Meeting The Challenge:
As outlined in the VT Long-Term Health Care Locational Facility Analysis the building of facilities and providing the personnel required for 3500 additional Beds over 9 years can be attained through coordinated action and resolve between the State of VT, City and Towns, and the Facility Owners.
Below are suggested actions governments can implement to support the necessary growth and continued operation of Long-Term Health Care Facilities. Additional Information for States from The National Govenor’s Assoc. are included below.
Support Facility Expansion –
- Ensure investors and existing operators that State compensation for services is adequate now and, in the future, to cover their capital and continuing operating cost.
- Establish an Ombudsman or Division of DAIL for Long-Term Health Care Facility Implementation. This ombudsman will facilitate actions between Facility Owners and Operators, State and Local governments, Financing, Education, and Building Contractor members to ensure the necessary facilities are built and provide annual reports to the State Executive and Legislative branches on Facility expansion.
- Establish Quantifiable Long-Term Care Facility Objectives in the State Plan on Aging
- Establish a Regional Long-Term Care Commission between the Northeastern States to foster cooperation and long-term planning in such areas as; Education, Employment, Facility requirements, Personnel requirements, Tax policy, and co-ordinate when new facilities being built near a bordering state.
- Foster Workforce housing to be included with a new and existing facilities.
- State to Coordinate with local Cities and Towns on zoning and building approvals.
- Establish an on-line real time bed inventory geographic based web site.
- State to Co-ordinate the multiple capital funding sources. Co-ordinate State, Federal and Private funding sources to facilitate the building of the new LTC facilities.
- State/Federal Govt. -Consider Underwriting/Guaranteeing Construction Loans
- Technology to support data for decision making. Establish a Facility Bed Inventory Database. To Analyze and Forecast by Location, Facility Type and Service type a database needs to be established and maintained monthly.
Attract Long-Term Care Personnel –
- Offer Student tuition reimbursement with an associated work time in the State.
- Consider a Partial Salary Tax exemption, i.e., no income tax on the first $50K of Salary. Relocation expense reimbursement for moving to VT or within VT.
- Provide the Living Wage (as defined by the County specific MIT Living Wage Tables Living Wage Calculator – Counties and Metropolitan Statistical Areas in Vermont (mit.edu)) for workers at these facilities in lieu of the State or Federal minimum wage.
- Ensure State and Regional educational facilities/programs are available.
Support Facility Operational Cost –
- Provide the additional Medicaid monies to bring the VT ACCS and ERC Rate Adjustments level up to the findings of the “Specific Home-And Community -Based Service Provider Rate Study” dated Feb. 15, 2023, presented to the VT Legislature.
- Provide a consistent yearly Increase methodology to set the ACCS and ERC rates. These increases could be tied to the US Bureau of Labor Statistics Northeast Regions Annual CPI rate for Medical Care Services, or the Medicaid % increase for Nursing Homes.
- Reduce the facilities depreciation term from 37 to 20 years. State and Federal governments acknowledge that the Long-Term Care facilities, built in the next 10 + years may not have sufficient 65+ population with the passing of the “Baby Boomer Cohort” to economically operate.
- Establish a lowered utility rate category for the LTC Facilities (Water, Elec. Gas, Oil, etc.).
- Establish a lowered State/Local Property Tax category for LTC Facilities.
Supporting Research by the National Governors Association (NGA)
The NGA has published several publications and letters regarding the need to address the Health Care Industry, especially a letter on the “Health Care Workforce Shortage” that was sent to the US Senate. Listed below are several of these publications, which provide additional and expert analysis, state examples and suggestions for States to consider. The NGA has also created a Healthcare Collaborative to discuss and learn from other States.
Click on the Picture to see the full report:
“It was once said that the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped.” ~ Hubert H. Humphrey