Vermont Veterans Home seeks $337,439 increase, cites hiring gains and reimbursement risks

Melissa Jackson, chief executive officer of the Vermont Veterans Home, told the Senate Appropriations committee the home is seeking a $337,439 increase in its fiscal 2027 budget and described workforce and reimbursement pressures shaping the request.

Jackson said the home expects to reduce contracted third‑party staffing by $2,300,000 after an aggressive hiring push led by Director of Nursing Sarah Sigsberry, who Jackson said has "hired 16 nurses." Jackson added the reduction is optimistic and the home could return to the committee for a budget adjustment of as much as $2,200,000 if hiring targets are not met.

The request is driven largely by salaries and benefits, Jackson said, and the home’s funding mix is roughly one‑third general funds and two‑thirds federal and private revenue (Medicare, Medicaid, private pay and VA). She said the home expects about $8,600,000 in VA revenue in FY27 and built its budget on current Medicaid reimbursement rates and a projected Medicaid settlement of $3,700,000.

Jackson described operational constraints and capital needs: the facility currently has 30 beds offline for environmental and plumbing work, has completed design work and "has applied for a VA construction grant" (the VA would pay about 65% and the state about 35%), but she cautioned there is a multi‑billion‑dollar backlog for VA construction funding.

She raised a separate reimbursement risk tied to the federal Medicaid 1115 waiver, which is authorized through Dec. 31, 2027. "If for some reason it is not renewed, we will be subject to what's called the Medicare ... upper payment limit," Jackson said, estimating that loss of the waiver could require an additional $5–$6 million in general funds.

Jackson also flagged clinical cost pressures that affect admissions: the home sometimes denies admission to veterans who require very expensive oral chemotherapy medications — "they can be upwards of $50,000 a month," she said. The National Association of State Veterans Homes is pursuing federal legislation to require reimbursement for medications costing more than 8.5% of the daily rate; Jackson said Congresswoman Balint has cosponsored that effort.

On quality and utilization, Jackson said the home remains highly rated nationally and noted a recent US News & World Report recognition; she described an active recruiting and training pipeline and said an L&A class of eight graduates recently boosted direct staffing on the second shift. The home reported an average resident age of 81, 83 current veterans in house and ongoing waiting‑list activity.

Jackson closed by noting the home will continue working with the Department of Buildings and General Services on capital plans, and that board action is pending on a slight private‑room rate increase to recover a small portion of costs.

The committee asked follow‑up questions during the presentation; no formal committee action or vote was taken on the request at the hearing.