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 biggest problem CFC has repeatedly encountered is how to use those savings - whether to reinvest the savings in an improved home and community based services program, as required by the Federal waiver, or to offset other pressures and priorities in the state budget.
The Choices for Care (CFC) program continues to be an issue of discussion among the House Appropriations committee. We continue to advocate with partners for a restoration of grants to Adult Days and case management in residential care. The House Appropriations Committee (HAC) has discussed the balance between the proposed increases to nursing homes with cuts to Home and Community Based Services, although it should be noted that there is a proposed increase for Home Health Agencies. HAC will continue to struggle with this balance. There is also a concern about the funding for Moderate Needs as we approach the end of the increased funding from two years ago. We will work with partners to ensure that the Moderate Needs funding is continued at the increased level with whatever savings is available at the end of FY 15.
- 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 Governor’s FY ’16 budget cut LIHEAP by $6 million from last year’s appropriation for FY ‘15. Currently the House Appropriations Committee is making determinations about the FY 16 budget and this issue has not yet been decided. We’ve worked with other LIHEAP advocates to ask that the money be restored, although given the budget situation and the Governor’s commitment
to revisit this issue in the FY 16 Budget Adjustment, it is a tough argument to make. There had been some talk of reducing eligibility, but that issue seems to have been taken off the table at this point. COVE and AARP VT just sent a joint letter to HAC to reinforce our concerns, and we will continue to advocate for full restoration of the $6 million dollars through the House and Senate appropriations process.
- Adult Protective Services: APS investigates reports of abuse, neglect and exploitation of vulnerable adults. When reports are substantiated, APS can take steps to protect the victim and can put the perpetrator on the adult abuse registry to ensure that person cannot get another job working with vulnerable adults.
There are two bills that address concerns related to Adult Protective Services. H.112 makes it easier to investigate allegations of financial abuse of vulnerable adults, a concept that COVE has supported in the past. H.112 received a hearing in the House Human Services committee in late February, but it was not voted out by crossover (March 13 - see explanation of “crossover” on page 4), so we do not expect it to move this year.
H.131 provides greater protections for abusers of vulnerable adults, including greater transparency about the nature of the charge, an attorney for the alleged abuser, and other protections. COVE opposes this bill. No testimony has been taken on it, and it seems unlikely that it will move this year.
- Transportation: The House Transportation Committee heard testimony recently from VTrans (Vermont Agency of Transportation) on a proposed Elderly and Disabled (E&D) Transportation study. The last study was conducted 10 years ago, so there is not enough recent information to make a good estimate of the current and future needs for E&D transportation. Further-more, that study did not consider social activities or grocery shopping, an issue that was discussed by the committee. The proposed study would identify both gaps in service and sources of local funding. In the course of the committee discussion, it was noted that prior problems with the fairness of the distribution of E&D funds among the various regions in the state have been resolved.
- S. 20 Dental Therapists (formerly called “Licensed Dental Practitioners,”: This bill has moved through two Senate Committees so far. Health & Welfare (H&W) passed an amended version of the bill on a 5-0 vote, but some of the amended language would have limited the increased access to oral health care that the bill was designed to provide. Government Operations (Gov Ops) found a compromise that garnered the support of 4 of their 5 committee members, and the bill was passed out of that committee on Tuesday, March 17. Since it missed crossover, it was sent to the Senate Rules Committee, which promptly gave it a green light to proceed, and it was committed to the Finance Committee, because it has fees in it. (The H&W amendments and Gov Ops’ strike-all amendment may be found on the March 18 Senate Calendar: http://legislature.vermont.gov/assets/Documents/2016/Docs/CALENDAR/sc150318.pdf#page=1 The bill as introduced may be found at this link: http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/S-0020/S-0020%20As%20Introduced.pdf.)
- S.5 Observation Status: This is an important issue, as seniors are often put on such status instead of being admitted as inpatients, resulting in the hospital stay being covered differently and an inability to access important Medicare funds to be used for care following their release from the hospital. COVE supports this bill. The language in S.5 is currently included in sections 3 and 4 of the Senate Health and Welfare health care bill (H.139) and is supported strongly by the committee. This would be a good step forward for elders and consumers of health care who receive care in hospitals. (http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/S-0139/S-0139%20As%20Introduced.pdf)
- H.110 Jury duty for elders: This bill would allow elders 70 and over to opt out of jury duty solely based on their age. It appears to send a message that elders are somehow less capable than younger Vermonters, and at our last board meeting, several board members expressed strong opposition for that reason. It could be interpreted as bestowing a benefit on elders as well, but sentiment on the COVE board was clearly disapproval. To date this bill has not moved and given that it missed crossover, it appears that nothing will happen with this bill this year.
- H.46 Vulnerable Adult Fatality Review Team: The House Human Services committee took testimony on this bill from a variety of stake holders including the Attorney General’s office, Department of Disabilities, Aging and Independent Living (DAIL) Commissioner Wehry and the Medical Examiner’s office. The Committee had seemed interested in working on this bill, but unfortunately, concerns expressed by the Commissioner led to a halt in action on it for this year.
- H.25 Natural Burial Grounds: COVE has lobbied in support of H.25, a bill that would expand access to natural burial grounds in Vermont. This would allow a lower cost option for people who want to be buried in a natural setting. The bill passed out of committee unanimously, has been passed by the full house, and is now in the Senate. (http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/H-0025/H-0025%20As%20Passed%20by%20the%20House%20Unofficial.pdf)
- S.38 Long Term Care (LTC) Task Force: COVE strongly supports this bill, which would establish a long term care task force to assess and catalogue LTC services provided by or funded by the state. This task force is a fantastic opportunity to establish a body that can raise the level of discussion of LTC issues in Vermont. We succeeded in getting the bill added to Senate Health and Welfare’s health care bill (S.139, section 8), and COVE will appoint one of the members. (http://legislature.vermont.gov/assets/Documents/2016/Docs/BILLS/S-0139/S-0139%20As%20Introduced.pdf)
EXPLANATION OF LEGISLATIVE JARGONESE:
“Crossover” is a date by which all bills have to be voted out of committee in order to have a reasonable chance or being acted on by the other body. This year’s crossover date was March 13. Bills that miss crossover may be taken up by the other body if a prior agreement was made and/or with approval of the governing rules committee. (Crossover for bills in money committees is a week later – March 20 this year.)
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.
