Vermont’s Health Care Advocate is facing a budget cut as the state’s health care reform agenda accelerates.
For the second year in a row, the Health Care Advocate’s office, a publicly financed consumer protection program, could lose money even as it is asked to play a larger role in consumer issues and the formation of health policy.
Lawmakers scrambled last spring to fully fund the office, but the operation faces a shortfall of $157,000 in FY 2015.
That’s roughly 11 percent of the office’s $1.4 million budget.
Trinka Kerr, the state’s chief health care advocate, said her office hired staff and expanded operations based on the expected funding, and the cut would force her to fire people.
“It’s not like we’re running an extravagant operation over here,” Kerr said.
Paralegals who answer a health care hotline run by the office make less than paralegals working for the state, and the same is true of a policy analyst hired at the behest of the Green Mountain Care Board.
The board paid for that analyst last fiscal year, but it appears it doesn’t plan to pay for the position going forward.
As the state has expanded the regulatory authority of the Green Mountain Care Board, the role of the Health Care Advocate has expanded proportionately to ensure there is a consumer voice in the rate review process and other policy decisions.
The Health Care Advocate, formerly the health care ombudsman, is a service of Vermont Legal Aid and is funded through a variety of sources.
A large chunk of funding for the office comes from the Department of Vermont Health Access and the Department of Financial Regulation. Together the two departments pay about $520,000 of the budget for the advocacy office.
Those so-called “core grants” haven’t increased in nearly a decade, Kerr said.
The Health Care Advocate office received a piece of the nearly $171 million in federal grants the state has received to implement Vermont Health Connect. Kerr said her office has helped many people resolve issues with their coverage with the state’s health care exchange.
Several federal grants that supported the office have lapsed, and the others are slated to do so at the end of the calendar year — about halfway through the state’s fiscal year.
The administration has set aside some money in the Vermont Health Connect Sustainability program — the budgetary vehicle it has proposed to pay for the ongoing cost of the exchange after the federal dollars evaporate — but it’s not enough to make up the difference.
Previously, Kerr’s office was funded through two separate contracts with DVHA and DFR, but starting in January the state unified the contract and placed it under the Agency of Administration’s stewardship.
Kerr said it’s possible the Agency of Administration thought it had set aside the full amount. This is the first year the agency has coordinated funding for her office.
“I’m hopeful the Legislature will figure this out,” Kerr said, “It’s a terrible time to not fund us adequately.”
Darcie Johnston of Vermonters for Health Care Freedom — a staunch critic of the Shumlin administration — said she sees it differently.
“(The administration) basically wants to abandon consumers and have all government entities protecting government entities,” Johnston said.
Rep. Alison Clarkson, D-Woodstock, said the shortfall in the Health Care Advocate’s funding should have been addressed in the the governor’s proposed budget.
The Health Care Advocate’s work is important, Clarkson said, and she isn’t sure why the administration couldn’t locate the money.
“It’s perplexing given that (Kerr) is working closely with the administration,” Clarkson said, “Why wasn’t it built into the budget?”
Health Care Reform Commissioner Robin Lunge, whose department is in the Agency of Administration, said her office is simply the “pass through organization” for the advocate’s funding.
It’s up to the Legislature to adjust and approve the budget, she says, and if lawmakers want to fully fund the Health Care Advocate they can do that.
Lunge rejected the idea that Kerr would be forced to fire her people if she doesn’t receive additional state money.
“Like all other nonprofits they can seek funding from other sources like private donations,” Lunge said.
