Is Vermont in the forefront of culture change with long term care?

The Wall Street Journal on Monday examined how a new program in Vermont “is trying to give elderly people a choice of where they want to be cared for: in an institution or at home.” Under the program, called “Choices for Care,” Vermont residents can earn nearly $10 an hour to care for an elderly relative. Elderly people in the program typically receive about 25 to 30 hours of care per week. According to a 2002 Vermont study, nursing home care costs the state $122 per day per resident, while home-care costs the state $80 per day per resident. Since the program was launched one year ago, it “has achieved incremental results,” the Journal reports. There are 2,131 residents in nursing homes, 155 fewer than in October 2005, and there are 1,111 people receiving home care, or 123 more than a year earlier. About 500 Medicaid patients who are not yet eligible for nursing home care also received home care through the program. If the program is successful, “it could influence a wider change in the multibillion-dollar industry that cares for the aged,” according to the Journal. However, “the idea faces huge hurdles, including opposition from the nursing home industry and a culture of dispersed, busy families that has become accustomed to having others care for their loved ones,” the Journal reports. Janice Zalen — senior director of special programs for the American Health Care Association, which represents more than 10,000 nursing homes nationwide — said the group is “concerned that people would not be getting the care they needed — both amount and quality.” Meanwhile, Patrick Flood, commissioner of Vermont’s Department of Disabilities, Aging and Independent Living, called nursing homes “an outdated model,” adding, “It is a crazy situation. The service that people don’t want and is more expensive” is guaranteed by the government, while “the service people prefer and is cheaper, isn’t” (Lagnado, Wall Street Journal, 10/23).