Five years ago, Louis LaRose had a stroke, paralyzing the right side of his body. Unable to get around, LaRose, 65, moved to a South Burlington apartment building where he could receive round-the-clock care through University of Vermont Health Network Home Health & Hospice.
But the health agency is ending its 24/7 program on Nov. 4 due to staffing problems, forcing LaRose and his neighbors to reduce their care, hire their own caregivers or, possibly, move out.
“This is a heartbreaking situation,” said Kim Fitzgerald, CEO of Cathedral Square, a nonprofit that owns and operates the South Burlington apartment building. “But it’s a completely understandable one, given the staffing crisis that we are having in the state of Vermont.”
The one-bedroom apartments — eight of 10 are currently occupied — house people with mobility impairments who annually make $33,600 or less, or $38,400 for a household of two.
Nissa James, director of communications and engagement strategies at University of Vermont Health Network Home Health & Hospice, said it is working with the state Department of Disabilities, Aging & Independent Living so that every resident ends up in the “most appropriate setting.”
James said the agency is also working “to ensure that every single personal care attendant and licensed nursing assistant who works for us currently is able to transition to a different job within our organization.”
Home Health & Hospice has also stopped accepting new referrals for clients who require personal care attendant services as well as referrals for case management services.
“All of us here in the building and the families have been trying to find somewhere to go. There’s nowhere,” LaRose said during an interview in his apartment on Wednesday.
LaRose said that he has tried to apply to live with a family, also known as adult family care, but one place had a two-year waiting list and the other wouldn’t permit him to bring his cat.
LaRose said that he doesn’t want to go to a nursing home, in part because his wife died in one, making him distrustful of the care they provide. Even if he did, he said it would be difficult to secure a spot, given that many homes are also struggling with staffing problems and aren’t accepting new residents.
LaRose said his daughter moved into his one-bedroom apartment two months ago so that he’d have someone to take care of him at night. But he requires care throughout the day to help with daily needs, including moving.
He’s frustrated with how the situation has been handled. “All of a sudden they came with this bullshit about ‘you don’t fit our model,’” he said, while laying in bed and shaking his head. “And now you’re telling me, ‘You got 90 days to figure it out?’”
James said agency leaders pushed the deadline as far as they could based on their staffing.
The housing difficulties that LaRose has encountered aren’t unusual. Fitzgerald said that Cathedral Square, which provides housing to older adults and people with special needs, has a waiting list of more than 1,000 individuals to get into one of its 27 communities in Chittenden, Franklin and Grand Isle counties.
Staffing shortages plague Vermont’s entire long-term care system, according to Angela Smith-Dieng, director of the Department of Disabilities, Aging & Independent Living’s adult services division. Three of the state’s 11 home health agencies have had to pause some of their services.
As of last year, 10 residential care homes have closed since the pandemic began, according to Long Term Care Crisis Coalition — an alliance between several Vermont organizations that advocate for long-term care.
Fitzgerald suspects that an additional residential care home has since closed.
Earlier this year the state provided an 8% increase in Medicaid rates for home and community-based services so agencies could increase wages and benefits, according to Smith-Dieng. Federal American Rescue Plan Act funding allowed for additional payments to home and community-based providers.
But that additional funding hasn’t abated staffing challenges, according to Jill Mazza Olson, executive director of VNAs of Vermont, a trade association representing nine home health and hospice agencies, including UVM Health Network Home Health & Hospice.
“(It’s) a really important step in the right direction that absolutely we needed and is helping, but much more is needed to actually change the trajectory. The underpayment is so chronic and has been happening for so long that one really strong increase is not going to turn it around,” Mazza Olson said.
VNAs of Vermont in 2021 found a 33% vacancy rate for personal care attendants in home health and hospice agencies statewide, Mazza Olson said.
As far as wages, she said, “we’re competing with McDonald’s and Walmart.”
