We are the parents, guardians, doctors, supporters and members of the community who have responsibility for the safety, health and direct care of our most vulnerable population.  We are the caregivers of those who are medically and psychologically fragile, elderly, disabled and living with chronic and life-threatening conditions. During this declared State of Emergency the nurses, Personal Care Assistants and other direct care providers are not allowed in our homes to provide care to keep our loved ones safe and healthy.  Before home nursing and Personal Care Programs were available, our loved ones would have lived long-term in hospitals and institutions due to their significant medical, psychological and other care needs. Now that these aids and nurses are not allowed in our homes, our most vulnerable population’s health is at risk and an unsustainable strain is on our families.  We have an obligation to keep individuals with disabilities and life threatening illnesses well enough at home so that the hospitals and understaffed Vermont Healthcare systems do not become additionally overburdened during the Coronavirus pandemic.  

Vermont Department of Health and other agencies have been proactive and supportive but we need more momentum.  With urgency, Governor Scott needs to implement additional community mitigation strategies to prevent and control outbreaks of COVID-19 in order to protect those at the greatest risk.  He can do so by mirroring institutional efforts (such as limiting visitor access to hospitals and facilities that serve the elderly and very ill) into the home setting where qualified staff would otherwise be providing a significant level of in-home care (at least 4,000). Here are the 3 critical mitigation strategies necessary to support the most vulnerable population in their home care setting:

Update the State of Emergency Executive order to waive the restrictions against parents and guardians utilizing their family’s existing budgets to provide medical and personal care to their dependent.
Add Personal Care Assistants and Home Nursing to the list of essential workers, so they can be utilized where possible AND determine how they can be paid while not working for us so we can retain them for post-pandemic.
Remove or expedite processes to approve parents and guardians as caregivers authorized to charge time against budgets including Developmental Services Waivers, High Tech Nursing Care, Children’s Personal Care and other relevant care budgets.
 

Budgets are routinely allocated to each of our families to pay nurses and aides to be in our homes for medical and personal care, as well as respite.  However, due to the highly contagious nature of COVID-19, these funds will now go under-utilized because of the State of Emergency. At least two states (California and Colorado) allow parents/guardians to be paid as the nurse or personal care assistant to their loved ones under normal circumstances.  Implementing this mitigation strategy in Vermont, even as a temporary solution, is critical to help reduce additional health and financial challenges that exist for our families even in the best of times.  It is also paramount in allowing us to comply with the State of Emergency orders as well as CDC recommendations to protect our most vulnerable.

With our 1:1s and home nurses no longer able to come to our homes, we also risk job loss ourselves as we now personally provide the level of medical and personal care which previously would have required long term hospitalization.  Parents and Guardians need to charge this valuable time to whatever budget remains in their dependent’s funding immediately. This change prevents parents from requiring unemployment compensation when giving up paid work for what would otherwise be unpaid caregiving, providing relief from an unsustainable level of care and a much needed income for families who can’t access qualified help OR any natural supports during this time.  The changes we are requesting to the executive order will also give the same level of protection afforded to similarly vulnerable individuals in hospitals and facilities.  The burden to the healthcare system will also be reduced, safety and care will improve for our most vulnerable population, unemployment demands won’t be as high and some predictability would be achieved by utilizing existing budgets which otherwise would go under-utilized.

Please order these additional mitigation strategies immediately so we can best protect the most vulnerable population, their families and caregivers.