The Vermont Statutes Online

Title 33: Human Services

Chapter 062: Supports for Older Vermonters

• Subchapter 001: OLDER VERMONTERS ACT

• § 6201. Short title

  This subchapter may be cited as the “Older Vermonters Act.” (Added 2019, No. 156 (Adj. Sess.), § 1, eff. Oct. 5, 2020; amended 2021, No. 113 (Adj. Sess.), § 4, eff. July 1, 2022.)

• § 6202. Principles of system of services, supports, and protections for older Vermonters

  The State of Vermont adopts the following principles for a comprehensive and coordinated system of services and supports for older Vermonters:

  (1) Self-determination. Older Vermonters should be able to direct their own lives as they age so that aging is not something that merely happens to them but a process in which they actively participate. Whatever services, supports, and protections are offered, older Vermonters deserve dignity and respect and must be at the core of all decisions affecting their lives, with the opportunity to accept or refuse any offering.

  (2) Safety and protection. Older Vermonters should be able to live in communities, whether urban or rural, that are safe and secure. Older Vermonters have the right to be free from abuse, neglect, and exploitation, including financial exploitation. As older Vermonters age, their civil and legal rights should be protected, even if their capacity is diminished. Safety and stability should be sought, balanced with their right to self-determination.

  (3) Coordinated and efficient system of services. Older Vermonters should be able to benefit from a system of services, supports, and protections, including protective services, that is coordinated, equitable, and efficient; includes public and private cross-sector collaboration at the State, regional, and local levels; and avoids duplication while promoting choice, flexibility, and creativity. The system should be easy for individuals and families to access and navigate, including as it relates to major transitions in care. The system should be designed to address the needs and concerns of Older Vermonters and their families during normal times and in the event of a public health crisis, natural disaster, or other widespread emergency situation in this State.

  (4) Financial security. Older Vermonters should be able to receive an adequate income and have the opportunity to maintain assets for a reasonable quality of life as they age. If older Vermonters want to work, they should be able to seek and maintain employment without fear of discrimination and with any needed accommodations. Older Vermonters should also be able to retire after a lifetime of work, if they so choose, without fear of poverty and isolation.

  (5) Optimal health and wellness. Older Vermonters should have the opportunity to receive, without discrimination, optimal physical, dental, mental, emotional, and spiritual health through the end of their lives. Holistic options for health, exercise, counseling, and good nutrition should be both affordable and accessible. Access to coordinated, competent, and high-quality care should be provided at all levels and in all settings.

  (6) Social connection and engagement. Older Vermonters should be free from isolation and loneliness, with affordable and accessible opportunities in their communities for social connectedness, including work, volunteering, lifelong learning, civic engagement, arts, culture, and broadband access and other technologies. Older Vermonters are critical to our local economies and their contributions should be valued by all.

  (7) Housing, transportation, and community design. Vermont communities should be designed, zoned, and built to support the health, safety, and independence of older Vermonters, with affordable, accessible, appropriate, safe, and service-enriched housing, transportation, and community support options that allow them to age in a variety of settings along the continuum of care and that foster engagement in community life.

  (8) Family caregiver support. Family caregivers are fundamental to supporting the health and well-being of older Vermonters, and their hard work and contributions should be respected, valued, and supported. Family caregivers of all ages should have affordable access to education, training, counseling, respite, and support that is both coordinated and efficient. (Added 2019, No. 156 (Adj. Sess.), § 1, eff. Oct. 5, 2020.)

• § 6203. Definitions

  As used in this subchapter:

  (1) “Area agency on aging” means an organization designated by the State to develop and implement a comprehensive and coordinated system of services, supports, and protections for older Vermonters, family caregivers, and kinship caregivers within a defined planning and service area of the State.

  (2) “Choices for Care program” means the Choices for Care program contained within Vermont’s Global Commitment to Health Section 1115 demonstration or a successor program.

  (3) “Department” means the Department of Disabilities, Aging, and Independent Living.

  (4) “Family caregiver” means an adult family member or other individual who is an informal provider of in-home and community care to an older Vermonter or to an individual with Alzheimer’s disease or a related disorder.

  (5) “Greatest economic need” means the need resulting from an income level that is too low to meet basic needs for housing, food, transportation, and health care.

  (6) “Greatest social need” means the need caused by noneconomic factors, including:

  (A) physical and mental disabilities;

  (B) language barriers; and

  (C) cultural, social, or geographic isolation, including isolation caused by racial or ethnic status, sexual orientation, gender identity, or HIV status, that:

  (i) restricts an individual’s ability to perform normal daily tasks; or

  (ii) threatens the capacity of the individual to live independently.

  (7) “Home- and community-based services” means long-term services and supports received in a home or community setting other than a nursing home pursuant to the Choices for Care component of Vermont’s Global Commitment to Health Section 1115 Medicaid demonstration or a successor program and includes home health and hospice services, assistive community care services, and enhanced residential care services.

  (8) “Kinship caregiver” means an adult individual who has significant ties to a child or family, or both, and takes permanent or temporary care of a child because the current parent is unwilling or unable to do so.

  (9) “Older Americans Act” means the federal law originally enacted in 1965 to facilitate a comprehensive and coordinated system of supports and services for older Americans and their caregivers.

  (10) “Older Vermonters” means all individuals residing in this State who are 60 years of age or older.

  (11)(A) “Self-neglect” means an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks, including:

  (i) obtaining essential food, clothing, shelter, and medical care;

  (ii) obtaining goods and services necessary to maintain physical health, mental health, or general safety; or

  (iii) managing one’s own financial affairs.

  (B) The term “self-neglect” excludes individuals who make a conscious and voluntary choice not to provide for certain basic needs as a matter of lifestyle, personal preference, or religious belief and who understand the consequences of their decision.

  (12) “Senior center” means a community facility that organizes, provides, or arranges for a broad spectrum of services for older Vermonters, including physical and mental health-related, social, nutritional, and educational services, and that provides facilities for use by older Vermonters to engage in recreational activities.

  (13) “State Plan on Aging” means the plan required by the Older Americans Act that outlines the roles and responsibilities of the State and the area agencies on aging in administering and carrying out the Older Americans Act.

  (14) “State Unit on Aging” means an agency within a state’s government that is directed to administer the Older Americans Act programs and to develop the State Plan on Aging in that state. (Added 2019, No. 156 (Adj. Sess.), § 1, eff. Oct. 5, 2020; amended 2021, No. 113 (Adj. Sess.), § 4, eff. July 1, 2022.)

• § 6204. Department of Disabilities, Aging, and Independent Living; duties

  (a) The Department of Disabilities, Aging, and Independent Living is Vermont’s designated State Unit on Aging.

  (1) The Department shall administer all Older Americans Act programs in this State and shall develop and maintain the State Plan on Aging.

  (2) The Department shall be the subject matter expert to guide decision making in State government for all programs, services, funding, initiatives, and other activities relating to or affecting older Vermonters, including:

  (A) State-funded and federally funded long-term care services and supports;

  (B) housing and transportation;

  (C) health care reform activities; and

  (D) public health crisis and emergency preparedness planning.

  (3) The Department shall administer the Choices for Care program, which the Department shall do in coordination with efforts it undertakes in its role as the State Unit on Aging.

  (b)(1) The Department shall coordinate strategies to incorporate the principles established in section 6202 of this subchapter into all programs serving older Vermonters.

  (2) The Department shall use both qualitative and quantitative data to monitor and evaluate the system’s success in targeting services to individuals with the greatest economic and social need.

  (c) The Department’s Advisory Board established pursuant to section 505 of this title shall monitor the implementation and administration of the Older Vermonters Act established by this subchapter. (Added 2019, No. 156 (Adj. Sess.), § 1, eff. Oct. 5, 2020; amended 2021, No. 113 (Adj. Sess.), § 4, eff. July 1, 2022.)

• § 6205. Area agencies on aging; duties

  (a) Consistent with the Older Americans Act and in consultation with local home- and community-based service providers, each area agency on aging shall:

  (1) develop and implement a comprehensive and coordinated system of services, supports, and protections for older Vermonters, family caregivers, and kinship caregivers within the agency’s designated service area;

  (2) target services and supports to older Vermonters with the greatest economic and social need;

  (3) perform regional needs assessments to identify existing resources and gaps;

  (4) develop an area plan with goals, objectives, and performance measures, and a corresponding budget, and submit them to the State Unit on Aging for approval;

  (5) concentrate resources, build community partnerships, and enter into cooperate agreements with agencies and organizations for delivery of services;

  (6) designate community focal points for colocation of supports and services for older Vermonters; and

  (7) conduct outreach activities to identify individuals eligible for assistance.

  (b) In addition to the duties described in subsection (a) of this section, the area agencies on aging shall:

  (1) promote the principles established in section 6202 of this subchapter across the agencies’ programs and shall collaborate with stakeholders to educate the public about the importance of each principle;

  (2) promote collaboration with a network of service providers to provide a holistic approach to improving health outcomes for older Vermonters; and

  (3) use their existing area plans to facilitate awareness of aging issues, needs, and services and to promote the system principles expressed in section 6202 of this subchapter. (Added 2019, No. 156 (Adj. Sess.), § 1, eff. Oct. 5, 2020; amended 2021, No. 113 (Adj. Sess.), § 4, eff. July 1, 2022.)

• § 6206. Plan for comprehensive and coordinated system of services, supports, and protections

  (a) At least once every four years, the Department of Disabilities, Aging, and Independent Living shall adopt a State Plan on Aging, as required by the Older Americans Act. The State Plan on Aging shall describe a comprehensive and coordinated system of services, supports, and protections for older Vermonters, including individuals with Alzheimer’s disease and related disorders, that is consistent with the principles set forth in section 6202 of this subchapter and sets forth the nature, extent, allocation, anticipated funding, and timing of services for older Vermonters. The State Plan on Aging shall also include the following categories:

  (1) priorities for continuation of existing programs and development of new programs;

  (2) criteria for receiving services or funding;

  (3) types of services provided; and

  (4) a process for evaluating and assessing each program’s success.

  (b)(1) The Commissioner shall determine priorities for the State Plan on Aging based on:

  (A) information obtained from older Vermonters, their families, and their guardians, if applicable, and from senior centers and service providers;

  (B) a comprehensive needs assessment that includes:

  (i) demographic information about Vermont residents, including older Vermonters, family caregivers, and kinship caregivers;

  (ii) information about existing services used by older Vermonters, family caregivers, and kinship caregivers;

  (iii) characteristics of unserved and underserved individuals and populations; and

  (iv) the reasons for any gaps in service, including identifying variations in community needs and resources;

  (C) a comprehensive evaluation of the services available to older Vermonters across the State, including home- and community-based services, residential care homes, assisted living residences, nursing facilities, senior centers, and other settings in which care is or may later be provided; and

  (D) identification of the additional needs and concerns of older Vermonters, their families, and their caregivers in the event of a public health crisis, natural disaster, or other emergency situation.

  (2) Following the determination of State Plan on Aging priorities, the Commissioner shall consider funds available to the Department in allocating resources.

  (c) At least 60 days prior to adopting the proposed plan, the Commissioner shall submit a draft to the Department’s Advisory Board established pursuant to section 505 of this title and the Commission on Alzheimer’s Disease and Related Disorders established pursuant to 3 V.S.A. § 3085b for advice and recommendations. The Advisory Board and Commission shall provide the Commissioner with written comments on the proposed plan.

  (d) The Commissioner may make annual revisions to the plan as needed. The Commissioner shall submit any proposed revisions to the Department’s Advisory Board and to the Commission on Alzheimer’s Disease and Related Disorders for comment within the time frames established in subsection (c) of this section.

  (e) On or before January 15 of each year, and notwithstanding the provisions of 2 V.S.A. § 20(d), the Department shall report to the House Committee on Human Services, the Senate Committee on Health and Welfare, and the Governor regarding:

  (1) implementation of the plan;

  (2) the extent to which the system principles set forth in section 6202 of this subchapter are being achieved;

  (3) based on both qualitative and quantitative data, the extent to which the system has been successful in targeting services to individuals with the greatest economic and social need;

  (4) the sufficiency of the provider network and any workforce challenges affecting providers of care or services for older Vermonters; and

  (5) the availability of affordable and accessible opportunities for older Vermonters to engage with their communities, such as social events, educational classes, civic meetings, health and exercise programs, and volunteer opportunities.

  (f) With regard to individuals with Alzheimer’s disease and related disorders, the State Plan on Aging shall address:

  (1) home-based care or placements and hospital and long-term care placements and transitions to and from care in home, hospital, and long-term care settings;

  (2) support and education for families and caregivers; and

  (3) strategies to promote affordable and accessible long-term care and home- and community-based services to individuals with Alzheimer’s disease and related disorders. (Added 2019, No. 156 (Adj. Sess.), § 1, eff. Oct. 5, 2020; amended 2021, No. 113 (Adj. Sess.), § 4, eff. July 1, 2022; 2021, No. 113 (Adj. Sess.), § 2, eff. January 1, 2023.)

• Subchapter 002: SUPPORTS FOR INDIVIDUALS WITH ALZHEIMER'S AND RELATED DISORDERS

• § 6221. Public education resources

  (a) The Departments of Health and of Disabilities, Aging, and Independent Living shall jointly develop and maintain easily accessible electronic, print, and in-person public education materials and programs on Alzheimer’s disease and related disorders that shall serve as a resource for patients, families, caregivers, and health care providers. The Departments shall include information about the State Plan on Aging as well as resources and programs for prevention, care, and support for individuals, families, and communities.

  (b)(1) To the extent funds exist, the Departments of Health, of Mental Health, and of Disabilities, Aging, and Independent Living, in consultation with the Commission on Alzheimer’s Disease and Related Disorders and other relevant workgroups and community organizations, shall, as part of existing and relevant public health outreach programs:

  (A) educate health care providers regarding:

  (i) the value of early detection and timely diagnosis of Alzheimer’s disease and other types of dementia;

  (ii) validated assessment tools for the detection and diagnosis of Alzheimer’s disease, younger-onset Alzheimer’s disease, and other types of dementia;

  (iii) the benefits of a Medicare annual wellness visit or other annual physical for an adult 65 years of age or older to screen for Alzheimer’s disease and other types of dementia;

  (iv) the significance of recognizing the family care partner as part of the health care team;

  (v) the Medicare care planning billing codes for individuals with Alzheimer’s disease and other types of dementia; and

  (vi) the necessity of ensuring that patients have access to language access services, when appropriate; and

  (B) increase public understanding and awareness of:

  (i) the early warning signs of Alzheimer’s disease and other types of dementia; and

  (ii) the benefits of early detection and timely diagnosis of Alzheimer’s disease and other types of dementia.

  (2) In their public health outreach programs and any programming and information developed for providers pertaining to Alzheimer’s disease and other types of dementia, the Departments shall provide uniform, consistent guidance in nonclinical terms with an emphasis on cultural competency as defined in 18 V.S.A. § 251 and health literacy, specifically targeting populations at higher risk for developing dementia. (Added 2021, No. 113 (Adj. Sess.), § 4, eff. July 1, 2022; amended 2023, No. 164 (Adj. Sess.), § 1, eff. July 1, 2024.)