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Vermont Joint Fiscal Committee Waiver Approval Motion Sept. 2005
Joint Fiscal Committee
Motion to approve with amendments the recommendation of the Health Access Oversight Committee to grant contingent approval of the Global Commitment to Health Demonstration Waiver Program.
Approved: September 30, 2005, unanimously.
Senator Bartlett, seconded by Representative Westman, moved:
That the recommendation of the Health Access Oversight Committee to the Joint Fiscal Committee to grant contingent approval of the Global Commitment to Health Demonstration Waiver Program is accepted and approved by the Joint Fiscal Committee with amendments, and that as amended, the Joint Fiscal Committee moves:
(a) That the Joint Fiscal Committee, pursuant to its authority under Section 250(c) of Act 71 of 2005, grant contingent approval to the Global Commitment to Health Demonstration Waiver Program negotiated by the Administration and the Centers for Medicare and Medicaid Services (CMS) as delineated in Special Terms and Conditions, Number 11-W-00914/1, dated September 27, 2005, and that pursuant to this contingent grant of approval the Administration may begin implementation of the Demonstration Waiver Program on October 1, 2005 for the five year period, from October 1, 2005 through September 30, 2010.
(b) That the Joint Fiscal Committee’s full approval to the Global Commitment to Health Demonstration Waiver Program be granted on or before November 17, 2005, if, on or before that time, the Joint Fiscal Committee finds that the following conditions have been met:
(1) Complete demonstration provisions furnished. That a complete and comprehensive listing and description of all the provisions of the Demonstration Waiver agreement be prepared and included in the letter of acceptance to CMS by the Office of Vermont Health Access (OVHA) and provided to the Joint Fiscal Committee, comparing the original proposal for the Demonstration Waiver Program with the outcome of the negotiations with CMS; and that the Joint Fiscal Committee finds that these final provisions are in accord with the terms and conditions presented to the Joint Fiscal Committee as the basis for its contingent approval.
(2) Final premium amounts determined to be sufficient. That OVHA present to the Joint Fiscal Committee the final premium amounts adopted by the Agency of Human Services (AHS) upon actuarial certification, and that the Joint Fiscal Committee finds that such amounts are sufficient to support the Demonstration Waiver Program including the state’s current Medicaid and expansion programs.
(3) Agreement regarding future years’ premiums. That AHS work with CMS regarding the criteria utilized in future waiver years in order to ensure that future premiums will not be negatively affected by successful cost savings efforts achieved by the state, and that OVHA report to the Joint Fiscal Committee and the Health Access Oversight Committee on the status and provisions of any agreement reached.
(4) MCO Savings Identified. That OVHA present to the Joint Fiscal Committee a list of criteria and an updated list of MCO targeted health care investments which support the administration’s recommendation that the financial value of the Demonstration Waiver program to the state is within the range of $135 million to $165 million.
(5) Attorney General Review. That the Attorney General review as to form the Special Terms and Conditions (STC), the Intergovernmental Agreement (IGA), and other legal documents regarding the demonstration waiver program.
(c) That by granting contingent approval of the Demonstration Waiver program, the Joint Fiscal Committee cedes none of the authority of the General Assembly to determine policy, eligibility and benefits for the Medicaid program (including expansion programs), through legislative enactments, administrative rules review, the state budget and appropriations process, or any other means of legislative oversight. Further, the Joint Fiscal Committee affirm the legislature’s commitment to providing health care benefits to low-income Vermonters through the Medicaid program.
(d) That pursuant to #40 of the Special Terms and Conditions, revenue from capitation payments will be used to reduce the rates of uninsured or underinsured and improve the access and quality of services to that group; that the approval letter from the Department of Health & Human Services also indicate that Department’s understanding that “Vermont will demonstrate its ability to promote universal access to health care”; and therefore, to the extent that there is unused spending capacity as measured by the difference between the amount necessary to maintain the current Medicaid program and the Demonstration Waiver program’s maximum certified premium, that unused spending capacity shall be used to fund health care initiatives authorized by the legislature to improve the access to and quality of health care services received by the uninsured and underinsured.
 1115 Waivers Page
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