VAHHA Voice -
Selected articles from the Summer 2001 issue of the VAHHA Voice, the newsletter of the Vermont Assembly of Home Health Agencies.. For a print copy of the Voice call 229-0579.
(To read the VAHHA Annual Report)
The articles reprinted below, from the Summer 2001 issue of the VAHHA Voice, include:
Southern Vermont Home Health, VNA Alliance To Merge
Southern Vermont Home Health of Brattleboro and the Home Care Alliance of Vermont New Hampshire, with its main office in White River Junction, are planning a merger of the two agencies on July 1. The new agency will serve 58 towns in Vermont and 15 in New Hampshire and will be the largest agency in Vermont with a service a population base of nearly 160,000.
"We are actively pursuing the steps necessary to merge SVHHA and the VNA/VNH organizations in what we expect will be a beneficial relationship for staff and patients," said
Kathy Anderson the director of the Southern Vermont agency. "Home care and hospice have become more specialized and we believe that both organizations can benefit from merging our staff and resources to meet the changing needs of patients and to thrive in this challenging health care environment."
According to Anderson, the process of merging involves careful review on the part of both SVHHA and VNA/VNH including meetings with all SVHHA staff, letters to patients, physicians, and other key stakeholders.
"If a merger agreement is approved by both boards, we anticipate the same nurses, therapists, home health aides, personal care attendants and homemakers will be providing care to patients in the communities served by SVHHA. Details of the transition are in the planning process."
Betsy Davis, the Executive Director of the Alliance said: "All of us at VNAVNH are looking forward to working together with the very fine SVHHA staff in meeting the ever changing challenges in home care and hospice. We see this merger as mutually beneficial for both agencies as well as for our patients and families. We also look forward to a strong continuing relationship with Brattleboro Memorial Hospital where we hope to utilize some of their specialized staff and capitalize on their general knowledge of the area."
Both agencies are full service, Medicare Certified home care agencies and each is certified by the Joint Commission on the Accreditation of Health Care Organizations. The Southern Vermont Home Health Agency serves 1100 Vermonters a year and makes approximately 38,000 visits. The VNA Alliance, which is an affiliate of the Hitchcock Alliance of Lebanon, New Hampshire, make more than 143,000 home visits in Vermont and serves 4,000 Vermonters.
The VNA/VNH was formed in 1992 with the merger of 7 agencies in Vermont and New Hampshire and later joined by another home health agency in New Hampshire and by three volunteer hospice organizations. The Alliance joined the Dartmouth Hitchcock Alliance in 1996. The Alliance includes a group of affiliated health care institutions including Mary Hitchcock Memorial Hospital in Lebanon; Cooley Dickenson Hospital in Northampton, MA; Upper Connecticut Valley Hospital in Colebrook, NH; West Central Services in Lebanon, NH; Mt. Ascutney Hospital and Health Center in Windsor, VT; and the Central Vermont Hospital in Berlin, VT.
Ten years ago the Department of Aging and Disabilities released a report entitled "Shifting The Balance" that said too much was spent on institutional care and not enough on home and community-based services. "A system balanced between institutional care and non-institutional services would spend no less than thirty percent of public money on in-home and community-based services," DA&D officials concluded in their report. The study suggested that Vermont should work toward a gradual shift in spending with more spent on home care services and less on nursing home care. At the time more than 80% of the money spent on community based services was spent on nursing home care.
Five years and several dozen meetings later, between all the major players involved, Vermont lawmakers gave official state approval to the shift in emphasis from institutional care to community-based care. In the winter of 1996 the Vermont Legislature passed "Act 160" which suspended Medicaid payments that paid for 236 nursing home beds and shifted the money to home and community-based services.
The legislation was designed to reduce the number of state-funded nursing home beds and to provide money for community-based services. Included in the programs targeted for expansion were the Medicaid Waiver program, a program that provided services to Vermonters with traumatic brain injuries, homemaker services, and adult day care.
"The intent of the law is to spend taxpayer dollars more wisely and to serve almost twice as many people as would otherwise have services, without having to increase revenues proportionally," said Larry Crist, who was then DA&D Commissioner.
In the meantime, Vermont Medicaid added a high tech program for children which provides health care service for children with serious high technology medical needs, services that previously could only be provided in hospitals and long term care institutions. This program completed the shift in emphasis from institutional-based care to community-based care for Vermonters of all ages.
Behind Act 160 were both the high cost of nursing home care and the scary projections in growth of Vermont’s elderly population. In 1980 there were fewer than 60,000 Vermonters aged 65 or older. By 2015, the number will approach 90,000. The 85+ group is the fastest growing sector of Vermont’s population. Every DA&D Commissioner since Crist has said that Vermont simply cannot afford to continue business as usual and that continued heavy reliance on nursing home services as Vermont’s long term care solution, will break the Medicaid bank.
In addition, when asked, Vermonters made it clear they prefer home care to institutional care. "We know that consumers thirst for change. Overwhelmingly, they express a desire to remain at home when faced with long illness or disabling condition," David Yacovone, the DA&D Commissioner who followed Larry Crist, wrote in the Vermont State Plan on Aging in 1998. "Now, we craft Vermont’s long term care policy for the 21st Century, we have a unique opportunity to respond to these consumer imperatives, to reshape our priorities and redefine our long-term care system, and, in the process, to give real meaning to our oft expressed commitment to community-based care," Yacovone wrote.
The biggest problem impeding the march toward more community-based care is the staffing crunch. The average age of a nurse in Vermont is 45 and 72% of all nurses in the state are over 40. The problem is even worse for paraprofessionals. According to a recent study, the average age of a personal care attendant in Vermont is 47. Compounding the problem is the greater needs of many home care clients. Not only are many of the elderly served by home care more frail than ever before but also many often require daily, sometimes twice-a-day visits, which has placed serious staffing stress on the agencies. In addition, the high tech program for children involves a large number of highly trained staff, staff very difficult to find. These children frequently need daily visits or more, and some even require nearly round-the-clock coverage.
The nearly decade long move toward more community-based care is clearly revealed in the home care data. In 1999, the most recent data available, Vermont’s 13 home care agencies served 23,628, one in every 40 Vermonters, one of the highest rates of service penetration in the nation, That year Medicaid comprised 28% of the total home care revenues in the state. In 1990, Medicaid comprised only 14.1% of the total state home care revenues.
CVHHH Celebrates 90 Years of Home Care Service
Central Vermont Home Health and Hospice (CVHHH) recently celebrated the agency’s 90th Anniversary of providing home health service to Central Vermont, and Hospice’s 20th Anniversary. With a banner that read, "Continuing A Tradition of Caring . . . 90 Years of Home Care and 20 Years of Hospice", dinner guests at the agency’s annual meeting at the Capitol Plaza Hotel in Montpelier joined in sharing a huge birthday cake.
National home health consultant Robert Fazzi, Ed.D was the keynote speaker at the event. His address, entitled "Home Care Tomorrow: Insights Into The Future" offered critical insights into the multitude of changes ahead as the home health industry will become an even more vital part of the health care industry. "The future of home care is going to take place in the community", Fazzi told the largest crowd ever assembled for a CVHHH Annual Meeting. "Home care will be the focus of future services. All the demographic trends suggest growth in services, as well as new approaches to the delivery of those services", he added.
Several CVHHH staff were recognized at the meeting for their service to the agency including: 25 years - Marilyn Moore; 20 years: Sue Calderara, Connie Colman, Kathy Finck, Yvonne Manning; 10 years - Rosalee Bell, Phyllis Hewett, Patricia Newall, Sally Perry, Sharon Turner, and Martha Vitagliano; and 5 years - Irina Assur, Barbara Bosma, Sandy Floersheim, Nancy Freund, Sue Grant, Penny Gray-Allen, Anne Greensfelder, Jane Hartzell, Carol Hill, Peter Kipp, Madeline McDermott, Kathy Mercurio, Steve O’Keefe, Jim Park.
The slate of officers elected to the Board of Directors were Edna D. Burnett of Montpelier, Board Chair; Ellen Fein of Montpelier, Vice Chair; Jane Pagel from Middlesex, Secretary; and Sandra Rousse of Barre, Treasurer. New members elected to the Board were Robert "Bob" Hickin of Washington and Charlene Lathrop of Northfield Falls. Hickin is retired from a 20 year career as Treasurer of Creare Incorporated in Hanover, NH, where he previously served as Vice President of the National Bank of Lebanon. His wife, Joan, received care from CVHHH’s Home Care and Hospice programs prior to her death in October of last year. Lathrop, a resident of Northfield Falls, is a Systems Developer with the State of Vermont Department of Taxes, where she has worked for the past 30 years. A lifetime Vermonter, Charlene has been a Hospice Volunteer since 1998, active with the Bereavement Support Group.
Earlier this year, Alan H. Weiss of Northfield joined the CVHHH Board of Directors to fill an unexpected empty seat. Weiss, a former two-term State Legislator who served as Chair of the Local Government Committee, is Coordinator for the Drug Free Communities Project in Northfield and Roxbury, and previously served as Executive Director of Association Vermont Independent Colleges. In addition to holding the post of Director of Continuing Education at Norwich University from 1980 to 1990, Weiss was Deputy Commissioner of Education for the State of Vermont, and has served as a teacher, principal, and school superintendent. His wife, Marjorie, received home care services from CVHHH prior to her death in 1995.
Volunteers and Community Partners Honored
CVHHH honored its volunteers and community partners at the meeting at ceremony held just prior to the agency’s annual meeting. In 2000, CVHHH Health Promotion Volunteers provided 265 hours of service, valued at $4,710; Administrative Volunteers gave 2,360 hours, totaling $26,120 in service; while Hospice Volunteers gave some 6,000 hours of service totaling just under $70,000 in savings to the agency.
Wayne Andrews of Northfield and Jane Valentine of Roxbury were presented with the Susan Mattuck Meacham Award in recognition of their service to the Hospice team by providing assistance with outstanding administrative support in the office.
"Both Jane and Wayne work diligently ‘behind the scenes", said CVHHH Hospice Director Diana Peirce. "Their contributions to the life of our department are very much appreciated by staff and patients alike."
The 2000 Hospice Partners Award went to two Barre businesses which have been exceptionally supportive of CVHHH through in-kind and at-cost printing services. Owners Larry and Diane Brown of L. Brown & Son’s Printing, and Alan Rubel of ProForma Vision of Success were honored for their years of support and generosity to the agency as a whole, and to hospice in particular.
RSVP, Retired and Senior Volunteer Program, was awarded the Health Promotion Partner of the Year. Joan Carrigan, RSVP Program Coordinator, was thanked for the many volunteers she sends to CVHHH who assist with Health Promotion activities including monthly foot care clinics, health screenings and fall flu shots. "Staffing our health promotion activities is a huge undertaking," said Cindy Isabelle, CVHHH Health Promotion Coordinator. "RSVP volunteers have the important job of greeting as many as 400 people at a clinic, helping them complete registration forms and sending them in the right direction. What a gift!"
Co-winners of the agency’s Administrative Volunteer of the Year Award for 2000 were Helen Gomez and Madelene Yacavoni, both of Montpelier. Madelene gave the agency 207 hours during 2000, averaging more than 17 hours a month. Helen gave the agency a total of 430 hours, averaging a very impressive 35.5 hours a month!
"With more than 30 administrative volunteers who support the agency’s office staff, Helen and Madelene have raised the bar and set a new standard for others to meet", said Barbara Butler, CVHHH’s Community Relations and Development Director. "The value of support provided by Helen and Madelene alone saved the agency more than $7,500 during year 2000. Along with their other community volunteer work, Helen and Madelene are both very deserving of this award."
Coffey, VNA of Chittenden’s New MCH Director
Jean Coffey RN, MSN, PNP is the next Director of Maternal Child Health Division of the Visiting Nursing Association of Chittenden, Grand Isle Counties. Jean is well known a clinical leader, advanced practice nurse clinician, educator and advocate for children and families. She is currently the Nurse Leader for the Pediatric and Adolescent Care Unit at the Dartmouth Hitchcock Medical Center. She is also Clinical Associate Professor of Pediatrics for both the UVM School of Nursing and the UVM College of Medicine. Prior to her work at Dartmouth, Jean was Nurse Leader for the Children's Health Care Service at Fletcher Allen Health Care.
Earlier in her career, Jean was director of pediatrics for Professional Nurses Service (PNS). Jean brings a deep personal commitment to children and families and broad experience in hospital as well as home and community-based settings. Her voluntary service includes the Vermont Lung Association, the Vermont Heart Association, VPQHC, and the Children's Miracle Network. Nationally she is a member of the American Academy of Pediatrics Expert Panel on School Health. When you meet her, you will see that she displays glowing enthusiasm for her new role as the leader of our MCH team. We are privileged to have recruited a person of her caliber to lead the continuing work of this cherished division of our agency.
The Killington Pico Rotary Club hosted the 14th Annual Golf Tournament on Wednesday, June 13, to benefit the Hospice Program of the Rutland Area Visiting Nurse Association & Hospice. The Tournament was held at the Green Mountain National Golf Course in Killington, Vermont. Over the past several years, Killington Pico Rotary Club has donated over $19,000.00 to support the Hospice program.
"This annual event is an opportunity for the Killington Pico Rotary to raise much needed funds to continue the vital health care and Hospice services provided by the Rutland Area Visiting Nurse Association and Hospice," said Ken Lee, Tournament Coordinator.
"We have made a commitment to our patients and their families that the programs we offer and the quality of our services will never change. Through successful fund raisers, such as the Killington Pico Rotary Tournament, we can continue this very proud legacy," said Ronald Cioffi, Executive Director of Rutland Area Visiting Nurse Association & Hospice.
First low net team winners were: Sal Salmeri, Jason Evens, John O’Donnell, John Reid. First low gross team winners were: Ken Budzna, Bill Bauer, Dennis Clark and Steve Durkee.
The Rutland Area Visiting Nurse Association and Hospice (RAVNA&H) offers a wide range of home health and community-based services including the Hospice Program which provides care for people with a terminal illness who are no longer seeking curative treatment. The goal of Hospice is to affirm life by helping patients find dignity, peace and comfort in their final days.