February 2019
From the Executive Director
In the first few months of my tenure as executive director of VNAs of Vermont, I shadowed a nurse and a therapist on some home visits. It was the most meaningful part of my orientation to home health. Seeing it in person is the best way to understand the work that home health and hospice agencies do every day. Like most community members who go on home visits, I was struck by the depth of the relationships that form between clinicians and clients, thanks to extended one-on-one contact in the place where the patient feels most comfortable. I was also impressed by the autonomy and critical thinking skills required of home health providers who routinely incorporate the realities of the home environment – the physical space, family members, pets – into their approach to care. 

Over the last several months, news coverage of a federal cut to home health care that impacts seven of our nine members brought some thoughtful reporters on some home visits. Both stories provide a window into the world of home health. If you didn’t catch them the first time around, I encourage you to check out last week’s WCAX story and a story from VPR late last fall. 
Vermont Update
Our advocacy activity in the 2019 session is picking up as committee chairs are turning their attention to bills of interest to home health and hospice agencies. We are pleased to report that since our last newsletter, the Senate unanimously passed  S.14 , a five-year extension of the existing certificate of need moratorium on new home health agencies. Testimony has not yet been scheduled in the House. 

A key Senate committee took more testimony on  S.23 , the  minimum wage bill that is expected to emerge from the committee shortly. The VNAs of Vermont are strong supporters of wage increases for our entry-level employees; we will continue to advocate for a Medicaid rate increase in the state budget to fund wage increases so that older Vermonters can receive the long-term care services they need to remain independent at home. 

This week, the Senate Finance Committee will take up  S. 27 , a bill that preserves  the home health provider tax . VNAs of Vermont Executive Director Jill Mazza Olson is slated to testify before the committee on Wednesday. In SFY2018, home health agencies paid $5.2 million in provider taxes. Under current law, the provider tax bill expires on June 30, 2019. S.27 eliminates the sunset, thus reinstating the tax. The provider tax draws down a federal match approximately equal to the amount of tax paid by agencies. This revenue helps support the Medicaid program. While Vermont’s agencies supported the provider tax at its inception as a mechanism to draw down additional federal revenue, over time the tax has become a significant cost burden. Since the tax was first levied on agencies, Medicaid rates have grown well below the rate of inflation and Medicare rates have been cut substantially.
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