OpEd: We Must Care for Our Most Vulnerable
January 31, 2025
by Kim Fitzgerald, CEO of Cathedral Square
How can this be?
Long-term care communities support our most vulnerable. For far too long, direct care staff have been underpaid and underappreciated. During the pandemic, they were our heroes – caring for people 24/7. During COVID outbreaks, they went to work in gowns and shields, continuing to offer compassionate care, often risking their own lives. They could not and would not leave their shift until someone relieved them.
On behalf of everyone at Cathedral Square, I cannot thank them enough. Unfortunately, this continues to be their reality every day. For many, flu and COVID outbreaks are a thing of the past, but not for long-term care communities. They care for those who can’t feed themselves, those who need help dressing, and bathing, or getting in and out of bed. They care for our loved ones, those who taught us, protected us, and raised us.
Yet the Governor’s budget doesn’t seem to care for them. While we are grateful that the budget does include necessary funding for our SASH® (Support and Services at Home) model, the SFY26 budget does not include an increase in funding for long-term care providers and communities that accept Medicaid to care for our most vulnerable.
How can we pay a reasonable wage to our workers (our heroes) if we do not receive an inflationary increase for Medicaid reimbursement rates? Many long-term care communities that accepted Medicaid have closed or limited the amount of Medicaid they accept. Without increases, I'm worried more facilities will close, only exacerbating the long waitlists that already exist.
Many Vermonters must rely on Medicaid to pay for their long-term care; they do not have any other means. Even for those who do have means, once they pay down their assets at a private care facility, they will be asked to leave in search of a community that accepts Medicaid. These locations are getting fewer and fewer. At Cathedral Square, 93% of our long-term care apartments are for very low-income Vermonters on Medicaid, and we have hundreds of people waiting to get in. We need more long-term care communities that accept Medicaid, not fewer.
Just recently we welcomed a new resident to Memory Care at Allen Brook, one of our assisted living communities, who had been living at the hospital for four months – not because they needed hospital-level care but because there were no available and affordable long-term care options. And this was not the first person we moved in from long, unnecessary, and costly stays at the hospital.
Vermont’s long-term care system is in crisis and the Governor’s budget does not include a solution. Medicaid rates need to be increased on an annual basis and should be included in our state’s fiscal priorities. We are committed to working with the Legislature to prioritize and fund the care our loved ones need and deserve. I urge the Governor to support our critical long-term care system, which rests precariously on the backs of an underpaid workforce and unpaid family members who often sacrifice their own financial stability to fill the gaps in a neglected system. Let’s come together and do the right thing – prioritize funding to care for our most vulnerable today and create a sustainable long-term care system for tomorrow.