Selected articles from the Spring 2002 VAHHA Voice, the newsletter of the Vermont Assembly of  Home Health Agencies.  For a printed copy of the Voice, call 229-0579 or e-mail VAHHA at: vahha@vnavt.com.

Governor Howard Dean, in his eleventh and last budget address, cut several Medicaid programs including prescription drugs, dental care and vision services. Dean told lawmakers times a tough and sacrifices had to be made.

The Dean budget for FY 2003 is $891 million in state spending, one percent more than the state expects to spend this fiscal year but nearly 3% less than the budget passed last year ($916 million). Revenues this year are expected to be $50 million below budget. Dean wants to use the "Rainy Day" fund to cover some of the $50 million shortfall but does not want to tap that fund for FY 2003. Next year’s budget is based on revenue estimates of $893 million.

If passed as presented, Dean’s budget would:

Eliminate the VScript Expanded Program.

Reduce the Vermont Health Access Plan pharmacy benefit.

Increase the co-pay up to $750/year for medicines under both the VScript and VHAP pharmacy programs. (Those eligible now pay only a few dollars for each filled prescription).

Eliminate the Medicaid dentures, chiropractic and podiatry programs.

Reduce the adult dental programs (cover pain and suffering only, not preventative care).

Add a 50% co-pay to adult vision programs.

Add a $250 co-pay per admission to VHAP inpatient hospital benefit.

Reduce the hospital outpatient payment by 10%.

Establish a hospital outpatient co-pay of $25.

These cuts would save about $27 million, $11 million in state money. Few advocates for the elderly are happy with the budget and have vowed to restore the money lost to these programs. A coalition of over a dozen advocacy groups held a rally and press conference at the Capitol building to denounce the budget cuts.

Dean also reminded lawmakers that they failed to pass a cigarette tax increase last year and suggested the 67 cent tax increase should be passed this year. Currently the Vermont cigarette tax is 44 cent/pack. Opponents of increasing the tax argue that this is, at best, a short term solution, especially since the number of smokers is declining. Opponents also complain that a higher tax would put the businesses along the Connecticut River at a huge disadvantage with New Hampshire because this increase would put the Vermont tax considerably higher than the New Hampshire tax. Proponents of a higher tax argue that a higher cigarette tax not only would provide badly needed money but also would discourage teenagers from smoking. Most studies show that high price is the most important factor in reducing teenage smoking.

On Saturday, February 2, Joan Blankinship, one of the founders of modern home health in Vermont, died after a long illness. She was 74.

I first met Joan in 1983. I was the newly-hired VAHHA director and Joan was the executive director of the Caledonia Home Health Agency. Caledonia was not a VAHHA member. I asked her if I could speak to her and her board to see if I could convince them to rejoin VAHHA. Joan had been one of the VAHHA founders but had withdrawn her agency from the association because she felt VAHHA was not doing a good job. I was nervous to meet her because her reputation made her bigger than life. I was told she knew everything there was to know about home care and couldn’t be fooled by fast talk and empty promises. If I wanted Caledonia to rejoin VAHHA, I had to prove myself, not with words, but with actions.

What I found out was that Joan was in fact bigger than life, not because she was tough, but because she was fair. She told me all she wanted from VAHHA was an association that worked for all the member agencies, not just a few. When I proved that to her, she would rejoin. Three months later Caledonia was again a VAHHA member.

Anyone who knew Joan remembers her humor, her stories, her good cheer, and her laugh, a laugh that could dominate a room and remind us not to take ourselves too seriously. She loved to sing and was an accomplished artist. It never bothered her that I rarely spelled her name the same way twice. Instead she thought was funny that I couldn’t decide whether she was Joan Blankinship or Joan Blankenship.

To those of us in home care what we remember most is that Joan was a tireless advocate and true pioneer in home health and hospice. She was the founder of both the Caledonia Home Health and Hospice and VAHHA. She served diligently on many local, statewide and national health-related boards including the Alzheimer’s Association chapters in both Vermont and New Hampshire, the Visiting Nurse Alliance of Vermont and New Hampshire and the Northeastern Vermont Regional Hospital. She was active in "Ladies First" a breast cancer prevention project and appeared in the early television commercials promoting the organization.

What I liked most about Joan was that she made me feel good. Her effervescent personality and good cheer were contagious. She made everyone she knew feel better about themselves. If there is a heaven, she is there telling stories and making everyone laugh.

Great Woman Dies
by David Reynolds

The following is a reprint from a memo by David Reynolds, CEO of the Northern Counties Health Centers, to the staff.

This past Saturday, a great woman died. Joan Blankinship, the founding Executive Director of Caledonia

Home Health Care and Hospice, passed away quietly in her home in the loving presence of her daughter, Martha.

To say that Joan was a founder of Caledonia Home Health, a significant enough achievement to define anyone’s life, still does not begin to capture her essence and importance. Yes, she created the Northeast Kingdom’s first home care organization, and she began one of the first home-based hospice programs in the country, and she established the Retired Senior Volunteer Program in the region. And yes, Caledonia Home Health, whose headquarters proudly bear her name, would not be what it is today without her, and, in fact, I doubt that Northern Counties Health Care would exist without her guidance and the mentoring she provided me. But, these tangible achievements are not her true legacy. Her true legacy is the vision and spirit she imparted to others who carry on her work for accessible, quality health care for all. She created the culture of cooperation that we just take for granted today in our part of the Northeast Kingdom – a culture that frowns on duplication and competitiveness. Joan believed that we are at our best when we come together to solve problems; as she said: "there’s too much to be done to tolerate nonsense!" These, her strongly-held principles and spirit live on and are her greatest contribution.

We are the children of her legacy. Many of us were nurtured and encouraged to strive to achieve our fullest potential by her. So, we will carry on her work. Her contributions are not in the past, but are an ongoing and living trust that she has bequeathed us.

New Leadership for the Visiting Nurse Alliance of VT and NH

The Board of Trustees of the Visiting Nurse Alliance of Vermont and New Hampshire announces the appointment of Susan H. Larman, BSN, MBA, to succeed Betsy Davis as President and CEO of the 86-community home health care, Hospice and family health services agency, headquartered in White River Junction.

Larman, from Canton, Michigan, is a former vice president and COO of the Visiting Nurse Association of Southeast Michigan. She held the same position at the Visiting Nursing Association of Western New York, part of the Millard Fillmore Health System in Buffalo, NY. She began her 25-year health care career as a nurse in the intensive care unit and has a proven record of accomplishments in corporate growth and strategic positioning to promote long-term viability in a challenging health care environment.

"A visionary thinker and planner who is excellent at building relationships," was the consensus of the VNA CEO Search Committee, which conducted a national search for the agency’s new leadership.

Larman assumed her new post January 21, 2002. "I am honored to be selected to lead this fine organization and look forward to working with the board and staff in continuing the long-standing traditions of serving patients and communities," said Larman, who will make her home in Vermont with her husband, William, a CPA, and sons, Drew and Kirk.

The Vermont Independence Project (VIP) is a collaborative effort between the Office of Vermont Health Access (OVHA) and the Department of Aging and Disabilities (DA&D), with funding from the Robert Wood Johnson Foundation. After several years of planning, the VIP Care Partner Program became operational with 2 pilot sites in March 2001. The unique aspect of this program is the co-location of Area Agency on Aging case managers/care partners in 7 Primary Care Provider offices for several hours each week in Franklin, Grand Isle and Windham counties.

VIP is working with 2 Long Term Care Coalitions on the implementation phase of this grant-funded project. The Franklin/Grand Isle Advocates for Long Term Care have 5 Champlain Valley Agency on Aging Case Managers working as Care Partners with 5 primary care provider offices. The Windham County Long Term Care Coalition has 2 Council on Aging for Southeastern Vermont Case Managers working as Care Partners with 3 primary care provider offices.

Potential clients are referred to the VIP Care Partner Program by their doctor or other office staff. Staff completes a referral form with information about the patient‘s insurance and issues to be addressed by the Care Partner. Clients are given a brochure to help explain the program, than meet with a Care Partner. The Care Partner completes the first seven pages of the VT Independent Living Assessment, and gets a signed release to share some of their information with the doctor’s office and the state.

The Care Partner then provides all the usual case management services, with the added benefit of increased communication with their client’s doctor. Care Partners also provide doctors with quarterly pharmacy reports for each client, listing all prescriptions paid by Medicaid. PCP’s will now know if the prescriptions they write are being filled, and if their patients are getting prescriptions from other providers.

The following Care Partners can answer your questions or accept referrals for this project. If you know of a family member or friend who lives in Franklin, Grand Isle & Windham counties and could benefit from this program please call the Care Partner.

Tammy Zilske COASEV Care Partner with Drs. Backus and Linder in Townshend

Call (802) 885-2655

Lilith Iversen COASEV Care Partner with Dr. Tortolani in Brattleboro

Call (802) 258-9724

Harry Benoit CVAA Care Partner with Dr. Zelaso and Physician’s Assistant Rosaire Bisson in Richford Call (802) 865-0360 ext 601

Connie Van Dine CVAA Care Partner with Dr. John Nicholson and Nurse Practioner Marty Linseisen in Grand Isle Call (802) 865-0360 ext 622

Rebecca Gill CVAA Care Partner with Dr. Mara Vijups in Swanton

Call (802) 865-0360 ext 604

Anne Marie Miner CVAA Care Partner with Dr. Robert Silverstein in St. Albans. Call (802) 865-0360 ext 613

Sara Miller CVAA Care Partner with Dr. Zelaso in St. Albans Call (802) 865-0360 ext 621

Or you can contact Brendan Hogan the Director of the Vermont Independence Project’s Care Partner Program at (802) 241-3989

The Rutland Health Foundation recently announced their grant awards for 2001. A total of $28,500 was distributed to three area programs serving the health and human service needs of the citizens of Rutland County. In his announcement, Tom Huebner, Chairman of the Foundation’s Board of Directors said, "All three of the programs selected have a distinguished history of providing greatly needed services to a broad cross section of individuals. Virtually every group from the elderly and disabled to families and new moms are impacted by the programs that we have funded. The Foundation is pleased to have provided support for their continued growth and success."

The Foundation awarded a $10,000 grant to Kids on the Move to extend pediatric rehabilitation services to children with special needs. Kids on the Move serves children in schools, at home and in the clinic setting.

The Childbirth Education program was granted $10,000 to maintain and upgrade current programs offered, continuing education for staff, expansion of services to other communities and purchase of educational materials. The Childbirth Education program has offered birthing and early parenting programs since 1978.

The Healthlinks program, Bridges and Beyond received $8,500 to support its volunteer and respite services to elderly and disabled individuals requiring in-home assistance.

Rutland Health Foundation was founded in 1994 to support innovative programs and services of Rutland Area Visiting Nurse Association & Hospice, Rutland Regional Medical Center and most recently Rutland Mental Health. The Foundation’s major source of revenue is the annual Rutland Health Foundation charity Golf Invitational which in 2001 raised over $30,000.

The annual Employee and Volunteer Recognition Dinner of the Orleans, Essex, VNA & Hospice was held recently at the Eastside Restaurant in Newport. Board members, staff, and guests enjoyed and evening filled with good food, lively entertainment, and recognition for a job well done.

Sen. James Greenwood, President of the Board of Directors, addressed the guests and acknowledged the challenges the staff faced and overcame. He emphasized the Board’s commitment to the staff and noted that in his travels throughout Vermont, he is made aware of the purpose of the organization and impressed with the skill and dedication of the OEVNA & H staff. Nancy Warner, Executive Director, thanked the Board for their support and the staff for their dedication to quality care and customer service.

As part of the evening’s activities, an All Staff Revue highlighted the talents of staff through dance, song, and skit. Donna Shelton entertained with her songbird voice (blue hair and all); everyone was enchanted (and amazed) by the grace of the hula performance of Lisa Cox; Karey Fields an Jodi Woodard delighted the crowd with a "news cast" filled with headlines about agency people and events; Karla Boone belted out a tune reminiscent of Ethel Merman and fit for Broadway; and toes were tapping to music performed by Delvin and Nancy Warner. Throughout the evening guests were serenaded and kept in stitches by the music of Tony and Linda Washburn.

The Agency’s resident theatre troupe, The Grin & Bear t Company, brought the house down with its performance of "Once Apon a Time," a rendition of Goldilocks and the Three Bears. Pam Brainard, Lisa Cox, Cheryl Heath, and Delvin Warner gave stellar performances, worthy of Oscar recognition.

The evening concluded with an award ceremony recognizing the volunteers, Board, and staff of the Agency. The community Appreciation Award was presented to Gary Kellogg for his support of the Hospice program. Mr. Kellogg has been an important participant in the success of the Hospice benefit gala.

Sr. Jeanne Berthiaume, Sr. Lillian Thibeault, and Lou Hammond were recognized for volunteering over 100 hours each to the Hospice and Hearts and Hands programs. Sheila Brodsky of Canaan was recognized for volunteering her time to wellness clinics such as foot care and flu immunization.

Years of service were celebrated for both Board members and staff. Over 80 years of service was recognized!

Board members Jim Greenwood, Brian Kinsley, and Rev. Frank Massa were recognized for their years of service and commitment to the Agency. Mr. Kinsley has served on the Board for ten years, and Sen. Greenwood and Rev. Massa have both served for five years. Five year service pens were awarded to Cheryl Labounty, Kim Vezina, Donna Shelton, and Elaine Leno. Celebrating Ten Years with the agency were Judi Hussey and Georgie Bourassa. Rita Stafford was honored for her twenty years of service.

Individual awards were presented to Jennifer Prevost for her support through utilization review, and to Kit Dorau for his work as an Occupational Therapist. Diana Hamilton and Betsy Lyons were recognized for achieving their certification as Hospice & Palliative Care Nurses. For the first time, a departmental award was presented to the group that exemplified teamwork and support. The Nursing Department presented this award for meeting the challenges of OASIS.

The Employee of the Year award for 2001 was presented to Vicki Sayarath, who has worked with the organization for almost 9 years and has been instrumental in obtaining funding for programs and services. Vicki is the Director of Special Programs and supervises the Hospice, Maternal Child Health, and clinics programs, as well as oversees programs funded through grant awards.

RAVNAH Recognized as "Best Practice" Agency

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