Waiver would permit home-based Medicaid care

Print More

(Host) State officials want to offer more people a choice between nursing homes and long-term care at home. The state has applied for a federal waiver that will allow it to use Medicaid funds to pay for home-based care for the elderly and disabled.

VPR’s John Dillon reports:

(Dillon) For years, Vermont has used Medicaid funds to pay for home health care. There’s now about 2,200 people covered by Medicaid in nursing homes, and about 1,100 who are cared for at home.

The state now wants to allow more people to stay home if they want to. To do that, the Department of Aging and Disabilities needs a waiver from the federal government, which pays about 63% of Medicaid.

Patrick Flood is commissioner of the department. He says that care in a nursing home is an entitlement under Medicaid, if you meet income guidelines. He wants to put home care on an equal footing.

(Flood) “We think that if you give people equal choice, it’s just as likely as not that people will chose to stay home, if they really have the option. If they do, it does cost us less and so our per-person costs go down and we can serve more than 3,300 people. I certainly think it’s reasonable to think that anywhere from 100 to 300 people at some point, who can’t get served today, could get served under the new model. Maybe more.”

(Dillon) Flood on Tuesday briefed a legislative committee about the state’s plan. Mary Shriver, who represents the Vermont nursing home industry, told lawmakers that the state may have underestimated the costs of stay-at-home care.

(Shriver) “It costs more to stay at home than simply have a visiting nurse or homemaker service show up for a few hours every week. It’s very difficult to replicate the 24 hour, seven day a week care of a nursing home in a home-based setting at a lower or even at an equal cost.”

(Dillon) Flood said the federal waiver should allow the state to better control costs. He says that under the current system, people who want to stay home sometimes have to go to a more expensive nursing home.

(Flood) “What ends up happening in reality because we cap on the home-based side, there are some people who’d rather stay home, they go to a nursing home because they don’t have any choice.”

(Dillon) Flood says the federal government may take months to review the proposal. But he hopes for approval in the spring, and says he would like to implement the changes by next July.

For Vermont Public Radio, I’m John Dillon in Montpelier.

Comments are closed.