Nearly two years after Vermont began its innovative Choices for Care program, success is already evident. The number of Vermont's elderly poor and disabled residents sent to nursing homes has declined, while their quality of life has improved, allowing them to stay in their homes and maintain their independence. This is the first Medicaid-choice waiver program in the U.S., allowing eligible residents to elect their own care. Previously, nursing home care was the only option available to Medicaid-eligible citizens.
How does the state program work? Seniors who need help with daily living activities and/or housekeeping and meal prep can elect to receive care provided by a family member or friend, who then gets paid by the state, on average of $10/hour. These dollars are via a combination of federal and state money, as approved by Medicaid budget limits for Vermont.
How much is Vermont saving by channeling these dollars into various community-based initiatives, including assisted-living facilities, privately run boarding homes for seniors and elder day-care centers? As cited by the Associated Press, it costs approximately $122/day for Medicaid-covered seniors living in nursing homes, versus $80/day for seniors receiving care at home. The goal is to reinvest these savings into the program, thus reaching even more eligible residents.
Choices for Care has its critics, especially from the nursing home industry. They argue that subsidized home care is not as high quality or as consistent as what a typical nursing home can provide. They also cite a high burnout rate from untrained in-home caregivers, who fail to understand how exhausting and draining the work can be.
For more info on the Choices for Care, visit www.dad.state.vt.us/1115waiver/1115default.htm
