn't all come back, but I think they could speak to that more specifically. Is

[DCF Representative (GA/OEO lead) [name unknown]]: your understanding that those are going to

[Rep. Theresa Wood (Chair)]: be community partners resources at community partners, or are they It's a state. State positions? What's the are they

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: That is my understanding that

[Executive Director, Addison County Home Health & Hospice]: it would be community providers.

[Rep. Theresa Wood (Chair)]: You find what you wanted to find?

[DCF Representative (GA/OEO lead) [name unknown]]: Yeah, physicians that would be embedded in the family shelter hotel would be they would engage in services that are different. I think that's in response partially to the municipalities and their concerns that there wasn't staff at the hotel or motel to support the families and that they were being called out to address a lot of issues, where if we had a staff person there that was ensuring that they were engaging in programming, that they were pursuing housing, that the people that were supposed to be in the hotel were in the hotel. The people that we were placing there were the ones, and that there weren't additional folks that maybe were preying on them.

[Rep. Theresa Wood (Chair)]: We would have staff there to monitor that. So yeah, that's what I understood. I was just trying to understand the I'm not sure that I really still have it, other than I'm understanding that the 12 positions, limited service positions, that would be more assigned to hotels are for families only, not for other people. I'm understanding that from what you're saying.

[DCF Representative (GA/OEO lead) [name unknown]]: Is that correct? That's correct. Okay.

[Rep. Theresa Wood (Chair)]: Okay, I wanna make sure that we're able to get through the rest of the presentation. So I'm gonna ask us to move on. But before I do, because I'm gonna forget if I don't, I had asked last week at the beginning of the week for a spreadsheet that outlined 25, twenty six and twenty seven, the base, the one time, and anything else that you have that, including carryforward. And then how that was being spent in 'twenty five and how that moves to 'twenty six and then how that ends up at 'twenty seven. And I've been told that it's about to be provided.

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: Monica had emailed it to you, but let me I will Did she? Just her name.

[Rep. Theresa Wood (Chair)]: Was it just Okay. I checked I checked this morning, but I didn't see it. But thank you in advance then if it did.

[DCF Representative (GA/OEO lead) [name unknown]]: End of day Monday, maybe.

[Megan [last name unknown], DCF Budget/Finance]: It it was earlier this week. I also forwarded it to Repshai and Nolan because they asked

[Rep. Theresa Wood (Chair)]: me Okay. As All right. It got lost in my email then. Thank you very much. I will be back in contact if I have more questions. Never mind. We'll move on to the

[DCF Representative (GA/OEO lead) [name unknown]]: next slide. Okay, so traditional GA with modified eligibility utilized as temporary overflow, 10,000,000. And this would be a continued safety net for state fiscal year 'twenty seven, serving approximately three twenty seven households, utilized when shelters are unavailable, there'd be modified eligibility.

[Rep. Esme Cole (Member)]: Pardon me?

[Rep. Rey Garofano (Vice Chair)]: I was wondering if you can just talk a little bit about what modified eligibility Yes.

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: So I think we're talking about really those, the older, a lot of the categories that we have now, except for those where we feel like we have met the needs in other ways. So it would be those that are 65, those that are medically vulnerable. And we know that we're going to talk about that definition, be in alignment with Dale there. Families that are not able to get into the specific shelters, right? Like if there isn't movement, but I will say that there is movement that we see in our populations. But just in case there isn't, as well as pregnant persons.

[Rep. Theresa Wood (Chair)]: And so does this figure include adverse weather, winter weather? That's separate. Okay. And so what are the time limits that you're proposing on this? Or are you, maybe you're not? That would be delightful. What did you say, I was delighted to hear on the family shelters, you weren't thinking about time limits. I thought I might ask about delightful here.

[DCF Representative (GA/OEO lead) [name unknown]]: I don't think you'll find it delightful. I think it's eighty days. Eighty days? Yes. Okay.

[Rep. Theresa Wood (Chair)]: Well, it's not less than what we currently have, so that's good news. Okay.

[Rep. Rey Garofano (Vice Chair)]: It's good.

[Rep. Theresa Wood (Chair)]: It's not delightful, but it's good. Okay, go ahead.

[Rep. Eric Maguire (Member)]: If I found myself homeless, which of the sheltering options would I fit into? And I'll tell you, I don't consider myself to be medically vulnerable or otherwise fit into the specialty, regularity of.

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: I think as currently, that's where I think we see our community based shelters really fitting that need and continuing to expand that capacity where folks with us were then not otherwise served. And that would be true, I think, even today under the current rules.

[Rep. Eric Maguire (Member)]: And so expanded capacity, I've taken most I've understood or assumed that the request for shelter expansion has been for the types of shelters we've been discussing this morning and this afternoon. Is there also funding for shelter expansion for our traditional shelter providers?

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: Yeah, the first,

[Rep. Theresa Wood (Chair)]: I don't know if

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: it was the first slide. So larger slide, the one time money, that's really for community based and primarily single adults, again, recognizing that capacity.

[Rep. Theresa Wood (Chair)]: Any other questions on this one? I have an overall question, but I'll wait because it might be answered as you move through.

[DCF Representative (GA/OEO lead) [name unknown]]: So the next is adverse weather conditions, that'd three point six million. That one is approximately five thirteen households. Based on historical data, we figure it'd be about eighty seven days, and it's day to day and weather dependent.

[Rep. Theresa Wood (Chair)]: You knew I wasn't going to like that one. I heard you have a precursor of that. So I will admit, it's a little hard to track to try to compare what our current capacity is with what your proposed capacity is. I don't know if this I'm just looking for the spreadsheet now. I'm not sure if the spreadsheet's gonna

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: Stop here. Thank

[Rep. Theresa Wood (Chair)]: you. I'm not sure if the spreadsheet is gonna answer that question or not. But if it if it doesn't, that's something we definitely kinda need to see sort of side by side. Because, I mean, obviously, know 513 households. We have way more than that in winter weather shelters right But I also know you've talked about increased capacity in other areas. And so I don't know. So if you looked at this five thirteen and you looked at the 200 and some odd you had in family shelters, And I guess, I don't know if you can really count the other ones in the slide just before this, because that would be non winter weather. So just really trying to right there, Miranda Gray. Just trying to thank you.

[Rep. Eric Maguire (Member)]: Trying

[Rep. Theresa Wood (Chair)]: to understand the differences, if there are differences, in terms of the capacity that the system that you're proposing will have. Both, I guess, I would say during what you're kind of highlighting as a transition period, because you're moving a lot of money out of base into one time. So I'm presuming that that means that you don't intend to keep that forever, that Although we've been funding a lot of one time stuff in the last few years. Is that something, do you

[DCF Representative (GA/OEO lead) [name unknown]]: have a think I know what you're asking for. You're asking about the bed capacity in each of them to total up what we have in '26, '27, '28. Is that

[Rep. Theresa Wood (Chair)]: Yes. So, yeah, wanna be able to Or '25, 2627. And if you've got 28 in terms of what you're anticipating to have, that's great too. Okay.

[DCF Representative (GA/OEO lead) [name unknown]]: Let's see what we can come up with.

[Rep. Theresa Wood (Chair)]: And then my guess is we'll probably have more questions after we have a chance to sort of like really understand the spreadsheet. But thank you, Miranda, for putting that at the top of my inbox. Okay, thank you. Yeah, go ahead, Representative Cole. I mean,

[Rep. Esme Cole (Member)]: back and this is a policy choice, just going back to the eighty day limit and looking at these categories that we mentioned before, know, it's fibroad or pregnant. I I don't know what the administrative costs, relative to the savings of somebody who's pregnant for nine months, and we're saying eighty days is the amount of shelter that we can provide through service, I guess. So kicking them off, I don't know. I mean, I'm just trying to find the logic in what kind of cost savings you think that's gonna achieve or

[DCF Representative (GA/OEO lead) [name unknown]]: We're saying hotel room. Yeah. Know. They might be moved to a different shelter or to Especially with this model, it

[Rep. Esme Cole (Member)]: sounds like those hotel rooms in this new vision are being used specifically because there's not enough shelter otherwise. So this is like a temporary solution while that's being built. And it seems like it is designated for these very specific populations. And so we're kicking them out, but then again, they are supposed to be the designated populations for this purpose while we don't have shelter for them elsewhere. So I don't know, I just, again, in terms of being judicious with our resources and also mitigating trauma and also your efforts in re enrolling somebody whose condition has not changed, access to housing hasn't changed, no matter how much they've engaged in services or not. So I don't know, just the logic behind that, again, to maintain that even with this new system designation.

[DCF Representative (GA/OEO lead) [name unknown]]: So I think we might be a little bit more hopeful. And when we're looking at it, we're not looking at we're kicking them out at eighty days. We're looking at, okay, we have eighty days to get them engaged and move someplace else. That's how we're looking at it. And that's what we're working toward. So we're not looking to have someone stay in a hotel for six months.

[Rep. Esme Cole (Member)]: Of course, and I don't think anyone in this situation actually would be either. I think the intention is the same, although I don't know that the

[DCF Representative (GA/OEO lead) [name unknown]]: real impact of that limit is helping either the agency or the people affected. We think if we strengthen the program and offer more services, it will improve. We think right now that those services aren't being they're not necessarily available or they're not being engaged in. So if people are choosing not to engage, then we're not helping them to move forward. This will encourage them to engage.

[Miranda Gray, Deputy Commissioner, DCF Economic Services Division]: Thank you.

[Rep. Theresa Wood (Chair)]: Okay.

[DCF Representative (GA/OEO lead) [name unknown]]: Emergency cold weather shelters. We're currently supporting capacity for 167 individuals. We're hoping to expand to other communities in state fiscal year 'twenty seven, and it would be day to day weather dependent community based shelters.

[Rep. Theresa Wood (Chair)]: And I think we have some general idea about how that's been implemented this year through My Interfaith Action. And have you made any financial awards to any municipalities for the work that they've been doing over the, especially the last two weeks and this weekend coming up? Has there been any support to municipalities directly?

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: So municipalities were eligible to apply when we had the notice of funding last summer, fall. And for instance, the city of Rutland is playing a primary role in their extreme cold weather shelters. So municipalities were one of the entities that was eligible. And we really saw, I think, just Rutland step up in that role. There's nothing that would exclude payments to municipalities as part of overall shelter plans or budgets. I there's I would have to go back and check with Vermont Interview Actions because they administered that notice of funding with the communities. I think like Leanne II, again, Rutland, maybe in Burlington, they had some municipal costs. Again, there's nothing that excluded them from being part of the overall plan. Separately, in those past weekends, are trying to just administer one plan throughout the whole winter and not necessarily be changing costs or adding in As needed. As needed. And really, again, trying to see how can we build a stable program. So municipalities, again, not excluded, but trying to make sure people know in August, September what the plan is going to be for the winter so that everyone's aware of what capacity they will or will not have and then can make other arrangements or just plan relative to that.

[Rep. Theresa Wood (Chair)]: Yeah, I mean, I think that obviously planning ahead is good practice. But I think obviously we see that communities don't necessarily think about that until the crisis is in front of them and they try to react to it. And I'm just wondering, so did you do outreach through Vermont League of Cities and Towns to put the notice of grant award or RFP, whatever it was called out? I'm just trying to think, they wouldn't necessarily think to be on your website or on the state contracting website looking for something like that in the August. I understand you're saying they're not excluded, but-

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: Yeah, prior to actually issuing the notice of funding, Vermont Interfaith Action spent about two or three months going to communities, doing

[Rep. Theresa Wood (Chair)]: a little

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: bit of a roadshow, talking to people. And as you said, things come up mid year. We are planning, and again, this is part of our plan, to hold a full debrief conference at the end of the winter season, see what we can learn, what adjustments we want to make. I think Vermont Interfaith Action has been very responsive and very much in the moment communicating with us at the agency around what they're seeing and do we need to make adjustments. But obviously, there'll be lessons learned as we go through this winter.

[Rep. Theresa Wood (Chair)]: And I guess one of the other things that I would say, because we did have them in here to testify, and we've heard from some of the other communities or through other witnesses that and I recognize, and I think it was obviously something, again, that was NH91. We anticipated that was something that we had hoped would happen. And so one of the things, just in terms of feedback, I think, I mean, you already know we think that the minus 10 or zero is not sufficiently it's not a sufficient temperature number. But also, some have reported that it seems to be fairly complex record keeping wise for something that I think could be done simpler, I think. I'm just giving that as by way of feedback in case you haven't. You'll probably hear that during your debrief at the end of the winter, maybe you've heard it already. I recognize there's a balance between taxpayer dollars and accountability and wanting to encourage these supports to be out in the community. Maybe we could look at whether we have struck that balance or not. Yeah,

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: we meet very regularly with Vermont Interfaith Action, and I appreciate that feedback. I think, again, we also just have some projects that are not even opening at the optional zero degrees Fahrenheit and have expressed real So again, we also don't want to create a program that is so drastically different community to community, but we are absolutely continuing to monitor that closely and be responsive. We are also working with them regarding record keeping and reporting. And I think one of the things that we're trying to balance is these really, I think, in some ways are an important indicator of what are the gaps in our system. And so if there is data to be learned from people who are otherwise unsheltered, that could then inform how we make our strategic investments. That's so important. And we recognize that these are really, again, operating with high levels of urgency, quick opening. So really trying to walk that line. And again, appreciate the ongoing feedback. And it is something that we talk about regularly with them.

[Rep. Theresa Wood (Chair)]: I'm representing Donahue. Then I'm going to want to move on while Lillie is still here because we saw the couple other slides that I want to make sure we get to.

[Rep. Anne B. Donahue (Ranking Member)]: Just a quick clarification, because this last one is references shelters. The adverse weather condition doesn't say shelters. It doesn't quite say, well, are these people? What's it envisioned? And then we have family sheltering. It doesn't seem broken out about in terms of what do we actually mean by shelter or a shelter or different levels.

[DCF Representative (GA/OEO lead) [name unknown]]: We've said that along. I maybe I I wasn't clear. The hotel that maybe I had

[Rep. Theresa Wood (Chair)]: to step out from an So I apologize. I'll go back and look at the tape. When we got

[Rep. Eric Maguire (Member)]: to these

[Rep. Esme Cole (Member)]: last TV

[Rep. Theresa Wood (Chair)]: and, like, very interesting. What do we mean by the use of the would

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: be the motel, and the extreme cold weather shelters are often places that are used they maybe have, like, a a different day service and then at night are able to be leveraged for this. So faith community spaces, public, Racker library spaces. And

[Rep. Anne B. Donahue (Ranking Member)]: what about the family shelters and medically vulnerable shelters? Hotel. Hotel

[DCF Representative (GA/OEO lead) [name unknown]]: where Dale is going to talk more about what they're envisioning, but currently it would be hotels. Thank you. Then we get to rental assistance, That's 1,400,000 for approximately 80 households, targeted in households experiencing homelessness. The average benefit would be $14,800 annually. The way it would be is the households are paying 30 to 40% of their adjusted income for rent and utilities.

[Rep. Theresa Wood (Chair)]: So I think asked this question, I don't remember where or when, but the state housing authority has presented a proposal to us for $3,000,000 for what we calculate two twenty families or individuals households. And I guess I'm interested to know what your thoughts are about that. I know that you're proposing to operate this, think. Would you be doing it in house or would you be providing funds out to community partners or would you be contracting with housing providers directly or how would you propose to stand this up? Or could it be part of an existing program someplace?

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: I think likely we would do a notice of funding or a partner to respond to their role. I think that, similar to what I said earlier, some of these things are scalable. And when you look at our proposal for Vermont State Housing Authority, I think one difference potentially, which again, for us, this is really mindful of prioritizing those who are experiencing homelessness and trying to really focus on impacting that population as a primary goal that holds this together. My understanding of the Vermont City Housing Authority proposal as it's currently written is that it's just slightly bigger. It's a broader kind of AHS population, which includes folks who are not experiencing homelessness. But in general, I think it's the same We have the same motivation. We're seeing this federal impact. We know that rental assistance is a key tool to help people exit homelessness and maintain homelessness. It's two different versions of the Yeah. Same

[Rep. Theresa Wood (Chair)]: So do you have a time limit on this or would it be until the hopefully eventual bridge to access HUD financed? So this would be based funding and not one time funding. So it would

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: be in base. And I think it would be as similar aspects of the proposal mentioned and similar to what we do currently. Individuals have their own housing plan. We'd be looking at their own budget and working toward longer term plans, not wanting to create abrupt end dates, but also not seeing this as going on forever, but ideally Right, that's a

[Rep. Theresa Wood (Chair)]: It triggers that bridge. That's what they are proposing as well. Any questions on this, people? Okay, next.

[DCF Representative (GA/OEO lead) [name unknown]]: Enhance case management.

[Rep. Theresa Wood (Chair)]: And so I was kind of talking And about what I

[DCF Representative (GA/OEO lead) [name unknown]]: this would provide case management to all households in sheltershelter like option, or standardize outreach and case management across the state and across programs, and standardize the workflow and supplement existing capacity. And this is where Lily was talking about AHS being able to give more information on what the vision is across the board for case management.

[Rep. Theresa Wood (Chair)]: I heard you say all, and it says as many as resources allow. Is it all or as many as resources allow?

[DCF Representative (GA/OEO lead) [name unknown]]: For what? Said all. You said all. Yeah.

[Rep. Theresa Wood (Chair)]: I guess I'll go with what's written.

[DCF Representative (GA/OEO lead) [name unknown]]: I'd be wise. It's written as all. Not up there, it's nice. Nelly must have said, Oh no, no. Didn't say that. Go lock yourself in. No, Nelly's smart.

[Rep. Theresa Wood (Chair)]: Thank goodness for Nelly. This would I So, guess my question is, would this be in those situations where we're setting up specialized shelters? Is that where this money would go? Since it's AHS wide, if it were just to people in shelters that you all contract with, it wouldn't be going AHS wide, I presume.

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: I think this is again, part of it is a coordination to make sure that we're fully leveraging resources that exist across the agency and not duplicating, for instance, between a DMH outreach worker or DSU outreach worker. So I think providing a little bit of structure to current services of people who are serving those experiencing homelessness across all

[Rep. Theresa Wood (Chair)]: locations. And then some money to fill in where the identified gaps are. So aren't necessarily people who we know of who are in shelters or in the GA hotels or anything like that. They could be people who DMH knows of that aren't connected at all with the services that you all currently provide. Is that what

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: you're saying? I think it's trying to bring some cohesion across the agency, knowing that we have quite a bit of resources and make sure that we're not either missing people or duplicating in certain circumstances.

[Rep. Theresa Wood (Chair)]: Okay. And so to get more information on this, are you suggesting we talk to Kristen? Are you suggesting Yes. Okay.

[DCF Representative (GA/OEO lead) [name unknown]]: Renee Weeks. Renee Weeks? Yeah, probably. Renee? Yeah, go ahead.

[Executive Director, Addison County Home Health & Hospice]: You're all set.

[DCF Representative (GA/OEO lead) [name unknown]]: Thank you. And then one thing that we didn't do a slide for was the

[Executive Director, Addison County Home Health & Hospice]: natural support support. Is that what it was called in the housing?

[DCF Representative (GA/OEO lead) [name unknown]]: Flexible funding? For $200,000 for folks if they have supports out Thank you so much. They should really appreciate you.

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: Yeah, thank you. Thank If

[DCF Representative (GA/OEO lead) [name unknown]]: they have supports outside of Vermont and the barrier to them returning to where they want to be is funding, AKA. No, you don't like that. I

[Rep. Esme Cole (Member)]: just want to make sure folks Yes.

[Rep. Theresa Wood (Chair)]: Okay. We can talk in code language, but it's not helpful to make sure we're talking all about the same thing. Okay. Thank you. I And have a question for Megan. So I'm looking at, in your book, I'm looking at page 144, 145 in the book, as we see it as printed, at least. I don't know if electronically it's gonna be the same page number or not. Is DCFGA emergency housing as carry forward from FY 'twenty of $11,000,000 $11,100,000 And looking at your spreadsheet, I don't understand how that is included or not.

[Megan [last name unknown], DCF Budget/Finance]: So, okay. So you're looking at the carry forward in the one time appropriations. So let me pull up my one time appropriations. I have to make sure we have so many of them these days. Twenty five zero five. So that's composed of two buckets of funding, 10.1 of general fund and a million of eWAP. So the federal funds isn't available to us anymore just the spending authority remains. And so, then this is this is what's for hotel bills so hotel bills continue to come in long after the stay. And so we need to roll when when a state fiscal year ends, it doesn't mean that the bills stop coming. So we still continue to draw down on that funding throughout the next year as hotels get around to billing us for stays. We calculate our need based on known authorizations because we have that information. And then we know, like, for example, how much we think we have outstanding authorizations that we just haven't been billed for yet, which is about half of that. And then a portion

[Rep. Esme Cole (Member)]: of

[Megan [last name unknown], DCF Budget/Finance]: it is associated with known with what you're saying. And the remaining funding has been obligated into awards, for various shelter projects.

[Rep. Theresa Wood (Chair)]: Okay. So we're gonna need something a little more specific than that.

[Megan [last name unknown], DCF Budget/Finance]: Well, I would look to Lily, but

[Rep. Theresa Wood (Chair)]: she just left the room. She just had

[DCF Representative (GA/OEO lead) [name unknown]]: to leave. Yeah.

[Rep. Theresa Wood (Chair)]: So so I wanna make sure I understand. So I'm gonna repeat back to you what I think I just heard. So the 1,000,000 for ERAP, that was federal and that had to be used by that time and that's done. We get that. Okay. So that leaves ten point one. And you're saying roughly half of that has gone out the door by now, I'm presuming, since we're six and a half months into the next fiscal year, that I can give my points.

[Megan [last name unknown], DCF Budget/Finance]: The exact number do you want? The exact number?

[Rep. Theresa Wood (Chair)]: Exact is always wonderful.

[Megan [last name unknown], DCF Budget/Finance]: So right now, we've liquidated all but 3,000,000 of it.

[Rep. Theresa Wood (Chair)]: I I I mean, for obligations to hotels, not for shelter development.

[Megan [last name unknown], DCF Budget/Finance]: That I can't give you based off of a vision report. I'd have to check with Lily on that. But, yeah, we have 3.1 remaining unliquidated.

[Rep. Theresa Wood (Chair)]: Okay. I guess what I'm trying to understand, one, it's not included in this plan anywhere, and it wasn't included in your spreadsheet. I guess it was theoretically because it was in the appropriated in FY '25. But I think that we will ask and maybe somebody can carry forward this question from the DCF team to know where that shelter development was, how that plays into what this plan is, and how much of that was well, I guess we can do the math. If you have 3,000,000 left and you tell us how much was in shelter development and how that plays into this plan, we can tell how much was hotel payments for the previous fiscal year. So getting that detail would be helpful because that's actually $3,000,000 that's available to be allocated. Wanna make sure that there's I know you're saying that there's probably obligations pending for that. And I guess I just need to be clear is that the legislature didn't authorize any particular obligations beyond what we authorized in the f y twenty five budget. So this is part that it gets a little frustrating when you just kinda decide to spend it how you think to best spend it. Not saying it's bad spending. I'm just saying it's not authorized, And that's the job of the legislature. So yeah, more information on that 11,000,000 or 10,100,000.0 would be helpful. Thank you. And the spreadsheet was really helpful, Megan. I haven't had a chance to really dive into it, but that is very helpful Okay. Piece of So as we wrap this up, are there other questions that people have right at this moment? There's, I'm sure, going to be a bevy of other questions as we sit with all the information that you've shared with us today. And again, I do want to appreciate you coming back and enabling us to finish this piece up this afternoon. I really appreciate that.

[Lily [last name unknown], Agency of Human Services (AHS) housing/homelessness coordination]: Thank you.

[DCF Representative (GA/OEO lead) [name unknown]]: Yeah. I do wanna be recognized that there's been a ton of work that's gone into this and that we're just not pulling arbitrary numbers and we're as committed to helping Vermonters as you are. Sometimes I don't know if you get that, but we do, we are committed to it, and we're working hard to fix a system that we don't think is working very well.

[Rep. Theresa Wood (Chair)]: Yeah, I think that everybody probably pretty much agrees that I don't even call it a system, to be honest. It's a compilation of a lot of history and a lot of recent history and not really a system. And so I think we share a mutual goal of trying to create a system that works. And I think because we haven't been able to really suss out what the capacity in your proposal is in total for the number of Vermonters that you're proposing to serve, in a sort of transitional phase and then in an ongoing way. It would be helpful to clearly understand that from you so that we're not guessing about that. And we just honestly try to balance that with what we know are between 4,505 Vermonters who lack dependable housing and a good chunk of them who are without housing altogether. We know that currently we are not meeting that need. We know that. But we're doing roughly somewhere around half of that. If when all the numbers sugar out, this is less than that, that's going to be hard. But we do appreciate the amount of work and the fact that this was an AHS wide. And I said at the outset when we all met downstairs that it's the first time that I really feel, this is just me personally, that we've actually had something that resembles a plan for what it is that you feel would be a wise investment of resources as an agency. I wanna give you credit for that. Any other questions for witnesses? Did you get to ask any questions you might need, Representative Lamoille?

[Executive Director, Addison County Home Health & Hospice]: No, the committee did a good

[Rep. Rey Garofano (Vice Chair)]: job and I need to pull it all together and

[Executive Director, Addison County Home Health & Hospice]: talk to some of the points on your committee before I have more questions.

[Rep. Theresa Wood (Chair)]: Thank you. Thank you all. Thank you, Megan, for coming back on. I really appreciate it.

[Rep. Jubilee McGill (Member)]: Thank you.

[Rep. Theresa Wood (Chair)]: Thank so much. Hey, folks. Have Laurie to thank for many things. So she worked through, her computer died halfway through testimony this morning. So when I sent her a little note saying, can we get DCF in here at 01:30? She's like, my computer's not working. But she did it all. And so thank you, Laurie, for that. I really appreciate it. We have Nolan coming in at three. So why don't we just take a break until three and gives you a chance to think about all the stuff that we've heard over the last