By David Mickenberg
Choices for Care (CFC): CFC is Vermont’s long-term care (LTC) program for low to moderate-income elders and adults with disabilities. It provides for both nursing home and home-and community-based care for those with financial and clinical needs for the same. The program has been very successful in giving Vermonters a choice as to where to receive services and in saving the state significant dollars.
The legislature has begun its budget adjustment process. DAIL (Department of Disabilities, Aging & Independent Living) was one of the first Administration presenters and the highlight of its presentation was additional spending on CFC. DAIL proposed spending $1,241,748 of carryover on CFC programing related to the moderate needs group. This money will be used to avoid having to cut Vermonters who are currently enrolled in the Moderate Needs group. The use of this money demonstrates a positive move by the administration and an acknowledgement of the need to continue to invest and reinvest in Home and Community Based Services.
Low Income Home Energy Assistance Program (LIHEAP): The federal LIHEAP provides assistance paying for home heating for people of all ages, including many elders whose household income does not exceed 150 percent of the federal poverty level.
The LIHEAP benefits released by the Administration last month will now need approval in the budget adjustment process. Currently the House Appropriations Committee is talking about providing sufficient funding to keep beneficiaries at the benefit level they received last year, then using approximately $1.6 million for emergency housing (temporary motel for individuals without a home) needs. They have yet to determine whether the funds will be used in this manner or not.
Paid Sick Days (H.187): Paid sick days received an additional boost from the Governor’s State of the State address, in which he mentioned it as a priority for his Administration this session. It will likely be taken up by the Senate Economic Development committee early this session and will hopefully be on the Senate floor by mid-to-late January. COVE is an active participant in the coalition working for passage. The House-passed version is at: http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/H-0187/H-0187%20As%20Passed%20by%20the%20House%20Unofficial.pdf.
All Payer Waiver: As noted in our December update, the Green Mountain Care Board (GMCB) is in the process of negotiations with the federal government over an “All Payer Waiver” for health care in Vermont. Such a waiver would give the state the ability to set prices across the board for providers of health care. Importantly to COVE and other elder groups, this All Payer Waiver would include payments for Medicare.
COVE participated in meetings with the Chair of the Green Mountain Care Board and the head of health care reform for the Administration. The meetings helped inform the discussion about the All Payer Waiver (APW), and in particular the impacts that it may have on Medicare. The Terms Sheet that is being negotiated with CMS is anticipated to be released in the coming weeks. The release of the terms will provide great understanding of the impact that the APW will have on Medicare. However, it is anticipated that Medicare recipients will see no visible impact on benefits or administration of their health care. In fact, the hope is that there will be improvements to Medicare, including the possibility of coverage of services that are currently not covered. COVE will continue to follow this important discussion.
H.46 and S.40, Vulnerable Adult Fatality Review Team: This legislation appears to have new life. It would establish a review team that examines the deaths of vulnerable adults and recommends changes in statute, rule, policy, procedure, training, or service coordination that would decrease the number of preventable deaths in Vermont’s vulnerable adult population. With the change in leadership in DAIL, that department has developed an interest in working on this issue with a number of interested parties, including advocates and organizations that serve vulnerable adults, and other departments of State Government. COVE supports this bill, which may be found (as introduced) at: http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/H-0046/H-0046%20As%20Introduced.pdf.
S.24 and S.176 (or H.238): These two bills deal with accessibility issues for homeowners, and we hope they will be taken up together by the Senate Finance Committee this winter.
S.24 proposes to require disclosure of compliance with accessibility standards prior to the sale of residential construction. COVE was involved in passing legislation several years ago requiring that housing built for speculation meet certain accessibility standards. Enforcement has been difficult, and this bill would help to address that problem. The bill as introduced is at: http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/S-0024/S-0024%20As%20Introduced.pdf.
S.176 (or H.238) would create a State income tax credit to mitigate the expense of home modifications required by a disability or physical hardship. The credit is for a percentage of the expense or $9,000, whichever is less, and it varies, depending on the income of the person claiming the credit. The bill as introduced is at:
http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/S-0176/S-0176%20As%20Introduced.pdf
S.20, Dental Therapists: S.20 passed the Senate last spring and is set to be taken up shortly by the House Human Services (HHS) Committee. After HHS, it goes to House Government Operations, then to House Ways and Means, and finally to the full body of the House for a vote.
This bill would establish and regulate dental therapists, who would work under a collaborative agreement with a dentist who chose to add them to their dental team. Adding these practitioners would help to address the current lack of access experienced by many elders, and by children and younger adults as well. The shortage of dentists in Vermont is projected to increase as more dentists retire in the next decade or two and the supply of new dentists, now inadequate nationally to fill states’ needs, will remain so for many years.
The training program would be located at Vermont Technical College in Williston, which already hosts Vermont’s dental hygienist training program. Dental therapists must first be dental hygienists. Once trained, in order to be licensed they would have to meet the national standards implemented recently for dental therapists by the Council on Dental Accreditation, which also accredits dentists.
COVE is a member of the Leadership Team of the “Vermont Oral Health for All Coalition,” which is promoting S.20. The bill as passed by the Senate is at: http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/S-0020/S-0020%20As%20Passed%20by%20the%20Senate%20Unofficial.pdf.
EXPLANATION OF LEGISLATIVE JARGONESE:
If you go to the bill links noted in this report and view a bill that has been amended, the crossed-off language has been deleted from the bill as introduced, and the underlined language has been added.
