- 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.
As we’ve reported in the past, the Legislature funded the state portion of LIHEAP at $6 million for the FY 15 budget. Over the past few months we contacted the administration to help determine how we would cover the additional $2 million to keep beneficiaries, at the very least, at the same benefit level from last year. In the past few years, funds had been set aside to make up the difference. However, last week it was reported to the Joint Fiscal Committee that there is an anticipated carry-over from last year’s funding stream of a slightly more than $2 million. Given the anticipated cost of fuel and these carry-over funds, the administration testified to Joint Fiscal that the benefit level for the 2015 heating season should be almost the precise benefit level as last year. While it is positive that LIHEAP benefits will not be cut, COVE will continue to push for increased benefits particularly in light of the fact that purchasing power of recipients has been reduced over time. As the memo presented to Joint Fiscal indicates (http://www.leg.state.vt.us/jfo/jfc/2014/2014_09_05/Agenda%20Item%20-%20LIHEAP%20-%20combined%20stats%20sheets.pdf), purchasing power of individuals receiving assistance has gone from a high of 86% to the current level of approximately 28%. COVE will advocate for a full examination of reduction in purchasing power for those Vermonters in need of heating assistance.
- 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 promised, or to offset other pressures and priorities in the state budget.
As previously reported, the Administration’s proposed funding level for Choices for Care (CFC) for FY ’15 was approved by the legislature this past session. In addition to the FY ’15 appropriations, almost $3 million in CFC savings was allocated through the budget adjustment process, to be used over two years to support the CFC Moderate Needs Program. COVE and its allies were also able to get the legislature to agree to spend another $1 million in additional savings on investments into one-time Home and Community Based Services (HCBS) programs.
In early August the administration was confronted with the need to find approximately $31 million in rescissions because of lower than expected revenue forecasts. Consequently, in addition to eliminating the budgeted 1.6% Medicaid increase for providers, as well as the 2% increase for Area Agencies on Aging (AAAs), the administration sought to eliminate the general fund portion of the additional $1 million dollars that was to be used for the one-time investments in HCBS. COVE and its community partners condemned the Administration’s action and moved Joint Fiscal to restore some of the money that was cut from the administration’s proposal. It should be noted that this was one of the only items for which Joint Fiscal requested a change and on which the Administration relented. While that was a positive development, we remain concerned that CFC savings are being used to supplement other areas of government, undermining the Home and Community Based System, and raising the potential for people to turn back to costly institutional settings. We will continue to push the Administration and legislature to fully invest savings back into community services and will monitor DAIL’s mandated October report, which should outline investment opportunities. We also anticipate receiving updated numbers in the next few weeks on any projected savings being generated by the program this year, setting the stage for a Budget Adjustment conversation about how that money should be used.
Another related, and problematic, trend in CFC is surfacing regarding consistent and lengthy delays in eligibility determinations for CFC. These delays often go well beyond the time limits as set out in statute and regulations. Providers across the state are relaying stories of delays that are having significant impacts on Vermonters who need services. Such delays can cause people to be institutionalized or have negative health consequences, and they can place significant time and resource burdens on families and care givers. We will be requesting updated data from DAIL on this issue and will report back in October with recommendations for next steps.
- Telephone Lifeline: Act 105 changed the recipient of applications for the Telephone Lifeline program from the Tax Department to the Department of Children and Families (DCF). During the process, DCF agreed to develop an interagency MOU which would continue to promote the program through tax outlets such as in the tax booklet, on the tax department’s website, and through outreach to tax preparers. COVE has inquired about the status of the interagency MOU but has not received a response from DCF at this time. We will follow up on this to ensure that the MOU is drafted and implemented in the coming months.
- Adult Protective Services (APS) : Reports on the implementation of the APS settlement agreement with DAIL indicate that there have been positive developments and that APS is meeting many of the benchmarks mandated by the settlement. Consequently, it is clear that vulnerable Vermonters are in a much better position than they were prior to the law suit. However, there continue to be issues with financial exploitation cases and APS has developed a corrective action plan that, at this point, seems ambiguous in terms of its prospects for success. We will continue to monitor these important cases and make a determination as to whether COVE should be advocating for additional resources from the Legislature or Administration for the financial exploitation unit.
The case review panel has also raised concerns about ongoing issues in nursing homes and residential care homes. It appears that APS is not following its own policies with regard to cases involving these settings; and that they continue to not draft the required coordinated treatment plans.
Finally, the data provided by the Department is concerning because it indicates that there are many cases that are being opened but are not ultimately closed. There seems to be confusion about the current status of these cases. We will continue to work with our partners at Vermont Legal Aid to ascertain their status.
The House Human Services and House General Committees asked DAIL to convene a work group to look at the issue of the APS registry and who can access and disseminate the information on the registry. In particular, they were concerned about protecting vulnerable adults in housing where the landlord has been placed on the APS registry. DAIL responded to the letter by indicating that they would not be able to convene the group because of time constraints, but would be willing to participate. COVE is in the process of pulling that group together for a discussion of possible regulatory, policy or legislative fixes on this issue.
- Senior Housing: COVE has been asked to participate in conversations about a recent proposal by Vermont Housing Finance Agency’s (VHFA’s) board to change the eligibility criteria for how senior housing developers can access state tax credits to help fund their projects. In late September there will be a further discussion of this issue with the Joint Committee on Tax Credits, which advises the VHFA board on this issue. We expect to have an update in our next (October) report.
