Last week, the Vermont homebound vaccination partnership between home health agencies and EMS was poised to cross the 3,000 mark for first doses. More than half of those homebound Vermonters have also received their second dose. This effort is a national model that has brought relief and protection to vulnerable Vermonters and their families.

My husband and I have three elderly parents between us, each living alone and each in a different state. All of them have received their second dose; two out of three have reached the two-week post-vaccine mark. I notice myself exhaling some of the COVID-19 anxiety that has been pervasive in all our lives for more than a year. My age band becomes eligible this week and I am really looking forward to becoming a vaccinated Vermonter.

With supply expanding, now is the time to encourage Vermonters to get vaccinated. At the VNAs of Vermont, we’re routinely using and distributing the Vermont Department of Health toolkit. For the first time ever, I put a frame on my personal Facebook profile using the OurShotVermont branding. I actually had no idea how to do this; lucky for me the Department of Health posted a handy “click here” option. Many people remain vaccine-hesitant; spreading the word about COVID-19 vaccination is something we can all do to help bring this crisis to an end.

This week, the VNAs of Vermont is publishing our annual Crossover Report. Every year, mid-March marks a critical juncture in the legislative process known as Crossover. Generally, bills that haven’t made it out of committee by crossover are unlikely to made it over the legislative finish line. There are procedures that allow for exceptions, but in general, by the end of March we have a very good sense of where our priorities stand. This year, policy bills had to be out of committee by March 12 and the budget was slated for completion by House Appropriations by March 19. As is often the case, the committee needed a little more time to be sure all the details were nailed down and finalized their work last Monday.

The VNAs of Vermont is pleased to report that several important workforce proposals in the form of nurse scholarships and tuition breaks are on their way to the Senate. In addition, the budget includes a small increase for the Choices for Care program. H. 153, a bill that would establish a rate schedule for the program (though it won’t guarantee increases), also cleared the House.

Despite these positive steps, I remain deeply concerned about the Choices for Care program. In my view, bolder action is needed to ensure that older and disabled Vermonters can continue to receive long-term care services at home. As I testified earlier in the session, we estimate that home health and hospice agencies are spending at least 27% more to provide Choices for Care services than they are being paid by the program. Increases in the range of 2%— while most certainly a big improvement over the years when we receive no increase at all—are simply not keeping up with wage growth. The challenge of recruiting and retaining enough caregivers to provide Choices for Care services remains an existential threat to the program.

The VNAs of Vermont joined with our federal partners at the National Association for Home Care & Hospice (NAHC) in urging Congress to prevent Medicare sequestration cuts to health care providers like home health and hospice agencies, particularly while the COVID-19 pandemic continues to stress the health care system. Sequestration cuts were first delayed in the CARES Act until December 31, 2020 and then extended via an appropriations bill through March 31, 2021. We’re pleased to report that on March 25, 2021, the U.S. Senate passed H.R. 1868,which extends the two percent Medicare sequestration moratorium until December 31, 2021. The U.S. House has already voted to advance the bill. To offset the cost, the bill extends the timeframe for the Medicare sequestration to expire at the end of 2030. We are grateful to Vermont’s congressional delegation for supporting this bill.