This commentary is by Mary H. Hayden, the executive director of the Vermont Association of Area Agencies on Aging, on behalf of the Long-Term Care Coalition.
When Gov. Phil Scott’s recent budget recommendation called for a 3% increase for long-term care services provided at home and in the community for older adults and adults with disabilities, it marked the first time in years that a governor of any party had proposed an increase in funding for home and community-based long-term care services — things such as bathing, dressing, meals, companionship and other serious long-term care needs. While advocates and providers who care for and serve older and disabled Vermonters and their families appreciate this first step, far more is needed. Taken together, years of underfunding, the Covid-19 pandemic, statewide workforce shortages and Vermont’s aging population have shrunk the capacity of the system to serve everyone who needs this care.
To begin to address the crisis, Vermont’s Long Term Care Crisis Coalition is calling on lawmakers to pass at least a 10% increase in Choices for Care home and community-based services and Assistive Community Care Services, and bring the adult day services rate to $25 per hour.
Lawmakers must act quickly. The loss of services in the community increases the pressure on hospitals and long-term care facilities that are already struggling to keep up with demand. Every person cared for in the community is a person who is not in a hospital or skilled nursing facility bed.
Staffing shortages are the main driver behind the system’s shrinking capacity to care for Vermonters. In Vermont, one in three personal care attendant positions at home-health agencies is vacant. Since the beginning of the pandemic, three of 14 adult day centers have closed, while the rest are operating below pre-pandemic capacity. Additionally, 10 residential care homes have closed since the pandemic, eliminating 137 spots for older Vermonters to get the care they need in their communities. Others, including assisted living communities, are stopping or reducing new admissions at a time when the need for their services is growing exponentially. As a result of the lack of capacity in long-term care settings, Vermonters are forced to remain in more costly settings for longer than necessary.
Erica Frost of Colchester lost her mother to frontotemporal dementia in 2019. Reflecting on the importance that adult day care had been for her and her mother, she said, “Adult day care is an essential piece of the survival kit for so many touched by dementia. For primary caregivers, it can be one of the only ways we are able to squeak out time for ourselves. For people with dementia, adult day care provides a safety check-in and the promise of a meal, a community and a source of engagement and friendship.”
The coalition comprises representatives of more than 200 providers of assisted living, adult day care services, area agencies on aging, home health and hospice agencies, residential care homes, nursing homes and organizations that care for some of Vermont’s most vulnerable individuals in need of long-term care services.
Coalition members include AARP Vermont, Cathedral Square, the Community of Vermont Elders, Living Well Group, the Vermont Association of Adult Day Services, the Vermont Association of Area Agencies on Aging, Vermont Catholic Charities Inc., the Vermont Chapter of the Alzheimer’s Association, the Vermont Health Care Association and VNAs of Vermont.
To learn more, visit vermontelders.org/longtermcare.