The Senate Appropriations Committee is poised to vote the Big Bill out Monday afternoon. Sen. Jane Kitchel, D-Caledonia, said she will not make significant changes to the House version of the budget, which was largely based on recommendations from Gov. Peter Shumlin’s office.
Kitchel said the cuts to human services programs will not be altered by the Senate, with one the exception: the Senate Finance Committee has placed a 0.8 percent assessment on dental claims that will raise between $300,000 and $400,000 in tax revenues. The money would be used to pay for substance abuse counselors in local high schools. Under Gov. Peter Shumlin’s original budget proposal, the positions were eliminated.
The House split the baby on the deepest human services cuts. Programs for the developmentally disabled and the mentally ill were slated to be cut by 5 percent; the representatives cut these programs by 2.5 percent. The reductions come on top of previous reductions of $17 million (including matching Medicaid funds) over the last three years, according to advocates.
The governor and the House also deeply cut services for elderly Vermonters. Advocates say the reductions are fiscally counterproductive. The Choices for Care program keeps elderly Vermonters out of nursing homes, and at the moment the program has a $7 million carry forward, according to Michael Sirotkin, a lobbyist for the Community of Vermont Elders.
“Advocates are always challenged by legislators who say ‘if you want your cut restored, find us the money,’ Sirotkin said. “Well in this case, we have. And the beauty of it is, we don’t have to raise taxes or take from another worthy program to do so. The money is right there and it is money that was already appropriated exactly for these purposes. It’s a win-win situation for all.”
The Shumlin administration and lawmakers, however, continue to insist that $1 million must be cut from Choices, in spite of the fact that for every elderly Vermonter the state keeps out of nursing home care, it saves $40,000.
In the past, savings from Choices has been siphoned off into the General Fund, instead of being plowed back into the program as required under state statute.
Ironically, because of the Senate Appropriations Committee’s $1 million proposal to cut the Choices for Care program, Vermonters who will see a significant reduction in services under the Choices program may be headed to local nursing homes at the same time the state receives millions of dollars from the federal government to bring seniors in nursing homes back into their communities.
Consequently, it looks like the state may be playing a game of “musical beds,” with poor, elderly Vermonters in the near future.
The federal government, which recognizes the financial benefits of home care, is offering grants to the state for a national initiative to put residents of nursing homes into community-based care. The Department of Disabilities, Aging and Independent Living has applied for an $18 million grant under the “Money Follows the Person” pilot project.
Meanwhile, the Legislature is poised to cut $2.5 million ($1 million in General Fund money and $1.5 million in Medicaid money) from services that help the elderly stay in their homes (and out of nursing homes). Respite hours for family members who care for elderly relatives would be cut by 25 percent and the number of hours for assistants who help seniors with chores like shopping, cooking and cleaning, would be reduced.
Sirotkin said the Vermonters who qualify for Choices are low income and frail, elderly and disabled Vermonters.
“Many of them live alone and in isolated settings and all have clinical conditions, such a dementia, which would qualify them for far more expensive nursing home care,” Sirotkin said.
Under the House budget, the individual assistance program and respite care for the elderly sustained a 25 percent cut. Respite care would be reduced from 720 hours to 540 hours a year; assistants for daily living services from 4.5 hours a week to 3.5 hours a week. Sirotkin say these cuts are about $3,000 per person on average, an amount that the elderly individuals, many of whom are very poor, cannot make up.
The Choices for Care program is designed to keep the most vulnerable older Vermonters from needing expensive institutional care — it has the side benefit of also saving the state money. It costs $70,000 a year to place residents in nursing home care, as opposed to $30,000 to provide the services they need to stay at home.
