SmartTranscript of House Appropriations - 2025-01-23 - 11:10AM

[Chair ]: Good morning. This is the House Appropriations Committee. It is Thursday, January twenty third twenty twenty five. We're continuing, to go through the Budget Adjustment Act. And this morning, we have joining us, remotely, via Zoom, the folks from the Vermont Veterans Home. And we're just talking about budget adjustment today. We'll have you back for the FY twenty six budget, when we get that from the governor. So, we appreciate your flexibility, and we got a little behind this morning, but I think we'll catch up with you guys. And we have a lot of new members, so we'll go around and introduce ourselves, and then we'll ask you to introduce yourselves and talk about your budget adjustment. Great. John to get this started. [John Kosenska ]: Good morning, and welcome. John Kosenska from the town of Burke, and I represent the Essex Caledonia District. Hi. Mike Nigro, Bennington and Palenal. [Tom Stevens ]: Tom Stevens from Waterbury representing the Washington Sydney District. [John Kosenska ]: Jim Harrison, I represent Bennington and Bennington and Pittsfield. Welcome. [Chair ]: Robin Shy from Middlebury. Fitz Willey from Burlington. [John Kosenska ]: Travis Whirl, Underhill and Jericho. [Wayne Ross ]: Wayne Ross, Berkshire, Franklin, Richburg. I think [John Kosenska ]: Good morning. Mike from the Wyndham Ford district. Put me in dumpster. [Chair ]: Hi. Lynn Dickinson. I represent Saint Alden's Town, and I think we have a new member that wants to introduce. [John Kosenska ]: So, Dave, [Chair ]: you can finish that. [Dave Giacoboni ]: Greetings. Dave Giacoboni from Morrisville, and I'm representative for the Lamoille Washington District. [Chair ]: And, Wayne LaRoche will be your, budget, partner here in the hospital bridge. So so introduce yourselves and take it away, please. [Melissa Jackson ]: Good morning. I am Melissa Jackson. I'm the CEO and licensed administrator of the Veterans Home. With me, I'll let Asa and Steve introduce themselves. Go ahead. [Asa Whitcomb ]: Hi. I'm Asa Whitcomb. I am the COO of the Vermont Veterans Home. [Steve McClafferty ]: And I'm Steve McClafferty. I'm the finance director at the Veterans Home. [Chair ]: Great. Welcome, all of you. Thank you. [Melissa Jackson ]: Thank you. And I do know that watching, the Zoom link are several members of our board of trustees. [Chair ]: Oh, alright. Hello, members of the board of trustees. [Melissa Jackson ]: So, for those [Steve McClafferty ]: I know the committee assignments have changed with the the new biennium. But when we presented our f y, twenty five budget, we did say we would be back for a budget adjustment, and that's why we are here. So we wanna start with our budget adjustment presentation. [Melissa Jackson ]: I'll walk you through that, the PowerPoint. For those who don't know who we are, we are an agency of the state of Vermont. We always get that question. Yep. They seem to get us confused with the VA, but we truly are, an agency of the state of Vermont. We have a hundred and thirty licensed skilled, nursing beds. Thirty of those are on our secure memory care units, and we have eight residential care beds, which are similar to assisted living or what AHS would refer to as a residential care level three. And we are budgeted for a hundred and ninety five state employees. So our employees are members of VSEA, are covered by the same contract and collective bargaining agreement. So on slide four, we talk about our Medicaid settlement dollars. I do not know the specifics about how this waiver became into place, but AHS applied for a Medicaid waiver, which allows the Vermont Veterans Home to recoup our actual costs for our Medicaid patients. So what happens is we receive an interim rate of four hundred and seventy five dollars per day. And then when they do our cost report, we receive a a settlement that is two years behind. So for this budget adjustment, we are receiving a Medicaid settlement from twenty twenty three, fiscal year twenty twenty three, in the amount of four thousand two hundred and Four million two hundred and sixty seven thousand nine hundred and fifty eight dollars to bring us up to our actual true costs. Where am I going from here? So this is what our budget adjustment includes. On our next slide, we're doing a a total general excuse me. General bond request of six million nine hundred and three thousand three hundred and thirty one thousand dollars. A little over two [Speaker 8 ]: Right. [Chair ]: Go ahead. These are the because of the two years behind, this is always where you end up trying to settle up a budget adjustment and that starting in twenty six, we're gonna be doing it a different way. That was the conversation we had last year. Right? [Melissa Jackson ]: Yeah. Yep. The question regarding so, yes, hopefully, that's where we'll be. [Chair ]: Yes. Okay. We'll find out next week. [Melissa Jackson ]: So our total budget adjustment request is going to be nine point seven million dollars. And on slide six, it specifically breaks it down into the various areas of our budget where those figures are going. And these are to get us through the end of the fiscal year based on actual costs. So I wanna bring your attention to the VA security grant and the American Wing money. There are capital funds monies available for that. These projects were paid out of, actual, our cash, so we're trying to recoup those back through capital funds. So we need to [Steve McClafferty ]: So [Melissa Jackson ]: where exactly where to put those, so that's why they were placed there. [Chair ]: So that would go into the capital bill and the corrections and institutions. Oh, did we just get blocked? [John Kosenska ]: Well, they're behind me. Oh, [Chair ]: sorry. Our screen just okay. No. It went black. One of the screens went black. So k. So those could be bonded. Is that what you're saying? [Melissa Jackson ]: Well, the security grant money has already been bonded. So we're just in terms of how we obtain that money, in the past, all of our projects have gone right through BGS. This project was done differently. So we wanna make sure that we have a way of accounting that we need to get that money from the bond for both the American Way project and the security grant project. So they both have already been bonded. [Chair ]: Go ahead. [John Kosenska ]: Could you just clarify? Is that a federal grant that you're able to get, or is this just a regular part of our capital bill, which makes a little confusing with the cash account and the bond and amount? [Melissa Jackson ]: Sure. So as a state veterans home, we are able to access VA grant funding. So for the security grant project, we received, sixty five percent of the project from the VA, and the state is recouping the thirty five percent. And [John Kosenska ]: So the thirty five percent needs to come out of our general fund then? Could it state money? [Melissa Jackson ]: It should come out of the capital fund money, but, yes, it's state money. [John Kosenska ]: Okay. Is is is the thirty five percent number? [Melissa Jackson ]: For the VA's, security grant project, yes. [Speaker 8 ]: Thank you. What was the project? [Melissa Jackson ]: It we install installed a security system, at our facility. We went to a, RFID badge entry program, so all of our employees have a a badge entry. All of our doors are on a breach notification. We had an excess of forty doors that anyone could have accessed at any time without us knowing. We're working out the kinks, but we will have a lockdown button. We increased our parking lot light lighting. Unfortunately, we were having some issues with the local transient drug trafficking issues, and other people on our property wanted to keep our staff and residents safe. So [Chair ]: So the total project was around two and a half million dollars? Yes. Yep. Seems like Yeah. [Wayne Ross ]: We're we're [Melissa Jackson ]: a hundred and forty thousand square feet, one level, and we had an excess of thirty exterior doors. [Chair ]: Okay. Yeah. And I I think Brent and Brent just said [Wayne Ross ]: that excuse me, it's go ahead. So were were these monies in there were bonded dollars that were in the capital bill last [Melissa Jackson ]: year? Was it last year or the year before, Steven? I can't the security project is a couple of years old. The American wing money, we have design money that's actually classified for b and c wing that we're trying to transition over to the a wing project instead. [Wayne Ross ]: So you got bonding authority from bonding authority for for this amount through the institution's impressions committee? Correct. And and I haven't been sat on this committee before. [Chair ]: I don't I this is I'm confused by this. So maybe you can talk with Alice after this to find out because I'm [Asa Whitcomb ]: not sure this is where it should be coming from. [Wayne Ross ]: I don't I don't see the intersection. There may be an because last year, we had some intersections with the appropriation committee, and we had cash funds and stuff like that. So I wasn't sure because the institutions operations committee cannot appropriate money. They they can only approve spending authority or. Bonding authority with a certain limit set by the bond bank. So I'm not sure that this belongs in here, so we'll we should talk to Alice. [Chair ]: Right. Now this wasn't the governor's budget adjustment request, so it might be that also talking to Hardy or Adam, or make it explain why it's here and not the capital. [Melissa Jackson ]: Yeah. We just We said we haven't seen this before. [Chair ]: Every year, you have something new to show us. It's always interesting to see what happens. [Melissa Jackson ]: And we're unsure where to to put it because we've already spent, you know, our operating cash to cover those bills. So we wanted to make sure that we were requesting the bond you know, the the money that was bonded for these projects to be reimbursed back to us. So if going forward, if there's another way, we need to do that Yeah. We'll we'll see what we need [Chair ]: to figure out, if anything, on our end, but we need yeah. Yep. And the American Wing project is what? [Melissa Jackson ]: So we have a a unit offline. It's a a thirty bed unit. It is from the seventies, and, unfortunately, it has concrete pipes that were put into excuse me. Cast iron pipes put into a concrete slab, and the pipes are failing. And there's other issues there, and that unit needs to be torn down and rebuilt. So this is some of the design work for that project. [Chair ]: Okay. So we'll hear more about that over the years because if you're just in the design phase, you got a ways to go. [Melissa Jackson ]: Yes. [Chair ]: Okay. Brett Stevens [Wayne Ross ]: has a question. That was it. [Chair ]: That was it? Okay. I have I have another question while we're looking at this quest. You have five point million nine million for agency staff, and I think that's often what we call traveling staff or traveling nurses. [Melissa Jackson ]: That's accurate. [Chair ]: How does that compare with the last year or two? Is it going up? Is it going down? What's the trend? What [Melissa Jackson ]: was the I saw Steven. I missed it. [Chair ]: I think I saw it going down. Is that what you're saying? It it [Steve McClafferty ]: it it it Go [Melissa Jackson ]: ahead, Steve. [Steve McClafferty ]: Steve McClafferty, it is going down, and I think it's because of the a wing being closed. And we're consolidating and don't have, you know, the full hundred and thirty bed complement available. [Chair ]: Yes. Go ahead, Bruce. [Tom Stevens ]: Thanks for that clarification, Steve, but it leads me to the question of of my experience in the past with this budgeting process for for the home is beds at one point were reduced from a certain level down. And and now if we're at a hundred and thirty beds, but we're gonna lose thirty beds, is that right, in this renovation and this rebuilds? [Melissa Jackson ]: Nope. We'll get the thirty beds back. We'll we'll be maintaining our hundred and thirty beds. They're just While [Tom Stevens ]: the construction's going on? [Melissa Jackson ]: No. So we'll be at a hundred while the cons right now, it's [Tom Stevens ]: Right. Right. And so that's I guess that's and then maybe that's this is a big bill question of, it's already hard enough to make ends meet at a hundred and thirty beds. And so the question will be, how does how do we make ends meet when there's a hundred beds or whatever the next I mean, because that you'll be at a hundred beds then for until the wing is rebuilt. Is that right? [Melissa Jackson ]: That is correct. Yes. [Wayne Ross ]: Okay. [Melissa Jackson ]: And the reason that we're rebuilding that wing is going to be a state of the art memory care unit. So at some point in time, I'd like to have a really you know, I know now now is probably not the time unless you want me to go into a detailed explanation as to why that unit needs to be rebuilt for the, you know, memory care of our residents and why our current memory care unit is not the best environment for them. So [Tom Stevens ]: I I'll be interested. I I mean, just in general, I'll be interested in that, but I think that's a more of a maybe not a PAA question. Right? Okay. For me, anyway. [Chair ]: Yeah. Okay. [Speaker 8 ]: So [Chair ]: so your agency staff would be staying the same, but we're not for more beds going offline. Mhmm. What's happening in terms of trying to move up the agency staff to [Melissa Jackson ]: So state employees? As you probably will hear from other agencies [Chair ]: who [Melissa Jackson ]: work in health care, there is a national health care shortage. Yeah. We are running l and a classes. We've had our second one this year. Our first class graduated seven l and a's, all of which became our employees. Our biggest challenge is nurses for second shift, RNs and LPNs. That continues to be a a problem. We're working closely with HR to streamline our ability to hire a little bit quicker, but the applicants just aren't there. People left health care. So [Wayne Ross ]: Do you expect your your costs to be down during that period of construction when you're gonna be down thirty beds? For example, you're if we have less need for traveling nurses during that time period. [Melissa Jackson ]: So those beds are already offline. We made that decision, and we've we've closed that unit. We have a I mean, we could have our building filled tomorrow, but we made the, prudent decision not to fill the beds because our agency staff cost would have skyrocketed. I mean, they're already high to begin with, and I couldn't justify the continued expense. And also knowing that there were some, you know, pretty significant life safety and physical plant issues over there. So it'll be probably around this amount. We're going to continue to actively hire our own staff as we can. I will say my director of nursing is on the, state hiring page every day, checking for new applicants, interviewing as soon as a new applicant arrives. She you know, she's Johnny on the spot with us. We're doing everything we possibly can. We're doing higher end to ranges. So [Wayne Ross ]: Thanks. [Chair ]: Mhmm. Any You wanted to just mention some of these other other things that are on here that you Yep. [Melissa Jackson ]: So the the four hundred thousand dollars, roughly four hundred thousand dollars for our rehab services and the physician services, the eight hundred and thirty six thousand. Those are our actual costs. Most of the other stuff is food, your food, purchase services, or, expected costs. Our HVAC units, we had several units, decide that this was a good time to fail, and they need to be replaced. So that was an unexpected cost, but we needed to have those done. So that was an unexpected cost, excuse me, What is the reason? For, our budget adjustment. But, basically, everything else in here, brings us up to [Chair ]: Yeah. [Steve McClafferty ]: Our [Melissa Jackson ]: what we anticipated our our cost would be. [Chair ]: And then the million three fifty four for volume, what is volume in personal services? What does that mean? [Melissa Jackson ]: Where is that one? [Steve McClafferty ]: That is, our payer mix changes. When we do budget adjustment, we look at where we are with our, you know, Medicare, Medicaid, VA. And if there's any changes, like our budget may have said, we were projecting thirty two VA service connected and we end up with thirty three or thirty four that affects the general fund because I get more revenue from the federal government from the VA And then that would be less for, for the general fund. So that's what, that is. [Chair ]: And is that I'd have to and look at last year's. How does this compare to last year's number? It just seems like a large number to me. That sounds like there was a a change in the mix, what that you were thinking of, to have it be, oh, you know, almost one point four million. [Melissa Jackson ]: I see he's looking. [Chair ]: Yeah. Yes. I can tell. Yeah. So I'm looking at my computer screen. Look. [Steve McClafferty ]: While I'm looking, continue on. [Chair ]: We have another question, so I don't but Yeah. You wanna ask your question? Yes. [Asa Whitcomb ]: Sure. So I'm just looking I'm going back to the Medicaid settlement dollar page. And [Tom Stevens ]: Correct. [Asa Whitcomb ]: So I'm assuming that, the bullet relating to the waiver, the Medicaid, Medicare waiver, and I mean, sorry. The Medicaid waiver. [Speaker 8 ]: Yes. [Chair ]: Yes. So it's a waiver from Medicare or Medicaid? [Melissa Jackson ]: It's for Medicaid. [Asa Whitcomb ]: Okay. So so there's Medicare has said okay. So, is this part of the eleven fifteen [Speaker 8 ]: waiver Yes. [Asa Whitcomb ]: Application that we're still going through, and that would then be come, operational in twenty six. Right? Calendar year twenty six? [Melissa Jackson ]: I believe so. It's part of AHS does this big waiver, and they include us in it. [Asa Whitcomb ]: Yeah. Okay. Alright. Just wanna make you know that that you were part of that piece. [Melissa Jackson ]: So what it basically is is we get the interim rate of four hundred and seventy five dollars, and then Yep. They threw us up. Most recently, it's been a little over seven hundred dollars. So that's where the the difference is. That's the Medicaid settlement. Yeah. [Chair ]: That's Harrison. [John Kosenska ]: And then So so the four point two million is the state share. So the total cost is, I'm assuming, around ten million dollars. Is that [Melissa Jackson ]: That the four point two million is the additional dollars that of Medicaid dollars that are owed to us. [John Kosenska ]: But but Medicaid's made made up of state general fund plus federal, Medicaid funds. [Melissa Jackson ]: Right. I So Yeah. Steven, do you know if those are federal or state dollars that come to us? I don't know. [Steve McClafferty ]: I'm gonna presume this is from the federal side where the state goes to the feds and gets matching dollars, you know, because of that the eleven fifty five waiver. [Chair ]: Well, on the spreadsheet here, it only shows four hundred and eighty thousand people in federal money of the of the nine point seven million. [Melissa Jackson ]: So where so where the the actual dollars for our settlement comes from, we don't know. We're just Medicaid says, here's your Medicaid settlement. So how that flows from the federal government to the state of Vermont, I'm not in the know. And I don't believe Steven is in the know in terms of we just were, like, told, here's your, you know, here's your medic we get a note, a letter, an email. Here's your Medicaid settlement. Go ahead. [Chair ]: Okay. So I have rep Yakovone and rep Dickinson. Yes. [Dave Giacoboni ]: Just a couple of questions. Out of your current census today, how many of your residents are from New York state? None. None. Any from out of state? [Melissa Jackson ]: Not on Medicaid. No. [Dave Giacoboni ]: K. And the rest of your census, your Vermont census, if you will, are they from all over the state or predominantly Bennington? [Melissa Jackson ]: Predominantly, Rutland and below. [Dave Giacoboni ]: Southern part of the state? Yes. And your census today is? [Melissa Jackson ]: I wasn't in the I'm not unfortunately, I'm sick, and I wasn't in the office today, so I'm gonna defer that to Asa or Steven. [Chair ]: Somebody's you're you're either on mute, or I don't know what's on [Steve McClafferty ]: Our our census today is ninety four, which is eighty six on the nursing home side and eight in our assisted living or our domiciliary. Pardon me? [Dave Giacoboni ]: Most of those ninety four are for the southern part of the state. Okay. Thank you. That's all I have right now. [Chair ]: Thanks. Deputy Akwani. Rep Dickinson? [Rebecca Dickinson ]: Yeah. Thank you. When you talk about Medicaid and the, the waiver and the special well, my understanding from last year was that this two year lag is because the VA makes up some of that, or is that just regular federal state mix and goal expenses that you get reimbursed for. [Melissa Jackson ]: So the Medicaid settlement is truly Medicaid dollars. It has nothing to do with the VA. And [Rebecca Dickinson ]: So the VA has a separate thing that they give you for your [Wayne Ross ]: Correct. [Rebecca Dickinson ]: For your rates. [Melissa Jackson ]: Right. And that's But this is [Rebecca Dickinson ]: just the Medicaid people where you have Mhmm. Say, twenty dollars from the state and thirty dollars from the feds, but they make [Speaker 8 ]: sure that you meet the cost. Correct. [Chair ]: Yes. Thank you. [Melissa Jackson ]: Yes. The Medicaid pays us excuse me. The VA pays us on time the month after. So their their rates are current. So there's not this two year lag like there is with the Medicaid. [Wayne Ross ]: K. Thank you. [Chair ]: When you have questions, there's there's definitely things that you say, we don't know. We're sort of doing what they tell us or whatever. So I understand that. And I'm wondering, do you report? Do you ask if you've got questions? Do you talk to the central office at AHS? Or what who do you ask questions of? [Melissa Jackson ]: So our primary communication when it comes to our budget is through, finance and management. Okay. We haven't had a lot of conversation or input re related to the waiver. We just ask, is this waiver still happening, for budget planning? And we're told yes. Okay. [Chair ]: So Okay. So that's who your contact is. Not not really anybody at AHS, even though in our budget world, that's where you're under. [Melissa Jackson ]: Actually, you're not under. You're not. [Chair ]: You're yeah. You are, actually. It's [Melissa Jackson ]: No. Well, we're kind of our own Yes. [Speaker 8 ]: To be true. [Melissa Jackson ]: Own, but Yeah. Yeah. It's weird. Sleep it at that. [Chair ]: Yep. Okay. [Melissa Jackson ]: Steven, did you get answer to that question? [Chair ]: Oh, great. [Steve McClafferty ]: Yes. Coming back to the question of the payer mix changes in our twenty four budget adjustment, it was one million two hundred eighty three thousand eight hundred and fifty six dollars. So we're looking at approximately a hundred and seven thousand dollars more [Speaker 8 ]: Okay. [Steve McClafferty ]: Plus or minus. [Chair ]: So that's not an anomaly. It's kind of what you consistently have. Okay. Thank you. Did I see another handout? Are there other questions? Lee, did you have a question? [Wayne Ross ]: Essentially, we I mean, the appropriation process has to be similar for that federal money there as it is for any other federal money. So we should be able to get to the bottom [John Kosenska ]: of how that money goes. [Chair ]: Yeah. Yeah. Comments. Yeah. If this is Maria. Please. [Speaker 8 ]: So regarding the the dollars, the [Chair ]: four point three million, and [Speaker 8 ]: if you look at section b three zero one, which is the pole inspection, There's an additional four point three one in, goal commitment and one point eight of it in general funds. Two point four eight six is the federal funds, and it appears yeah. It's part of that. It's in the explanation. And it appears that that is those are the dollars that we're talking about. [John Kosenska ]: So so if you look at this chart, it suggests that this is all general fund, but it's not. [Speaker 8 ]: That's correct. It it's got [John Kosenska ]: for that. [Speaker 8 ]: Yeah. You could see three zero one, and then I believe I believe that the ninety eight dollars in your budget show up as special funds. Is that correct? I think that's, you know, on the ups and downs. [Melissa Jackson ]: Medicaid shows up in our special funds, Steven, for our ups and downs? [Steve McClafferty ]: Yes. Medicaid shows an increase of two million three ninety eight one ninety two. [Speaker 8 ]: Yep. Yeah. So anyway so I see that the answer is that it all gets reconciled in section b three zero one, [Wayne Ross ]: which is [Speaker 8 ]: the medic the global clinic section. And I will double check that. I I'll see, Stephanie here this afternoon, and [Chair ]: I will double check with her. [Melissa Jackson ]: Great. [Chair ]: But that's what I think the answer is. Thank you. Thanks, Mike. Okay. Any other questions for the balance? [Dave Giacoboni ]: Yes, Rebecca. Back on the case mix, is your Medicaid payment rate adjusted by the state of Vermont quarterly to reflect to reflect your case mix acuity? [Melissa Jackson ]: No. We've had the same interim rate probably for the last four or five years of four hundred and seventy five dollars. [Dave Giacoboni ]: They don't adjust it as they do other facilities, and that's why you're trying to do it at the end of the year. [Chair ]: I think. Years behind. Yeah. [Dave Giacoboni ]: The the gap that's here. Okay. Thank you. [Melissa Jackson ]: You're welcome. [John Kosenska ]: Repairsent. Is the Veterans Home owned by your organization independently, or is it owned by BGS and then leased to [Melissa Jackson ]: It's a state facility? [Chair ]: It's Yeah. [Melissa Jackson ]: So it's owned by the state? [John Kosenska ]: Most state facilities are owned by BGS. So And then they're leased back, but but there are some exceptions. So I'm just trying to understand. [Melissa Jackson ]: So we don't this is complicated. The land is owned by the board of trustees. So there is no lease back to the to the state or anything. So there is lease payment or anything like that. [Chair ]: But sometimes the buildings are leased back, so they rented out, and there's a fee for space amount. But I don't think we see that in [Melissa Jackson ]: your pocket. No. We don't have a fee for space. [John Kosenska ]: Okay. No. That's helpful. I I guess and and this is probably in the for all the right reasons, and I'm glad to see you reinvesting with Wing. Usually those types of expenses are all part of the capital bill and the plan, we need to invest whatever, dollars five million to do this in the first phase is the planning. So normally it wouldn't show up for other agencies and here's obviously a little different than in the budget practice. It would show up like capital though. [Chair ]: Right. That's sort [Speaker 8 ]: of weighing beyond that. [Wayne Ross ]: So the question that is you yes. Right now, it's undergoing planning. Is BGS doing the planning? [Melissa Jackson ]: We're working working with BGS with the ultimate we have a so it's in the if you look in our statutes, the veterans home, we work we collaborate with BGS. So, Tabrina from BGS is working with us as we go through the, design phase for American, but it's ultimately our project. [Steve McClafferty ]: But is BGS actually doing I [Wayne Ross ]: know you corroborate, but is BGS personnel doing the design, the drafting, and all that stuff? [Melissa Jackson ]: No. We've, hired outside, architectures architect company to do that. [Chair ]: Any other questions for the Veterans Hall? We actually have members of two other committees here, Mary Morrissey from Corrections and Institutions and, Rep. Woody Page from, the health care committee. And I wonder if either of you have any questions that you would like to ask? Not at this point. [Wayne Ross ]: I don't know if you're good. Okay. [Chair ]: And And rep Stevens? [Tom Stevens ]: Just a comment about the ownership stuff. And and I think I think when we have this discussion again with the big bill, we should have a better understanding of how it works with the board of trustees. It is it is complex. I'm not sure. And it can be complicated to understand, but I think it would be good to for as many people as possible to considering how much turnover we've had to understand the unique status of the the veterans home. So we can't apply Yeah. How BGS does business with them simply. And I know through I I get I know through past re working with with the veterans home in the past. It's not simple, and we should know better up here what's going how it works down there. And that's without judgment on whether it should be any different because it's been this way for all over a hundred years. [Chair ]: Yeah. Yeah. Exactly. Exactly. [Melissa Jackson ]: I do believe the legislature council [Steve McClafferty ]: wrote [Melissa Jackson ]: did a paper or opinion on that. I I think believe I have that so I can make sure we get that to you, but we'll definitely [Chair ]: That would be really helpful. That would be good. That'd be good to have it. Thank you. Representative Harrison? [John Kosenska ]: Melissa, I'm sure you have shared this when we do the fiscal year twenty six budget. I know by other measurements, you're expensive per bed per night, you know, versus a regular nursing home. But I do wanna applaud you because whenever you shared your quality measures, and it's something we're always asking ourselves now in terms of education, the Veterans Home does a very, very good job and with taking care of people that have served our country. So thank you. [Melissa Jackson ]: Welcome. Thank you. Anyway, we we just, received a national quality award, and, we were one of two nursing homes in the state of Vermont to be recognized by US News and World Report for both our long term care and our short term care, which you'll see in our, budget brief, but I never miss an opportunity to say how awesome might [Speaker 8 ]: happen. Congratulations. Thank you. [John Kosenska ]: Congratulations. Mhmm. [Chair ]: Excellent. Anything else for the Veterans Home right now? Okay. We have a little work to do on our end. And if there's questions, we'll we'll ask Wayne, and Wayne will be in touch with you. So, otherwise, thank you very much for your time, and we'll see you up here another time Okay. Perhaps. Okay. Take care. Bye bye. [John Kosenska ]: Bye. [Chair ]: So committee I'm gonna run this file. I have the agendas. We have a phone hearing at one. So if you could get here maybe ten of so we can be sure we're all set up. Just a reminder that this is a a listening experience for us. Take notes. We've also asked people to have written testimony if they're interested in doing that, and we will get that. [Wayne Ross ]: The the [Melissa Jackson ]: error will be making it available [Chair ]: as it comes in. And we'll have somebody else here from legislative staff to run a timer. People will have two minutes. So we'll we'll get that all set up. But if we can all be in their seats a little bit more once so we can get started, that would be a great thing. And then after that, this afternoon, we have the floor followed by ethics training. And I believe for this committee, that may be the last training that we have for this client, at least this session. So we did a training a couple [Dave Giacoboni ]: of days ago. That wasn't ethics. That [Chair ]: was No. You know, I kept calling it that, and it wasn't right. That was DEI training. Ethics is stated. It will be the entire body, entire house on the chamber floor, and our staff will be doing that. So That's [Tom Stevens ]: where we say if you are handed something with a big white on in a big white envelope, you shouldn't accept it. Right? [Chair ]: So Okay. [Melissa Jackson ]: It's [Chair ]: ticking. Just don't Yeah. Yeah. Approximate with the ground.

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