Since our founding more than three decades ago, the Community of Vermont Elders (COVE) has had a major impact on public policy affecting Vermont seniors. We have worked diligently for the dignity, security and well-being of all Vermont’s Senior Citizens. The following list of legislative accomplishment does not include scores of bills, which while passed, were less significant in nature or were those in which COVE played a secondary role. Missing from the following list is the critical work COVE does every year to protect and promote the interests of seniors’ programs within the Vermont State Budget process. COVE has achieved success because of its year-around testimony and advocacy on relevant rules and regulations and its membership on state advisory board and summer study committees. COVE has been able to save seniors millions of dollars yearly in medicomp insurance payments by representing them in the rate setting process. The following legislation list is in chronological order. Many of these laws were precedent setting or national models when enacted.
| 1981 & 1983 | Establishment of Vermont Independence Fund - Provided for flexible grant funding for home and community-based services for over a decade. For example, the independence fund is frequently credited with being the foundation of the adult day care network in Vermont. |
| 1981 & 1982 | Living Will - Codified the use of terminal care documents |
| 1982 | Simple Wills - Statutory framework of allowing for small estates to by-pass probate. |
| 1983 | Grandparents Visitation Rights - Guaranteed substantive and procedural rights for grandparents in custody cases. |
| 1985 | Omnibus protections for Elderly Abuse, Neglect, and Exploitation including remedial action |
| 1985 | Intermediate Sanctions for Nursing Homes and Residential Care - Allowing for more effective and flexible enforcement. |
| 1985, 1995 | Telephone Lifeline Program - Led the nation in providing a monthly subsidy to elders below 175% of poverty in response to adverse impact of deregulation. |
| 1986 | Conversions of Low Income Subsidized Housing - Notice requirements and state intervention to minimize displacement of seniors. |
| 1986 | Hospital Patients Bill of Rights - Expands upon federal requirements. |
| 1986 | Condominium Conversion - Provided significant notice requirements to elders being displaced in these circumstances. |
| 1986 | Personal Needs Allowance for Nursing Home Residents - Increased significantly beyond the federal mandate and providing for an annual inflation increase. |
| 1986 | Increased Protected Income Level for Medicaid Recipients - to highest-level permissible thereby qualifying thousands of additional Vermonters for Medicaid. |
| 1986, 1989, 1999 | Unemployment Insurance - Prohibited counting pensions and Social Security against any unemployment benefits laid-off workers might be entitled to. |
| 1987 | Prohibition Against Balanced Billing of Medicare Patients - Led the nation in saving seniors millions of dollars annually in out-of-pocket health care expenses until federal government ultimately followed suit. |
| 1987, 1991 & 1999 | Prohibiting Age Discrimination in Employment Vermont - preceded the federal government in banning mandatory retirement for all but safety-sensitive occupations. |
| 1988 | Establishment of The Office of Public Guardianship - This created a new office to handle difficult cases where paid of volunteer guardians are unavailable. |
| 1988 | Continuing Care Retirement Communities - Set minimum standards and consumer protections regarding the establishment and solvency of these entities in Vermont. |
| 1988 | Durable Power of Attorney for Health Care - Codified this Advance Directive, with significant consumer protections and education requirements. |
| 1988, 1990 & 1994 | Tenant Protections Regarding Mobile Home and Park Conversions & Sales - Regarding Mobile Home Park Conversions and Sales. |
| 1989, 1997 | Hearing Aids - First state to require physician/audiologist prescription prior to dispensing a hearing aid. Enjoined by FDA. |
| 1989 | Nursing Home Patients Bill of Rights - Expands upon federal requirements. |
| 1989 | Long Term Care Insurance - minimum standards for disclosures, refusal, benefits, and protections against lapsed premiums. |
| 1989 | Home and Community Based Waiver - Law forced Vermont to apply for 115 waiver. |
| 1989, 1997 | Hearing Aid Dealers - Required all hearing aid dispensers in Vermont to be licensed. |
| 1989, 1990, 1995, & 2000 | Pharmaceutical Assistance for the Elderly - Established Vermont’s first pharmacy subsidy program for seniors up to 175% of poverty. This program has since grown to 225% of poverty and over $25 million annually. This law made Vermont one of the leaders among state programs. |
| 1990 | Creation of Vermont Department of Aging & Disabilities - Reorganized and elevated the Vermont Office on Aging to Departmental status and consolidated disparate aging programs into one Department. |
| 1990 | Establishment of Medicare Advisory Project - Provides legal representation in administrative hearings on Medicare denials. |
| 1990, 1999 | Inclusion of “age” classification in Hate Crimes law |
| 1990, 1991, 1996, & 1999 | Medicomp Rate Relief - Established a process for consumers to intervene in Medicare supplement rate cases including the right to access independent actuaries and attorneys. One of the few states providing such a detailed view. |
| 1991 | Establishment of Ongoing Statewide Commission on Alzheimer’s disease |
| 1991 | Medical & Family Leave - Perhaps the strongest state family leave measure since it applied to all businesses with 10 or more employees |
| 1991 | Establishment of Right to Counsel in all Guardianship Proceedings |
| 1991, 2001, & 2002 | Relief from Abuse Orders - Extended civil domestic abuse orders/protections to elders in all households. |
| 1992 | Accessory Apartments - Required that residential zoning in every Vermont town allow for the construction of accessory (granny flats) apartments as conditional use. National Model for promoting family care giving. |
| 1994, 1996 | Establishment of an Office of Fuel Assistance - This new state office brought focus and staff to program in which seniors rely heavily, and which had previously little attention because it was seen as relying exclusively on federal funds. |
| 1996 | Shifting the Balance Legislation - Creation of a dedicated fund that mandated shifting over $40 million in nursing home to home and community based services in four years time. |
| 1996 | Pre-paid Funeral Contracts - Full disclosure on pricing, mandated options, inspections of homes, and country’s first dedicated consumer “default” fund for homes going out-of-business. |
| 1997 | Short Term Family & Medical Leave - Another nation-leading law, allowing workers to take up to 24 hours off (in up to 4 hour blocks) annually to care for sick family members or to deal with their affairs (e.g. nursing home placements). |
| 1997, 1999, 2002 | Property Tax Relief - Income-disregards established in property tax relief program for the income of any live-in caregiver, family co-owner, and elder parent who move in with family, thereby promoting care giving in shared housing. |
| 1997 | Mandated community rating for all Medicare supplement policies |
| 1998 | Office of Healthcare Ombudsman - Establishment of country’s first statewide office, independent of state government, to help consumers navigate the health system and advocate on their behalf. |
| 1998, 1999 & 2000 | Medicaid Homestead Recovery - Prohibited estate recovery against the home of a Medicaid long-term recipient when the intended heir’s income was below 300% of poverty, or the heir had provided informal care, which delayed the recipient’s institutionalization. |
| 2000 | Payment on Death Bank Accounts - Creative banking mechanism for those with small assets to retain control over funds, while avoiding probate. |
| 2000 | Personal needs Allowance for Community Care Homes - Increased PNA wages over federal amount, and required an annual inflation factor. |
| 2000 | Life Span Home (Visit-ability) - First in the nation law to requiring all new construction of single homes be adaptable to accessibility changes in the future (e.g. door widths, thresholds, blocking for grab bars, heights of outlets, etc.). |
| 2000 | Pre Buy Fuel Contracts - Forced state to enter into hundreds of contracts with local fuel dealers to lock in summer pricing with fuel assistance funds (LIHEAP). |
| 2001 | Minimum Staff ratios in Nursing Homes |
| 2002 | Modernization of Vermont’s Power of Attorney Laws - The disclosures, formalities of executions, and enforcement provisions of this law significantly heighten the fiduciary obligations under POA’s and reduce financial exploitation of dependent seniors and others. |
| 2002 | Joint Fiduciary Bank Accounts - Another simple and creative account mechanism to allow family members and friends to help seniors with financial affairs without exposing them potential financial exploitation. |
| 2002 | Pharmacy Cost Containment/Counter Detailing - First of its kind bill which requires drug companies to disclose who they give money and gifts to in an effort to promote their products. Also numerous provisions enacted to encourage preferred drug lists while protecting consumer choice, provide consumer education and counter-detailing of physicians, and the formation of multi-state purchasing pools to lower drug costs. |
| 2002 | Constitutional Amendment to eliminate mandatory retirement for judges - After a four -year legislative process to allow this amendment to go to the voters, it passed overwhelmingly in November 2002 thus eliminating the last vestige of age discrimination in the state of Vermont. |
| 2003 | Elimination of Pharmacy Cost Sharing - Elimination of all prescription sharing (other than small premiums) for 15,000 elderly/disabled Vermonters on state pharmaceutical assistance programs. |
| 2003 | Kidney Dialysis Needs Assessment - Statutorily created statewide needs assessment for kidney dialysis services in Vermont. |
| 2003 | Raised Mandatory Retirement Age for Judges - Raised mandatory retirement age for all elected and appointed judges to the age of 90. |
| 2004 | Advance Directive Registry Study - Mandated study of establishment of statewide electronic registry for all advance directives and for notation of advance directives on driver’s licenses. |
| 2004 | Dialysis Units - Successfully added first time funding to a private non profit hospital specifically for 9 new dialysis units. |
| 2004 | 1115 Waiver - Secured $1 million for jump-starting Vermont’s first in the nation 1115 waiver program, which establishes home and community-based long term care services as a Medicaid entitlement. |
| 2004 | Long term care insurance to cover Alzheimers/Mental Health Disorders - Mandated that Alzheimers and other mental health disorders be equitably covered under all long-term care insurance sole in Vermont. |
| 2005 | Establishment of new state Rx wrap around program (VPharm) to Medicare Part D - Ensures that the new Medicare drug plan will not dilute the assistance currently enjoyed by 15,000 seniors under Vermont’s pharmacy programs. For relatively small premiums, Vermont seniors will continue to receive comprehensive Rx coverage. |
| 2005 | Major expansion in eligibility for Medicare cost sharing programs (QMB, SLIMB, QI) - Eliminated the asset test for these programs which help pay seniors’ Medicare Part B premiums (and in many cases their deductibles and coinsurance). Should save thousands of dollars in out-of-pocket Medicare costs to thousands of low income seniors; and will also trigger automatic eligibility for additional federal Rx subsidies beyond Part D. |
| 2005 | Advance Directives Modernization - Enhanced utilization of and compliance with advance directives. Major practical improvements include an electronic registry for advance directives as well as advance directive information on drivers licenses. |
| 2005 | Adult Abuse - Enhances penalties and enforcement re: abuse, neglect and exploitation of vulnerable adults. Also improves the Adult Protective Services law and program, which provides relevant preventive, educational, and remedial services. |
| 2006 | Part D Point of Sale Assistance at Pharmacy - This law mandated state protocols to minimize the hardship caused to seniors during the complex transition to the new Medicare Part D program. The goal was to limit the number of seniors being turned away from the pharmacy counters without their prescription due to computer or other operational problems. Approaches included temporary supplies as well as individualized contacts with help lines. |
| 2006 | Long Term Care Sustainability Study - Participation in Legislative Study on Long Term Care Sustainability. The Legislature mandated the creation of a plan for the sustainability of the long term care system in an effort to address their concerns about the capacity and ability of the system to meet changing consumer needs and demands. |
| 2006 | Nursing Facilities for the 21st Century Study - Participation in a Task Force for the Legislative Study on Nursing Facilities for the 21st Century. The recommendations address the transition issues for nursing homes as more individuals use home and community based long term care services, how nursing homes can convert the services offered to provide long term care services differently, unmet needs for nursing home services for individuals, accessibility for individuals with disabilities in nursing homes. This report provides background information and recommendations to inform and guide the legislators, policy makers and the nursing facility industry as the long term care system continues to change in response to consumer demands. |
| 2006 | Direct Care Workforce Study - Establishment and participation in Legislative Study on Direct Care Workforce issues. COVE continued its efforts to address the growing Direct Care gap by successfully promoting a state promoted 18 month study by all affected stakeholders of the myriad of emerging workforce issues surrounding the provision of direct personal care to Vermont seniors and persons with disabilities. |
| 2007 | Direct Care Worker Registry - Matching up caregivers with those in need of these critical services was identified by the 2006 Legislative Direct Care Workforce Study Group as its most important interim recommendation. COVE worked to secure the necessary appropriations to launch the development of this free and easily accessible electronic registry and to sustain it into the future. |
| 2007 | Dedication of Money Saved Under the Choices for Care (CFC) Long Term Care Waiver- New detailed statutory language and reporting requirements will help ensure monies saved by reducing nursing home utilization gets redirected into home and community based long term care services and not “raided” for other unrelated governmental programs. |
| 2008 | Defeated Elimination/Significant Dilution of Vermont’s Rx Programs - Worked aggressively to stop large new pharmacy co pays, which would have caused hardship to thousands of low income seniors. |
| 2008 | Electric Affordability Initiative - Worked with AARP to finally authorize the Public Service Board to allow for affordable electric rates for those below 150% of poverty. |
| 2008 | Guardianship Monitoring Study - Established stakeholder study on improving guardian accountability; assuring the protection of the rights and well-being of individuals under guardianship; and training and supporting guardians in the execution of their guardianship duties. |
| 2012 | Adult Protective Services- prevented any legislative dilution of these services protecting vulnerable adults against abuse, neglect and exploitation by litigating the state’s performance in running this program. |
| 2012 |
Choices For Care- Successfully mandated that the state spend savings from reduced nursing home utilization on improved home and community based services (e.g. enhanced elder mental health, home care worker wages, case management, addressing self neglect, etc.) |
| 2012 |
Fuel Assistance – Convinced the state to backfill federal LIHEAP with state funds amounting to $8 million. |
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