Vermont Celebrates Anniversary of Home Care Option

MONTPELIER, Vt.–This month marks the first anniversary of
Vermont’s “Choices for Care” program, established under the first
Medicaid waiver that lets residents choose whether they want to
receive long-term care in their homes or in an institution.

Before the waiver was enacted by Gov. Jim Douglas, nursing home
care was the only option available to the state’s elderly Medicaid
recipients.

“Our push for this waiver was driven by the belief that more
people will choose to have their needs met in their own homes and
communities rather than in institutions,” Douglas said. “This is an
option that is desired by Vermonters and saves the state money
because community services cost less than institutional
services.”

The program was highlighted in a front-page story in the Oct. 23
Wall Street Journal. Under the program, Vermont residents
can earn about $10 an hour to care for an elderly relative. The
relatives typically receive about 25 to 30 hours of care per
week.

A 2002 Vermont study showed that nursing home care costs the
state $122 per day per resident, while home care costs $80 per
day.

Describing the waiver as a way to contain growth of long-term
Medicaid services, Patrick Flood, commissioner of the Vermont
Department of Disabilities, Aging, and Independent Living, called
the program “a forward-looking strategy to plan for the future
growth in the aging population as a result of the baby
boomers.”

Flood told the Journal: “We are never going to build
another nursing home. It is an outdated model.”

In July, CMS said it would give states $1.75 billion over five
years to allow elderly and disabled Medicaid recipients to live in
the community rather than in institutions (see HomeCare Monday, July 31).