State Must Step
Up to the Plate

For more than 30 years, the state of Vermont has funded Medicaid programs to provide medical and health-related services to low-income families and individuals including children, parents, the elderly and people with disabilities. Fully 80% of this care is given in the home.

Private, not-for-profit agencies like the Visiting Nurse Association & Hospice of Vermont and New Hampshire have been providing this home care for much longer than 30 years. Medical and health-related programs include maternal child (pre-natal care, health care, education of parents, child health services); and adult home health care and homemaker services that keep the elderly and disabled at home. We know that people want to stay in their communities, with their families and friends, in a setting where they are comfortable and secure.

Delivering services under Vermont Medicaid has become more and more of a challenge as the cost of care increases but the reimbursement fails to keep up with these increases. In effect, while the State of Vermont has experienced significant cost savings by keeping people out of nursing homes and rehabilitation facilities, this policy has put much financial pressure on agencies like the Visiting Nurse Association & Hospice. Further, the decline in use of nursing facilities is projected to continue for at least ten years while the number of people with significant disabilities living at home is projected to grow by 36%.

We are very grateful to receive funding from all of the 70 towns we serve in the state and from generous individuals and businesses, but Vermont must step up and do its share to support these programs.

The state does not have a system in place to evaluate the adequacy of Medicaid reimbursement rates. Consequently, it has not even granted agencies cost of living increases for many years but we have continued to provide services at a deficit. In our last full year, we helped 1,390 Medicaid patients, made close to 11,000 visits and provided 49,000 hours of attendant and home health aide services. This cost VNAH $1.6 million more than the state reimbursement.

With the population 65 and over expected to double by 2020, it is unrealistic to expect that any agency can continue to operate at this level with such a significant annual loss from Vermont Medicaid.

Home health care is compassionate and cost-effective. Our agency and the 11 other non-profit home health agencies have worked in partnership with the state for many years to create a vibrant home health care system. It is the responsibility of the Douglas Administration, the Vermont General Assembly, and the provider community to create sustainable financing for these public programs and to keep these programs strong and effective for all who need them today and all who will need them tomorrow.

Mark Hamilton, CFO

Visiting Nurse Assn. & Hospice

Of Vermont and N. Hampshire

White River Junction