Early February 2018 Newsletter
Executive Director's Message
Last thoughts during 
Heart Month
On January 1, 2018 Vermont's "all-payer model" experiment officially began. 2017 was the "year zero" for the effort - a year to plan, test and refine a variety of strategies to control health care costs. These strategies include new payment contracts for hospitals that create strong incentives to reduce hospitalizations through OneCare Vermont, an "accountable care organization"; dedicating more home and community-based resources toward keeping Vermonters with chronic conditions as healthy as they can be; and efforts like RiseVT, aimed at promoting healthy behaviors in Vermont communities.
Many home health and hospice agency leaders have observed that the greatest opportunity for controlling health care costs in the short term lies with focusing on Vermonters who are already living with complex chronic conditions. These individuals are likely to experience complications that lead to expensive hospitalizations and skilled nursing facility stays. Reducing those complications is better for those individuals, and it's less expensive.
In honor of February observations for "heart month," consider heart disease as a case in point.  Medical advances are allowing people to live longer lives with heart disease like coronary artery disease and congestive heart failure. With the support of home health nurses and telemonitors, those individuals can live comfortably and safely at home, where most people want to be. Telemonitors are digital, tablet-sized devices that allow patients to record their vital signs and symptoms and send that information directly to a home health nurse. The nurse develops a relationship with the patient and family members, encouraging heart-healthy habits like regular exercise, while monitoring the patient for signs that complications are developing. Home health agencies are "extending" primary care into the home ---    providing more "check-ins" with a health care professional with fewer trips to physician offices or rehabilitation facilities. For frail Vermonters living with the transportation challenges of rural Vermont, this is a welcome innovation. 
Nurses aren't the only professionals our members dispatch to provide heart care. While nurses might help patients with medication compliance, assess heart and lung sounds and blood pressure and attend to respiratory difficulties, physical therapists can offer cardiac rehabilitation, and home health aides can help prepare healthy foods or offer light housekeeping support after patients' heart procedures. All these services can help patients stick to to their caregivers' plans of treatment.
Check out this story  about James, a central Vermont resident who is taking full advantage of the Central Vermont Home Health and Hospice telemonitoring program.
As February draws to a close, I'm proud to celebrate the health care professionals in Vermont working together to keep all our hearts beating longer.

Jill Mazza Olson
Executive Director
Vermont Update
Legislative Issues

The approximate mid-point of the legislative session is fast approaching, with the Town Meeting week break coming up next week. House policy committees have weighed in on the Governor's budget and sent recommendations to the House Appropriations Committee.  Links to those budget memos from the House Health Care and Human Services Committees are HERE and HERE .
Between them, the committees are recommending the restoration of a number of health care and human services cuts in by the Governor's proposal; rejecting a proposal to provide universal home visits for newborns; and proposing the "transfer" of the funding for the SASH program from the state budget to OneCare Vermont.
The minimum wage bill (S.40) passed the Senate on a 20-10 vote. It will not be taken up by the House until after the Town Meeting break.
Regulatory Issues

On the state regulatory front last week, the Department of Vermont Health Access announced that it will be postponing the implementation of the Medicaid Face-to-Face requirement until April 1, 2018. The VNAs of Vermont and the Vermont Medical Society are working closely with DVHA to develop clear instructions for physicians and other health care professionals. 

Federal Update
The Board of Directors of the  National Association for Home Care & Hospice  (NAHC) announced the appointment of William A. ("Bill") Dombi as the President of NAHC. Dombi was originally named interim president of NAHC in August 2017 after the death of NAHC's long-time president Val J. Halamandaris. Click   HERE t o read the complete NAHC announcement. VNAs of Vermont members welcomed the news.
Last week, for the first time, the Centers for Medicare and Medicaid Services (CMS) posted results on Hospice Compare from a survey of families of hospice patients. Hospice joins home health agencies, hospitals and other providers in publicly reporting the results of a national standardized survey about their experiences of the care they or their loved one received.

Your Vote Counts

Each year on Town Meeting Day, voters across Vermont allocate funding to help ensure that everyone has access to the home health and hospice care they need. It used to be that towns hired Town Nurses to provide care at home to residents. With support from the cities and towns we serve, VNAs took on that role and today VNAs care for children, adults, seniors, and families, helping keep people where they most want to be - at home,  regardless of their ability to pay. These allocations and the generous donations of individuals in each community are critical to making that possible. Help make sure everyone has access to the dedicated and highly skilled expert staff of nurses, therapists, social workers, licensed nursing assistants, care attendants and hospice volunteers of Vermont's VNAs.  Vote on Town Meeting Day.

If you will be out of town, or are unable to go to the polls, you can request an
"early voting ballot" from your town or city clerk. Register to vote and request your ballot before the end of the week to make sure your vote counts!  Click here for more information from the Secretary of State.

Upcoming Events
February 26, 2:30 p.m.

Town Meeting Day: Be sure to vote!
March 6
In Person or by absentee ballot
Green Mountain Care Board Meeting
February 28, 2 p.m.  
In-person Event

hosted by National Association for Home Care and Hospice
March 19-20, 2018
Washington, DC

Upcoming Conferences
J6/JK Home Health and Hospice Medicare Summit 2018:
Maintaining a Healthy Compliance Program
hosted by National Government Services
September 19 & 20 | The Orleans, Las Vegas, NV 
Save the Date! Registration opens in February.
VNAs of Vermont | www.vnavt.com | info@vnavt.org | 802-229-0579