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Home health agencies report few safety discharges since law allowed denial of subsequent admissions
Summary
Representatives of the VNAs of Vermont told the House Health Care Committee that the statutory change allowing agencies to deny readmission for safety reasons has been used rarely; agencies reported 16 safety discharges statewide in 2024 and nearly no formal denials of subsequent admissions through early 2024.
Jill Olsen, executive director of the VNAs of Vermont, told the House Health Care Committee in April that the statutory change enacted last year giving home health agencies discretion to refuse subsequent in-person readmission to a previously discharged residence for safety reasons has been used sparingly.
Olsen described Vermont’s designated home health system—agencies assigned geographic coverage that must serve all clients regardless of ability to pay—and explained that the statutory change was intended to provide flexibility after agencies completed required safety processes and appeals under the designation rule. “We were actually having some issues with things being appealed to the Human Services Board and being required to go check to see if things were any safer,” Olsen said.
The VNAs surveyed members about calendar year 2024 activity and reported that 16 individuals statewide were discharged in 2024 for safety reasons. Olsen said that, as of early February 2024, no agency had used the law to deny a subsequent admission; she added she had heard of one anecdotal case since then. Olsen emphasized the figures are small relative to the system’s scale: home health agencies make roughly a half-million visits per year and have an average daily census on the order of several thousand. “So none of these numbers are very recent. So I don’t wanna be overly specific,” Olsen said in the hearing when discussing older system-wide statistics.
Olsen told the committee the safety-related discharges in 2024 included a mix of circumstances: some physical assaults, aggressive or threatening language, threats with weapons, refusal to secure animals, and unsafe physical environments ranging from active drug activity to hazardous structures. Agencies reported the occurrences were spread across organizations—large providers had as many as four or five safety discharges in the year, while smaller agencies reported zero or one.
When asked whether any of the incidents required law enforcement, Olsen said she did not ask that question of members and could not say how many, if any, involved police response. Committee members also asked whether VNAs recommended further legislative changes; Olsen said the association had no additional recommendations at the time but might revisit the question.
Olsen characterized the statutory change as primarily a worker-safety signal and a limited operational tool rather than a frequently used authority. “This is really more, something that helps our staff feel safer,” Olsen said. “We can say if something really serious happens, we can promise you you don’t ever have to go back there.”
No formal votes or policy changes were recorded during the presentation. The VNAs provided the committee with a summary of their survey results and agreed to answer follow-up questions about the report as requested by members.
