reglab/statecodes huggingface dataset:
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 122. Recovery of payments

§ 122. Recovery of payments
(a) The amount of assistance or benefits may be changed or cancelled at any time if the Commissioner for Children and Families or the Commissioner of Vermont Health Access finds that the recipient’s circumstances have changed. Upon granting assistance or benefits the Department for Children and Families or the Department of Vermont Health Access shall inform the recipient that changes in his or her circumstances must be promptly reported to the Department.
(b) When on the death of a person receiving assistance it is found that the recipient possessed income or property in excess of that reported to the Department for Children and Families or the Department of Vermont Health Access, up to double the total amount of assistance in excess of that to which the recipient was lawfully entitled may be recovered by the Commissioner for Children and Families or the Commissioner of Vermont Health Access as a preferred claim from the estate of the recipient. The Commissioner for Children and Families or the Commissioner of Vermont Health Access shall calculate the amount of the recovery by applying the legal interest rate to the amount of excess recovery paid, except that the recovery shall be capped at double the excess assistance paid.
(c) When the Commissioner for Children and Families or the Commissioner of Vermont Health Access finds that a recipient of benefits received assistance in excess of that to which the recipient was lawfully entitled, because the recipient possessed income or property in excess of Department standards, the Commissioner for Children and Families or the Commissioner of Vermont Health Access may take actions to recover the overpayment.
(d) In the event of recovery, an amount may be retained by the Commissioner for Children and Families or the Commissioner of Vermont Health Access in a special fund for use in offsetting program expenses and an amount equivalent to the pro rata share to which the United States of America is equitably entitled shall be paid promptly to the appropriate federal agency. (Added 1967, No. 147, § 1; 1997, No. 155 (Adj. Sess.), § 20; amended 2005, No. 174 (Adj. Sess.), § 73; 2009, No. 156 (Adj. Sess.), § I.39.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 123. Guardian or legal representative

§ 123. Guardian or legal representative
(a) If the Commissioner finds that an applicant for or recipient of assistance is incapable of taking care of himself or herself or his or her business affairs, the Commissioner may direct the payment of the assistance to a guardian appointed by the Probate Division of the Superior Court.
(b) If the Commissioner finds that an applicant for or recipient of assistance is incapable of prudently attending to his or her business affairs, the Commissioner may direct the payment of the assistance to the legal representative of the person appointed by the Probate Division of the Superior Court. (Added 1967, No. 147, § 1; amended 2009, No. 154 (Adj. Sess.), § 238a, eff. Feb. 1, 2011.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 124. Inalienability of assistance payments

§ 124. Inalienability of assistance payments
All rights to and all monies or orders granted to persons as assistance shall be inalienable by assignment, transfer, attachment, trustee process, execution, or otherwise. In case of bankruptcy, the assistance shall not pass to or through a trustee or other person acting on behalf of creditors. (Added 1967, No. 147, § 1.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 142. Bringing needy person into the State

§ 142. Bringing needy person into the State
(a) Any person who knowingly brings or causes to be brought a needy person from out of the state into this State for the purpose of securing assistance for the needy person or making him or her a public charge, shall be obligated to support the needy person at his or her own expense as long as the needy person or persons dependent on the needy person remain in the State.
(b) The Commissioner may bring a civil action on this statute to enforce support of the needy person and his or her dependents. In the action, the court may make an order, which shall be subject to change by the court from time to time as the circumstances require, directing the defendant to pay a certain sum periodically to the Department for the benefit of the needy person and his or her dependents residing in the State. The court may punish for violation of the order as for contempt. (Added 1967, No. 147, § 1.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 143. General penalty

§ 143. General penalty
(a) A person who knowingly violates a provision of this title for which no penalty is specifically provided shall:
(1) if the assistance or benefits obtained pursuant to a single fraudulent scheme or a course of conduct are in violation of subsection 141(a) or (b) of this title involving $1,000.00 or less, be fined not more than the amount of assistance or benefits wrongfully obtained or be imprisoned not more than one year, or both;
(2) if the assistance or benefits obtained pursuant to a single fraudulent scheme or course of conduct are in violation of subsection (a) or (b) of section 141 of this title and involve more than $1,000.00, be fined not more than an amount equal to the assistance or benefits wrongfully obtained or be imprisoned not more than three years, or both; or
(3) if the violation is under subsection (c), (d), or (e) of section 141 of this title, be fined up to $1,000.00 or up to an amount equal to twice the amount of assistance, benefits, or payments wrongfully obtained, or be imprisoned for not more than 10 years, or both.
(b) If the person convicted is receiving assistance, benefits, or payments, the Commissioner for Children and Families or the Commissioner of Vermont Health Access may recoup the amount of assistance or benefits wrongfully obtained by reducing the assistance, benefits, or payments periodically paid to the recipient, as limited by federal law, until the amount is fully recovered.
(c) If a provider of services is convicted of a violation of subsection 141(d) or (e) of this title, the Commissioner of Vermont Health Access shall, within 90 days of the conviction, suspend the provider from further participation in the medical assistance program administered under Title XIX of the Social Security Act for a period of four years. The suspension required by this subsection may be waived by the Secretary of Human Services only upon a finding that the recipients served by the convicted provider would suffer substantial hardship through a denial of medical services that could not reasonably be obtained through another provider. (Added 1967, No. 147, § 1; amended 1977, No. 206 (Adj. Sess.), § 2; 1999, No. 147 (Adj. Sess.), § 4; 2005, No. 174 (Adj. Sess.), § 75; 2009, No. 156 (Adj. Sess.), § I.41; 2021, No. 20, § 275.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 143a. Civil remedies

§ 143a. Civil remedies
(a) A person who violates subsection 141(c), (d), or (e) of this title with actual knowledge may be subject to a civil suit by the Attorney General for:
(1) restitution of the amount of assistance, benefits, or payments wrongfully obtained;
(2) interest; and
(3) a civil penalty of up to three times the amount of the wrongfully obtained assistance, benefits, or payments; or $500.00 per false claim; or $500.00 for each false document submitted in support of a false claim, whichever is greatest.
(b) The remedies provided in this section shall be in addition to any other remedies provided by law.
(c) The right to a jury trial shall attach to actions under this section. (Added 2003, No. 147 (Adj. Sess.), § 1.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 143b. Education and information

§ 143b. Education and information
By January 1, 2005, the Department of Vermont Health Access shall issue rules establishing a procedure for health care providers enrolled in State and federally funded medical assistance programs to obtain advisory opinions regarding coverage and reimbursement under those programs. Each advisory opinion issued by the Department of Vermont Health Access shall be binding on that Department and the party or parties requesting the opinion only with regard to the specific questions posed in the opinion, the facts and information set forth in it, and the statutes and rules specifically noted in the opinion. (Added 2003, No. 147 (Adj. Sess.), § 2; amended 2005, No. 174 (Adj. Sess.), § 76; 2009, No. 33, § 65; 2009, No. 156 (Adj. Sess.), § I.42.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 144. Statutory construction

§ 144. Statutory construction
(a) Section 143 of this title shall not preclude prosecution under 13 V.S.A. § 1801, 1802, or 2002 when the alleged violation involves forging an economic assistance check or where duplicate economic assistance checks have been wrongfully negotiated during any one welfare period.
(b) Section 143 of this title shall not preclude prosecution under any other title or sections of this title when the alleged violation is under subsection 141(c) or (d) of this title. (Added 1977, No. 206 (Adj. Sess.), § 3; amended 2021, No. 20, § 276.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 1 - Department for Children and Families › § 152. Access to records

§ 152. Access to records
(a) The Commissioner may obtain from the Vermont Crime Information Center the record of convictions of any person to the extent required by law or the Commissioner has determined by rule that such information is necessary to regulate a facility or individual subject to regulation by the Department or to carry out the Department’s child protection obligations under chapters 49-59 of this title. The Commissioner shall first notify the person whose record is being requested.
(b) The owner or operator of a facility licensed or registered by the Department may ask the Commissioner for the record of convictions and the record of substantiated reports of child abuse of a current employee or a person to whom the owner or operator has given a conditional offer of employment. The request shall be in writing and shall be accompanied by a release signed by the current or prospective employee. The owner or operator shall inform the current or prospective employee that he or she has the right to appeal the accuracy and completeness of the record. Upon receiving a request under this subsection, the Commissioner shall ask the Vermont Crime Information Center for the record of convictions of the current or prospective employee.
(c) If the person has a record of convictions, the Commissioner shall provide the owner or operator with a copy of the record. If the person has a record of substantiated reports of child abuse, the Commissioner shall inform the requesting owner or operator that such record exists.
(d) Information released to an owner or operator under this section shall not be released or disclosed by the owner or operator to any other person. Release or disclosure of such information by an owner or operator may result in the loss of the license or registration.
(e) As used in this section:
(1) “Commissioner” means the Commissioner for Children and Families or the Commissioner’s designee.
(2) “Employee” shall include volunteers.
(3) “Substantiated reports of child abuse” means reports of child abuse substantiated under section 4915 of this title.
(4) “Volunteer” means an individual who, without compensation, provides services through a public or private organization. (Added 2013, No. 131 (Adj. Sess.), § 13, eff. May 20, 2014; amended 2015, No. 60, § 12.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 4 - Department of Vermont Health Access › § 401. Composition of Department

§ 401. Composition of Department
The Department of Vermont Health Access, created under 3 V.S.A. § 3088, shall consist of the Commissioner of Vermont Health Access, the Medical Director, and all divisions within the Department, including the Divisions of Managed Care; Health Reform; the Vermont Health Benefit Exchange; and Medicaid Policy, Fiscal, and Support Services. (Added 2009, No. 156 (Adj. Sess.), § I.79; amended 2011, No. 48, § 5; 2011, No. 171 (Adj. Sess.), § 36, eff. May 16, 2012.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 4 - Department of Vermont Health Access › § 403. Financial institutions to furnish information

§ 403. Financial institutions to furnish information
(a) As used in this section:
(1) “Bank” shall have the same meaning as in 8 V.S.A. § 11101.
(2) “Broker-dealer” shall have the same meaning as in 9 V.S.A. § 5102.
(3) “Credit union” shall have the same meaning as in 8 V.S.A. § 30101.
(4) “Financial institution” means any financial services provider, including a bank, credit union, broker-dealer, investment advisor, mutual fund, or investment company.
(5) “Investment advisor” shall have the same meaning as in 9 V.S.A. § 5102.
(6) “Mutual fund” shall have the same meaning as in 8 V.S.A. § 3461.
(b) A financial institution, when requested by the Commissioner of Vermont Health Access, shall furnish to the Commissioner or to an agent of the Department of Vermont Health Access information in the possession of the financial institution with reference to any person or his or her spouse who is applying for or is receiving assistance or benefits from the Department of Vermont Health Access. The Department of Vermont Health Access shall issue instructions to the financial institution detailing the nature of the request and the information necessary to satisfy the request.
(c) A financial institution shall not be subject to criminal or civil liability for actions taken in accordance with subsection (b) of this section. (Added 2017, No. 210 (Adj. Sess.), § 6, eff. June 1, 2018.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 4 - Department of Vermont Health Access › § 404. State agencies to furnish information

§ 404. State agencies to furnish information
(a) Any governmental official or agency in the State, when requested by the Department of Vermont Health Access, shall furnish to the Department information in the official’s or agency’s possession with reference to aid given or money paid or to be paid to any person or person’s spouse who is applying for or is receiving assistance or benefits from the Department of Vermont Health Access.
(b) The Commissioner of Taxes, when requested by the Commissioner of Vermont Health Access, and unless otherwise prohibited by federal law, shall compare the information furnished by an applicant or recipient of assistance with the State income tax returns filed by such person and shall report his or her findings to the Commissioner of Vermont Health Access. Each application for assistance shall contain a form of consent, executed by the applicant, granting permission to the Commissioner of Taxes to disclose such information to the Commissioner of Vermont Health Access.
(c) On the first day of each month, each unit of the Superior Court shall provide to the Commissioner of Vermont Health Access a list of all estates, including testate, intestate, and small estates, opened during the previous calendar month within the jurisdiction of that unit’s Probate Division. The list shall contain the following information for each estate:
(1) the decedent’s full name;
(2) the decedent’s date of birth;
(3) the decedent’s date of death;
(4) the docket number;
(5) the date on which the estate was opened; and
(6) the full name and contact information for the executor or administrator or his or her legal representative. (Added 2017, No. 210 (Adj. Sess.), § 8, eff. June 1, 2018 (subsec. (c) eff. October 1, 2018).)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 5 - Department of Disabilities, Aging, and Independent Living › § 501. Disabilities, aging, and independent living policy

§ 501. Disabilities, aging, and independent living policy
(a) It is the policy of the State of Vermont that all older Vermonters and Vermonters with disabilities should:
(1) be able to live as independently as they choose and as their personal circumstances permit;
(2) be able to receive services and benefits that they need and to which they are entitled by law;
(3) be able to be full and active participants in the life of their communities, including competitive employment consistent with their abilities and interests; and
(4) be protected against unlawful and unnecessary restriction.
(b) The programs of the Department of Disabilities, Aging, and Independent Living shall be administered in a manner consistent with this policy.
(c) The laws pertaining to the Department of Disabilities, Aging, and Independent Living and its programs shall be construed liberally to carry out the policies stated in this section. (Added 1989, No. 219 (Adj. Sess.), § 3; amended 2005, No. 174 (Adj. Sess.), § 79.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 5 - Department of Disabilities, Aging, and Independent Living › § 502. Definitions

§ 502. Definitions
As used in this chapter:
(1) “Adult foster care” means provision of 24-hour home care services for one or two adult persons with a disability in the residence of the person providing the home care services.
(2) “Americans with Disabilities Act” means the federal Americans with Disabilities Act of 1990 and regulations promulgated under the Act, as amended at any time.
(3) “Commissioner” means the Commissioner of Disabilities, Aging, and Independent Living.
(4) “Department” means the Department of Disabilities, Aging, and Independent Living.
(5) “Home care services” include room, board, safety services, household services, and any specialized services to meet the unique needs of the individual.
(6) “Older Americans Act” means the federal Older Americans Act of 1965 and regulations promulgated under the Act, as amended at any time.
(7) “Older persons” means individuals who have attained the age of 60 years.
(8) “Persons with disabilities” means individual Vermonters who have functional limitations by virtue of physical, psychiatric, cognitive, or psychological conditions.
(9) “Rehabilitation Act” means the federal Rehabilitation Act of 1973 and regulations promulgated under the Act, as amended at any time.
(10) “Social Security Act” means the federal Social Security Act and regulations promulgated under the Act, as amended at any time. (Added 1989, No. 219 (Adj. Sess.), § 3; amended 2005, No. 174 (Adj. Sess.), § 79; 2007, No. 37, § 1; 2013, No. 131 (Adj. Sess.), § 16, eff. May 20, 2014; 2021, No. 20, § 279.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 5 - Department of Disabilities, Aging, and Independent Living › § 503. Composition of Department

§ 503. Composition of Department
The Department, created pursuant to 3 V.S.A. § 3085a, shall consist of the Commissioner of Disabilities, Aging, and Independent Living, the Advisory Board established under section 505 of this title, and all divisions and units of the Department, including the Division for the Blind and Visually Impaired and the Division of Vocational Rehabilitation. (Added 1989, No. 219 (Adj. Sess.), § 3; amended 2005, No. 174 (Adj. Sess.), § 79.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 5 - Department of Disabilities, Aging, and Independent Living › § 505. Advisory Board

§ 505. Advisory Board
(a) An advisory board to the Department is created for the purpose of advising the Commissioner with respect to programs and issues affecting older persons and persons with disabilities.
(b) The Board shall be composed of no fewer than 19 and no more than 24 members appointed by the Governor for terms of three years. Of these members, no fewer than 14 shall be individuals who are older persons or persons with disabilities, of which at least seven shall be selected for their familiarity with and interest in programs and issues affecting the interests of older persons, and seven shall be selected for their familiarity with and interest in programs and issues affecting the interests of persons with disabilities. Five members shall be selected to represent the interests of each of the five regions of the State. Persons who are paid providers of services to older persons and persons with disabilities shall not be appointed except as representatives of one of the five regions of the State or because they otherwise qualify for membership. The Advisory Board and Commissioner shall seek the advice and recommendations of paid service providers on an organized and regular basis.
(c) The Governor shall designate the chair of the Board.
(d) Members shall not be entitled to compensation but shall be reimbursed for actual and necessary expenses incurred in connection with their duties as members of the Board.
(e) A vacancy shall be filled in the manner provided for the original appointment for the unexpired portion of that term.
(f) The Board shall advise the Commissioner on matters related to the interests of older persons and persons with disabilities. It shall be guided generally by reference to the statements of objectives and policy found in the Older Americans Act and the Americans with Disabilities Act.
(g) The Board may establish committees to facilitate its work and to ensure it pays adequate and appropriate attention to the range of issues for which the Department is responsible. The Board may also create ad hoc committees to address discrete issues as they arise.
(h) The Commissioner shall ensure that the Advisory Board and its committees receive sufficient staff support to meet their responsibilities. (Added 1989, No. 219 (Adj. Sess.), § 3.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 6 - Prevention and Treatment of Sexual Abuse › § 601. Center for the Prevention and Treatment of Sexual Abuse

§ 601. Center for the Prevention and Treatment of Sexual Abuse
(a) There is established within the Agency of Human Services the Vermont Center for the Prevention and Treatment of Sexual Abuse (the Center). The Center shall be jointly overseen by the Commissioner of Corrections and the Commissioner for Children and Families.
(b) The purpose of the Center shall be to protect Vermont’s citizens from sexual assault and child sexual abuse. The Center shall oversee Vermont’s systematic response to sexual assault and child sexual abuse, while recognizing that many agencies, organizations, and individuals have their own independent roles and responsibilities within this system.
(c) The responsibilities of the Center shall include:
(1) coordinating sex offender treatment programs in correctional and juvenile institutions and in the community;
(2) coordinating victim and family treatment programs;
(3) providing support to sexual abuse prevention programs statewide and in local communities;
(4) providing training to recognize and prevent sexual abuse in consultation with the Department of Corrections, the Department for Children and Families, the Department of Mental Health, the Department of State’s Attorneys and Sheriffs, and other agencies, organizations, and individuals as are desirable and necessary;
(5) providing a central organization for the acquisition and dissemination of information regarding best practices for the prevention of sexual violence; the treatment and supervision of adult and juvenile offenders; the provision of victims services; judicial practices conducive to public protection and the supervision of offenders; protocols for coordinated investigations of allegations of child sexual abuse; and any other information that may be beneficial in aiding Vermont’s response to sexual abuse;
(6) making available an array of services to sexually abused children and their family members; and
(7) providing grants to community agencies to further the Center’s purpose of protecting Vermont’s citizens from sexual assault and child sexual abuse.
(d) The Commissioner of Corrections and the Commissioner for Children and Families shall be responsible for maintaining and providing staffing for the center. (Added 2009, No. 1, § 12, eff. March 4, 2009; amended 2011, No. 139 (Adj. Sess.), § 37, eff. May 14, 2012.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 900. Definitions

§ 900. Definitions
Unless otherwise required by the context, the words and phrases in this chapter shall be defined as follows:
(1) “Agency” means the Agency of Human Services.
(2) “Director” means the Director of Rate Setting.
(3) “Division” means the Division of Rate Setting.
(4) “Provider” means any entity, excluding a hospital or a physician, providing services to State-assisted persons pursuant to a contract or other form of agreement with the State.
(5) “Secretary” means the Secretary of Human Services.
(6) “State-assisted” means a person eligible for or receiving benefits administered by or in coordination with the Agency. (Added 1995, No. 160 (Adj. Sess.), § 9; amended 1997, No. 61, § 268; 2007, No. 172 (Adj. Sess.), § 9; 2013, No. 131 (Adj. Sess.), § 18, eff. May 20, 2014.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 901. Reimbursement objectives

§ 901. Reimbursement objectives
Reimbursement rates for nursing homes shall reflect the following objectives:
(1) maintain an equitable and fair balance between cost containment and quality care in nursing homes;
(2) encourage nursing homes to admit persons without regard to their source of payment;
(3) provide an incentive to nursing homes to admit and provide care to persons in need of comparatively greater care;
(4) be manageable administratively for both the State and nursing homes; and
(5) prevent unnecessary cost increases. (Added 1989, No. 267 (Adj. Sess.), § 1, eff. July 1, 1991; amended 1995, No. 160 (Adj. Sess.), § 10.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 902. Division of Rate Setting, Director

§ 902. Division of Rate Setting, Director
(a) There is hereby created in the Agency of Human Services a Division of Rate Setting, which shall provide the Agency of Human Services with special financial, accounting, auditing, and related legal expertise for the purpose of rate setting and such other duties as the Secretary shall direct.
(b) The Division shall be headed by a director who shall report to the Secretary of the Agency or the Secretary’s designee.
(c) [Repealed.] (Added 1977, No. 204 (Adj. Sess.), § 1; amended 1995, No. 160 (Adj. Sess.), § 11; 1997, No. 61, §§ 269, 271(b); 2005, No. 174 (Adj. Sess.), § 80; 2007, No. 172 (Adj. Sess.), § 9a.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 903. Division, staff

§ 903. Division, staff
The Director, with the approval of the Secretary, may employ such professional and clerical personnel as are necessary for the implementation of this chapter. The Director, with the approval of the Secretary, may also enter into contracts with attorneys, private auditors, consultants, and registered or certified public accountants for additional services including auditing providers as may be necessary for the proper administration of this chapter. (Added 1977, No. 204 (Adj. Sess.), § 1; amended 1997, No. 61, § 270.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 904. Rate setting

§ 904. Rate setting
(a) The Director shall establish by rule procedures for determining payment rates for care of State-assisted persons to nursing homes and to such other providers as the Secretary shall direct. The Secretary shall have the authority to establish rates that the Secretary deems sufficient to ensure that the quality standards prescribed by section 7117 of this title are maintained, subject to the provisions of section 906 of this title. Beginning in State fiscal year 2003, the Medicaid budget for care of State-assisted persons in nursing homes shall employ an annual inflation factor that is reasonable and that adequately reflects economic conditions, in accordance with the provisions of Section 5.8 of the rules adopted by the Division of Rate Setting (Methods, Standards, and Principles for Establishing Medicaid Payment Rates for Long-Term Care Facilities).
(b) No payment shall be made to any nursing home, on account of any State-assisted person, unless the nursing home is certified to participate in the State/federal medical assistance program and has in effect a provider agreement. (Added 1977, No. 204 (Adj. Sess.), § 1; amended 1981, No. 224 (Adj. Sess.), § 1, eff. May 4, 1982; 1989, No. 267 (Adj. Sess.), § 2, eff. July 1, 1991; 1995, No. 160 (Adj. Sess.), § 12; 1997, No. 61, § 270a; 2001, No. 63, § 99; 2013, No. 131 (Adj. Sess.), § 19, eff. May 20, 2014; 2021, No. 20, § 280.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 905. Basis for determination of nursing home rates

§ 905. Basis for determination of nursing home rates
(a)(1) Consistent with the objectives established under section 901 of this title, the Division shall develop a payment system based on cost categories established for each nursing home. The system shall include no fewer than the following three cost categories:
(A) direct care costs, which refer, at a minimum, to nursing salaries and nursing assistant wages, fringe benefits, and payroll taxes associated therewith;
(B) indirect costs, which refer to all operating costs not established under subdivision (1) of this subdivision; and
(C) property and related costs.
(2) At the discretion of the Director, the cost categories referred to in subdivision (1) of this subsection may be subdivided. Facilities may also be divided into groups, based on considerations such as size or other appropriate determinants within each cost category or subdivision thereof.
(b)(1) The basis for reimbursement within the direct care cost category shall be a resident classification system, which shall group residents into classes according to similarity of their assessed condition and required services. Each resident shall be assigned to one of no fewer than three classes, based on the nature and extent of nursing care needed. The Director may subdivide these classes.
(2) The direct care component of a nursing home’s payment rate shall be reflective of the necessary professional and paraprofessional nursing staff time and costs required to address the care needs of the residents of the facility.
(3) Assessments of residents for classification purposes shall be made on the basis of standardized information made available by each facility to the Division. Each nursing home shall assess all of its residents not less often than annually, in accordance with standards and a schedule developed by the Department of Disabilities, Aging, and Independent Living. The accuracy of the information shall be verified and final classifications made by the Department of Disabilities, Aging, and Independent Living.
(c) Rates shall be determined prospectively for each facility on the basis of cost reports submitted to the Director. The Director shall certify the rate for each facility annually by selecting a base year, setting a rate for the base year, and adjusting it annually by inflation factors that are reasonable and that adequately reflect economic conditions. The inflation factors may differ for direct care and other costs. The base years may be changed at different intervals for direct care and other costs. For direct care costs, such change shall occur no less frequently than once every three years, and, for other costs, no less frequently than once every four years, unless the Secretary of Human Services certifies to the General Assembly that it is not necessary to do so. (Added 1989, No. 267 (Adj. Sess.), § 3; amended 1995, No. 160 (Adj. Sess.), § 13; 2005, No. 174 (Adj. Sess.), § 81; 2013, No. 131 (Adj. Sess.), § 20, eff. May 20, 2014.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 906. Facility payment

§ 906. Facility payment
(a) The payment rate for each facility shall be the sum of its per diem allowance for each cost category, subject to such limitations as the Secretary shall prescribe by rule pursuant to section 907 of this title.
(b) The payment for each facility’s direct care costs shall be a function of the number of resident days of each resident class and shall be adjusted in a timely manner to reflect changes in the assessed needs of residents. (Added 1989, No. 267 (Adj. Sess.), § 4, eff. July 1, 1991; amended 1997, No. 61, § 270b.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 907. Payment limits

§ 907. Payment limits
(a) The Director shall establish payment limits consistent with the provisions of section 901 of this title to encourage the economic and efficient operation of nursing homes and other providers.
(b) The payment limits shall not act as a disincentive for nursing homes to address the assessed needs or improve the conditions of residents. (Added 1989, No. 267 (Adj. Sess.), § 5, eff. July 1, 1991; amended 1995, No. 160 (Adj. Sess.), § 14; 1997, No. 61, § 270c.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 908. Powers and duties

§ 908. Powers and duties
(a) Each nursing home or other provider shall file with the Division, on request, such data, statistics, schedules, or information as the Division may require to enable it to carry out its function. Information received from a nursing home under this section shall be available to the public, except that the specific salary and wage rates of employees, other than the salary of an administrator, shall not be disclosed unless disclosure is required under 1 V.S.A. § 317(b).
(b) The Division shall have the power to examine books and accounts of any nursing home or other provider caring for State-assisted persons, to subpoena witnesses and documents, to administer oaths to witnesses, and to examine them on all matters of which the Division has jurisdiction.
(c) The Secretary shall adopt all rules necessary for the implementation of this chapter. (Added 1977, No. 204 (Adj. Sess.), § 1; amended 1995, No. 160 (Adj. Sess.), § 15; 1997, No. 131 (Adj. Sess.), § 2; 2013, No. 131 (Adj. Sess.), § 21, eff. May 20, 2014; 2015, No. 29, § 9; 2021, No. 20, § 281.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 909. Appeal

§ 909. Appeal
(a) A nursing home that feels aggrieved by a final order of the Division may do any of the following:
(1) Have the right of direct appeal to the Vermont Supreme Court pursuant to the Vermont Rules of Civil Procedure and the Vermont Rules of Appellate Procedure under the same terms and conditions as if the appeal were taken to the Supreme Court from the Superior Court pursuant to the laws of Vermont.
(2) Have the right to appeal de novo to the Superior Court of the county where the nursing home facility is situated.
(3) Request a review by the Secretary of Human Services. The Secretary of Human Services shall designate an independent appeals officer who shall be a registered or certified public accountant. The appeals officer shall conduct appeal hearings and make findings of fact and recommendations to the Secretary. The appeals officer shall have the power to subpoena witnesses and documents and administer oaths. A party aggrieved by a determination of the Secretary may obtain judicial review under the provisions of subdivision (1) or (2) of this subsection.
(b) An appeal from any determination made under this chapter shall not be made under 3 V.S.A. § 3091. (Added 1977, No. 204 (Adj. Sess.), § 1; amended 1995, No. 160 (Adj. Sess.), § 16; 2021, No. 20, § 282.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 9 - Division of Rate Setting › § 910. Availability of payment for nursing home services

§ 910. Availability of payment for nursing home services
The Secretary may, with 90 days’ notice to the nursing home, reduce the number of days of nursing home service or the number of nursing home beds for which payments are available under the State/federal medical assistance program in order to meet State budgetary goals, provided that the standards of care required by section 7117 of this title and by rule are maintained. (Added 1977, No. 204 (Adj. Sess.), § 1; amended 1995, No. 160 (Adj. Sess.), § 17; 2013, No. 131 (Adj. Sess.), § 22, eff. May 20, 2014; 2021, No. 20, § 283.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 10 - Reach First › § 1002. Purpose

§ 1002. Purpose
(a) The purpose of the Reach First program is:
(1) to stabilize families in crisis, assess the family’s strengths and needs, and orient families to the programs, services, assistance, and participant responsibilities available to improve self-sufficiency, attain economic independence, and ensure the well-being of children;
(2) to refer families without recent work histories, recognizing individual and unique characteristics, to an appropriate program available to assist the family in obtaining the opportunities and skills necessary for self-sufficiency and economic independence;
(3) to assist families with recent work histories by providing short-term financial support and support services to stabilize the family while the family transitions back to employment;
(4) to support parental responsibility and positive parental role models, both custodial and noncustodial;
(5) to improve the well-being of children by providing short-term supports to their families and referrals to appropriate programs and services;
(6) to conserve State public financial resources by operating the system of human services in a manner that is efficient and avoids federal fiscal sanctions; and
(7) to conform to the federal TANF law.
(b) The critical elements of developing a short-term stabilization, assessment, and orientation program that assists families to maintain or attain self-sufficiency are:
(1) cooperative and realistic goal-setting, coupled with individualized case management that addresses each individual’s situation and barriers to self-sufficiency;
(2) a short-term monetary payment and support services of a limited duration to provide for immediate, short-term needs of the family until the family attains employment quickly, or transitions to an appropriate program to assist the family in order to ensure the family’s well-being and success to reaching self-sufficiency; and
(3) clear and comprehensive information on available options and appropriate services communicated to families in a simple fashion and easy transition to programs, such as Reach Ahead, Reach Up, the Postsecondary Education Program, and any other solely State-funded or separate State-funded programs. (Added 2007, No. 30, § 1, eff. May 17, 2007.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 10 - Reach First › § 1003. Eligibility

§ 1003. Eligibility
(a) A family shall be eligible for the Reach First program if the family’s income and resources are below the limits established for the Reach Up program, and the family resides in Vermont. All applicants for programs under this chapter or chapter 11 or 12 of this title shall be provided an orientation, initial assessments, the Reach First payment, and, if appropriate for the family, in-depth assessment, a family development plan, and services through Reach First.
(b) Reach First payments and services shall be available only once every 12 months for a family, except as provided for by rule. Families who have received Reach First within the past 12 months shall be provided financial assistance and services through Reach Up, the Postsecondary Education Program, or other program appropriate for the family. Families applying for or participating in other programs may also receive Reach First assessments, payments, or services as provided for by rule.
(c) The Commissioner may use the eligibility rules for Reach Up instead of adopting new eligibility rules for this program.
(d) An adult who accepts employment after reporting as directed under section 1007 of this title may receive Reach First or Reach Up, provided that the family remains financially eligible for the program in accordance with Department rules. (Added 2007, No. 30, § 1, eff. May 17, 2007.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 10 - Reach First › § 1004. Reach First payment

§ 1004. Reach First payment
(a) An eligible family shall receive a short-term cash payment, which is the equivalent of up to 120 days of Reach Up financial assistance for the relevant family size with the same income. The family may receive the payment in installments or a lump sum, if needed to avert a crisis as determined in the initial assessment or the family development plan, during the period in which the family seeks immediate employment or participates in assessment and creating a family development plan. The Commissioner may establish by rule exceptions to the limit on the amount of the payment, as long as the exceptions are budget-neutral to the program.
(b) The Department shall offer every eligible family the option of electronic or direct payment of the family’s housing or other expenses to the person providing the lodging, utilities, or other service as provided for by rule.
(c) For the purposes of calculating the payment, child support shall be treated as income, except that the first $100.00 amount of child support shall be disregarded from income. (Added 2007, No. 30, § 1, eff. May 17, 2007; amended 2023, No. 78, § E.323.1, eff. July 1, 2023.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 10 - Reach First › § 1005. Required services to participating families

§ 1005. Required services to participating families
(a) The Commissioner shall provide to all eligible families an orientation and an initial, up-front assessment to determine which programs, referrals, or services are appropriate. The orientation shall provide the family with information about services and referrals available to the family, and the programs established under chapters 11 and 12 of this title, including program requirements, participant responsibilities, and incentives for participation and obtaining employment.
(b) If needed by the family to improve the family’s prospects for job placement and job retention, the Commissioner shall provide participating families in-depth assessments of the full range of services needed by each family, intensive case management or case consultation services, referral to any agencies or programs that provide the services needed by participating families, and transition to other programs established under chapters 11 and 12 of this title. Services or referrals for services shall include:
(1) Appropriate child care, available at times that will enable employment or participation in services indicated by the participating family’s family development plan. As used in this subdivision, “appropriate child care” shall not include:
(A) child care that the Department classifies as legally exempt child care, and that a parent or caretaker determines to be unacceptable; and
(B) child care that the Department classifies as either a registered family child care home or a licensed child care facility, and that a parent or caretaker determines to be unacceptable when such determination is confirmed by the Department.
(2) Transportation that will enable employment or participation in services indicated by the participating family’s family development plan.
(3) Career counseling, education, and training, and job search assistance consistent with the purposes of this chapter.
(4) Vocational rehabilitation.
(5) Medical and dental assistance.
(6) Homelessness prevention and housing assistance.
(7) Family planning education and counseling.
(8) [Repealed.]
(9) Transfer to a State-funded program under chapter 11, subchapter 3 of this title, the Reach Up program, or the Reach Ahead program.
(10) Any other services identified in the family development plan and determined by the Commissioner to be necessary and appropriate to achieve the purposes of this chapter or chapter 11 of this title. (Added 2007, No. 30, § 1, eff. May 17, 2007; amended 2023, No. 78, § E.323.2, eff. July 1, 2023.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 10 - Reach First › § 1006. Case management; family development plans; coordinated services

§ 1006. Case management; family development plans; coordinated services
(a) If a family needs or requests in-depth assessment and ongoing services, the Commissioner shall provide all Reach First services to these participating families through a case management model. The case manager, with the full involvement of the family, shall recommend, and the Commissioner shall establish and modify as necessary, a family development plan for each participating family in need of ongoing services, with a right of appeal as provided by section 1132 of this title. A case manager shall be assigned to each participating family as soon as the family is determined to be eligible for this program and in need of services.
(b) The family development plan shall include:
(1) Each parent’s or caretaker’s employment goal or plan to engage in the program, to the best of the parent’s or caretaker’s ability.
(2) An assessment of each parent or caretaker’s strengths and barriers. The initial assessment shall include a literacy evaluation followed by a referral to an appropriate resource or program.
(3) An identification of the services, supports, and accommodations needed to overcome any barriers, to enable the family to achieve self-sufficiency, and to fulfill each parent or caretaker’s personal and family responsibilities.
(4) An assignment of responsibilities, family development plan requirements, and activities among the case manager and family members, together with a time schedule for such responsibilities, requirements, and activities.
(c) The initial family development plan shall be completed within 30 days of the first meeting with the case manager. The case manager shall establish a schedule for periodic review of the family development plan.
(d) The Commissioner shall adopt rules, consistent with research on best practices, establishing maximum caseloads for case managers. (Added 2007, No. 30, § 1, eff. May 17, 2007; amended 2023, No. 78, § E.323.3, eff. July 1, 2023.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 10 - Reach First › § 1011. Transition to other programs

§ 1011. Transition to other programs
(a) The Department shall transfer the family to Reach Up, a separate State program, or a solely State-funded program established under chapter 11 of this title if, after four months of receiving support in Reach First or sooner at the Department’s discretion, a family is assessed to need ongoing financial assistance and the family is financially eligible for Reach Up, a separate State program, or a solely State-funded program established under chapter 11 of this title, unless the family chooses not to participate.
(b) [Repealed.]
(c) [Repealed.]
(d) A family transferring to another program under subsections (a) through (c) of this section shall not be required to complete a new application. Verification of income or other documentation may be required as provided for by rule.
(e) Transitional medical assistance of up to 36 months shall be provided to families with a working adult who leaves Reach First and is not eligible for Reach Up, as provided for in the Vermont Medicaid rule M302.21 in effect on May 1, 2007, provided that federal financial participation is available for such transitional medical assistance. (Added 2007, No. 30, § 1, eff. May 17, 2007; amended 2009, No. 67 (Adj. Sess.), § 92, eff. Feb. 25, 2010; 2023, No. 78, § E.323.4, eff. July 1, 2023.)
2023 Vermont Statutes › Title 33 - Human Services › Chapter 10 - Reach First › § 1012. Notice and appeal

§ 1012. Notice and appeal
A participant may appeal decisions in accordance with 3 V.S.A. § 3091. The Commissioner shall provide notice to each participant of the standards and procedures applicable to such appeals. All federal and Agency of Human Services rules regarding conciliation, notice, hearing, and appeal shall be followed in connection with such appeals. (Added 2007, No. 30, § 1, eff. May 17, 2007.)