Final Reading: Alzheimer's advocates

Sen. Randy Brock, R-Franklin, one of the sponsors of the bill, said he sees it as a step toward formalizing the state’s approach to Alzheimer’s care. File photo by Glenn Russell/VTDigger

The state workforce is not prepared to care for Vermonters with Alzheimer’s and dementia in the coming years, advocates warned House lawmakers Wednesday morning.

An estimated 13,000 Vermonters age 65 and older had Alzheimer’s in 2020, according to data from the Alzheimer’s Association, a national nonprofit that funds Alzheimer’s research and advocacy. That number is expected to climb 30% by 2025, meaning an estimated 17,000 Vermonters would be living with the disease.

The association estimates Vermont will need to dramatically grow key roles in the workforce to keep up with rising demand: The state would need 30% more home health aids by 2028, and more than double the number of geriatricians by 2050.

But these estimates still undercount the actual number of Vermonters with dementia, Alzheimer’s Association’s Vermont policy director Megan Polyte said in testimony on Wednesday. That’s because they don’t include people with other types of dementia, or younger people with Alzheimers.

Pamela Smith, who also testified before the House Human Services Committee Wednesday morning, is one of those Vermonters who has younger-onset Alzheimer’s but is not included in state-wide statistics.

Smith began noticing memory loss at 49, sought medical treatment for it at 50, and received her Alzheimer’s diagnosis at 52, she told lawmakers.

Soon after, Smith was unable to continue her career in mental health and human services, and she resigned. She is now 55. She can no longer follow the plot of a book, she told lawmakers, or cook without supervision.

Smith hasn’t even gone gray yet. “My red hair is still natural,” she said to the committee.

And because Smith is under 65, she is ineligible for Medicare, she said.

“There is no system of care” for people with Alzheimer’s and other dementias, Smith told the committee.

“Instead, we have to be our own case manager, calling numerous community and state-based agencies to craft a path for limited service,” Smith said. “Through my numerous calls … I learned relevant agencies don’t know what the others offer.”

When Smith looked for private case management services, she was told it would cost her $125 an hour. The closest provider was an hour away.

Polyte, Smith and other advocates and representatives from state agencies testified in support of S.206, which passed the Senate in March. It’s a pure policy bill, with no appropriations for additional services or personnel.

The bill would give the Governor’s Commission on Alzheimer’s Disease and Related Disorders greater policy-making and advisory power. It would create a work group that would provide findings and recommendations to the Commission and the Legislature. It would require the Department of Disabilities, Aging, and Independent Living to collect Alzheimer’s-related data, and include Alzheimer’s-specific policy in the State Plan on Aging.

Sen. Randy Brock, R-Franklin, one of the sponsors of the bill, said he sees it as a step toward formalizing the state’s approach to Alzheimer’s care.

“It’s a disease that bankrupts people,” Brock said.

Both Polyte and Smith noted the gendered disparities in how dementia impacts caregivers. About two-thirds of caregivers are women, and about a third of dementia caregivers are daughters, Polyte said.

“It’s just as impactful on the workforce as not having child care, and yet, we don’t talk about it, because it’s old people,” Polyte said.

While Polyte and advocates voiced their support for the bill, they also urged lawmakers to do more. Polyte asked lawmakers to designate a state-wide point of contact to connect families with existing services.

“I fully support S.206, but we cannot even begin to think that this is going to solve the problem,” Polyte said. “We could never think that a zero-appropriation bill would solve a problem like this.”

— Riley Robinson

IN THE KNOW

The people most familiar with Vermont’s climate plan are not confident that the state will meet its 2025 emission reduction requirement.

In 2020, state lawmakers passed the Global Warming Solutions Act, which legally requires Vermont to reduce its emissions by set amounts in the coming decades. The first of those deadlines, 2025, is coming up fast, and as lawmakers work through climate legislation this session, gaps in the emission reduction plan are crystallizing.

Members of Vermont’s Climate Council crafted a statewide Climate Action Plan, published in December, calculated to decrease emissions by the necessary amounts. But key pieces of the plan have fallen apart or are not on track to be implemented in time to meet the 2025 deadline.

Read more here.

— Emma Cotton

In a surprise announcement Wednesday, Kevin Mullin, head of a powerful regulatory body in Vermont health care’s ecosystem, said he will retire in July.

Mullin chairs the Green Mountain Care Board, which regulates hospital budgets and insurance prices, among other things.

Mullin, a small business owner from Rutland, has been the board chair since 2018. His term would have expired in 2024, according to the website.

Mullin has been in public life since the 1980s. He was a Republican state senator from 2003 to 2017, and helped write the legislation that created the care board. He served on various committees, including the Senate Committee on Health and Welfare and the Senate Economic Development Committee.

Read more here.

— Liora Engel-Smith

Statehouse renovations are a pretty sure “go” at this point, confirmed Rep. Mary Hooper, D-Montpelier, who chairs the House Appropriations Committee.

There was already $1.5 million for planning Statehouse renovations in this year’s Budget Adjustment Act, which Gov. Phil Scott signed into law in March.

House Appropriations also set aside $20 million in American Rescue Plan Act money to fund renovations in their draft of the 2023 Big Bill. The line item is labeled “contingent,” but Hooper said this just means the funds could come from the General Fund or some other bucket if necessary — not that the project is up in the air.

The hope is to build another story atop the cafeteria, move the cafeteria upstairs and build new, larger committee rooms in what is now the cafeteria space, said Rep. Alice Emmons, D-Springfield, who chairs the Statehouse Oversight Committee.

But first, as part of the planning process, someone will need to test the current structure to see if it can withstand an additional floor, Emmons said.

Because there are no formal plans yet, there’s no set price tag, only a rough ballpark figure. Emmons told other lawmakers back in January that the construction could cost somewhere between $20 million and $25 million.

— Riley Robinson

ON THE FIFTH FLOOR

Gov. Phil Scott has signed into law the Legislature’s redrawn district maps, solidifying the political playing field in Vermont for the next 10 years.

Scott signed H.722 on Wednesday afternoon, according to a statement from his office. The maps can now go to the Secretary of State’s Office to begin the ballot-making process.

The maps also portray the realities of Vermont’s migrating population — and the resulting shift in political power. Most notably, the Northeast Kingdom (Essex, Caledonia and Orleans counties) lost one senator to Chittenden County, mirroring population shifts from rural areas to the metropolitan center. Three senators will now represent the Kingdom, and seven will represent Chittenden.

Read more here.

— Sarah Mearhoff

Vermonters who wish to amend the gender identity listed on their birth certificate will now be able to do so more easily, thanks to a new law signed by Gov. Phil Scott on Wednesday.

Scott said in a statement that he was “happy to sign” H.628, a bill that he said “takes an important step forward towards building a more equitable Vermont.”

“Working to make our state more welcoming and inclusive for all must be a priority, and this is another important step towards that goal,” he said.

Read more here.

— Sarah Mearhoff