For many years now, Vermont has taken a number of steps toward rebalancing its long-term care system to place more emphasis on home and community care and less on institutional care such as nursing homes and to give people more choice in where and how they receive long-term care services.
Records show, the state spent 32% of its long-term care money on home- and community-based care and 68% on nursing home care in 2005. Thus, a waiver was designed from the federal Centres for Medicare and Medicaid (CMS) which enables Medicaid recipients with the highest need for care to have equal choice and access between home- and community-based services and institutional settings such as nursing homes.
October of the same year, the State launched its Choices for Care program under the waiver wherein individuals who were already receiving long- term care Medicaid services when Choices for Care started (including nursing home care, home- and community-based services, and enhanced residential care home (ERC) services) were automatically enrolled into this new program.
The program allows eligible individuals to choose the setting in which they will receive their Medicaid long-term care services.
It serves the purpose of shifting more long-term care expenditures to a less costly environment and serves more people in the setting they choose. And, it seeks to provide choice and equal access, serve more people, manage the costs of long-term care, create a balanced system, and prevent institutionalization as well.When it comes to Medicaid eligibility, the State of Vermont has also produced a set of standards to manageably determine a residents' qualification for Medicaid. One amongst these is people must also be financially eligible for long-term care Medicaid.
The Department of Disabilities, Aging and Independent Living (DAIL), which administers the program, also created three beneficiary groups: (a) a highest need group entitled to either nursing facility or home and community-based services (HCBS) care. The functional eligibility threshold is higher than it was under the previous programs, (b) a high needs group that receives services as funds are available but is not automatically entitled to services, and, (c) a moderate needs group that includes people who do not meet nursing facility or HCBS waiver criteria but are at risk of admission to a nursing home and also receive services only if funding is available.
The state's Choice of Care program serves beneficial most importantly for the older citizens and for younger ones with physical disabilities. It helps people with everyday activities at home and in enhanced residential care settings and nursing homes. Its LTC services include hands-on assistance with eating, bathing, toilet use, dressing, and transferring from bed to chair; assistance with tasks such as meal preparation, household chores, and medication management; and increasing or maintaining independence.
Long Term Care in Vermont