This January, the Vermont legislature will convene for the second year of the 2021-2022 biennium, just before the two-year mark of the COVID-19 pandemic. We believe the long-term care workforce should be a top priority.
Because of chronic under-funding, the long-term care system was in trouble when COVID-19 struck. The pandemic has taken the long-term care workforce crisis to a new level. Vermonters who need help with bathing, dressing, nutrition and other daily needs cannot find the caregivers they need.
Even with the substantial subsidies they provide for the Choices for Care program, home health agencies cannot find employees. Job postings go unanswered, and candidates fail to show up for interviews. Private home care companies who are willing to help fill in the gap often limit the number of individuals they’ll serve under contract with the home health agency because the payment rates are so poor. Meanwhile, three of Vermont’s 14 adult day centers and 10 of Vermont’s residential care homes closed because of the pandemic (so far), placing further strain on the remaining system.
Vermont is deeply reliant on the home and community-based long-term care system, thanks to a conscious policy decision in 2005 to shift care out of facilities and into homes and community settings through a combination of payment and program policies. The number of individuals served at home has more than doubled; the number of individuals served in enhanced residential care has more than tripled, while the number of individuals served in nursing facilities has increased by less than 15 percent. Home and community-based services are not “nice to have” – they are essential.
There are two major actions legislators can take.
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First, they can enact the recommendations of the AHS Health Care Workforce Strategic Plan developed over the summer by a broad provider stakeholder group.
- Second, they can support a substantial investment in the Choices for Care program. The good news is that home and community-based long-term care services are relatively inexpensive. A $6 million dollar state investment would represent a substantial infusion into the program.
We urge budget writers and policy makers to support these critical services.
