Federal funding cuts threaten home health program for seniors

RUTLAND, Vt. (WCAX) Federal funding cuts threaten some of the agencies that serve seniors in their homes across the region. These home health care agencies drive six million miles a year to provide services to about 40,000 Vermont seniors. Last year Congress decided to phase out the rural add-on Medicare payment that offsets those expenses. That means Vermont will have to make up the difference.

A friendly greeting is the first thing Darian Fagan's patients hear when the occupational therapist arrives at their homes. She works for the VNA & Hospice of the Southwest Region. Tuesday, she's meeting Cathy Ricketts. The Rutland resident is recovering from a hip injury. "For some people it's a real lifeline," Fagan said.

Twice a week, she guides Ricketts through exercises designed to help her safely complete everyday tasks like bathing or meal prep.

Reporter Cat Viglienzoni: Why are those things important for you?
Cathy Ricketts: So that I have my freedom to get around the apartment.

Fagan's visits help Ricketts stay here in the apartment she's lived in for nearly 12 years. Without her help the longtime resident might otherwise have to go to a nursing home. But not everyone Fagan serves is in the city.

"I think people really deserve to age in place and live comfortably and safely where they are as long as they possibly can. And yeah, if you're on a back road, you're not going to be able to get to a rehab facility easily," Fagan said.

"There's no dirt road in Vermont that they don't go down," said Jill Mazza Olson, executive director of the VNAs of Vermont. She says while their agencies are committed to providing care, no matter where their patients live, it's more challenging when someone lives off the beaten path. "Providing home health in a rural setting is more expensive than providing home health in more urban settings, so our nurses drive further. They can see fewer patients in a day and those things really add to our cost."

The rural add-on, she says, was the federal government's way of acknowledging that. Of the nine VNAs in Vermont, seven of them are affected by losing the rural add-on. Chittenden and Franklin -- both not considered rural by the feds -- never had it.

Olson estimates without the add-on, they're going to have to make up $1.2 million. "And that's a significant amount," she said.

Rutland is considered rural and will lose some money. Fagan says she hopes people understand the value in what they do, and the joys of small successes, like a patient being able to put on their socks again after an injury. "To see that progress is unbelievably powerful," she said.

Olson says there are a couple ways they may be able to offset the loss. One is community support. Another is potentially more money in the state budget for their programs. And there is a small increase in Medicare payments for all agencies this year that may help. Olson says she's also working with Vermont's congressional delegation to see if Congress might have a change of heart.