GAO SC: Much-Needed PDN Rate Increase Helps Keep SC Medicaid Skilled Nursing Offices Open!

GAO Director Melissa Allman and SC office employees, field employees, and clients & families made all the difference in ensuring that medically-fragile residents could continue to access home care

Over the past several years, home care offices across South Carolina have struggled to stay sustainable due to low state Medicaid reimbursement rates for in-home nursing services. As more and more providers shut their doors, GAO and our advocates continued to fight towards a solution so that South Carolina’s most vulnerable residents could continue to access the skilled care they needed to stay at home.

After aggressive advocacy and a public affairs push throughout 2019, our concerted efforts are beginning to pay off! After more than a decade without a nursing increase, the state recommended a 15% increase, effective July 1, 2020. After further advocacy efforts focused on the urgent need for an immediate increase, including articles profiling affected families in the media, the SC Department of Health & Human Services (DHHS) issued the initial 5% increase be effective January 1, 2020. This 5% increase will generate nearly $230,000 in additional annual revenue.

BREAKING: DHHS is committed to including the remaining 10% to be effective July 1, 2020. If the provision is passed into law as planned, then PDN services will see a total 15% increase from 2019 levels (5% increase effective January 1, 2020, and an additional 10% targeted for July 1, 2020), resulting in nearly $690,000 in additional annual revenue.

Further increases are needed to ensure access to care for all vulnerable South Carolinians. These major steps forward would not have been possible without sharing our collective voices to showcase the importance of care in the home care and the need to regularly maintained viable reimbursement rates.

Thank you to all of our South Carolina offices, leadership, clients, and families that shared their stories and advocated for this important increase!

GAO PA: 2% Increase to Pennsylvania’s ACSP Practice to Help Vulnerable Residents Access Care

HHAs Antwain and Markeeta Lewis were featured in the Pittsburgh Post Gazette to bring public and legislative awareness to low PA PAS rates

Throughout 2019 GAO, Pennsylvania office & field employees, clients, and industry partners banded together to secure a 2% increase for Personal Assistant Services (PAS) under Pennsylvania’s Office of Long-Term Living (OLTL), effective as of January 1, 2020.  This increase will result in an additional $700,000 in annualized revenue, as well as an additional $625,000 in operating surplus and will predominantly affect our Assistive Care State Programs (ACSP) offices.

In addition to increased revenue for Pennsylvania’s ACSP offices, this rate hike will also benefit the state’s most medically fragile and vulnerable adults and seniors. GAO anticipates that service offices will be able to recruit and retain more home health aides and fill more shifts that are currently going uncovered. 

In addition to traditional lobbying and advocacy efforts, GAO and state ACSP service offices worked together on an aggressive public affairs campaign that resulted in several articles regarding BAYADA clients’ struggles with accessing care, and opinion pieces authored by Clinical Managers (CMs). This campaign further added pressure to the state legislature to begin to solve the access to care issue. In 2020, GAO is seeking to increase the PAS rate even more—an additional 8% to reach a 10% total increase over 2018’s reimbursement rate for PAS services.

GAO RI: Annual Cost of Living Adjustment (COLA) Increase Secured for 2019-2020; Additional 5.9% Proposed for 2021!

BAYADA staff and clients were instrumental in gaining public and legislative awareness on home care issues in Rhode Island. Here, client Brandon Stone (right) is pictured with mom Sherry (lower left) and nurse Jessica (center)

In 2019, GAO and industry advocacy led to the successful renewal of the Cost of Living Adjustment (COLA) of 1.9% for Medicaid reimbursement rates for Certified Nursing Assistant (CNA) and Skilled Nursing services. This adds an additional $232,941 to BAYADA’s annual revenue, and $26,535 to the company’s annual operating surplus.

The first-in-the-nation COLA adjustment was included in 2018 state legislation as a result of the advocacy efforts of GAO, client and employee Ambassadors and advocates, and Rhode Island industry partners, as well as a public affairs campaign that led to local print and broadcast media coverage on the need for regular rate reviews to ensure that reimbursements for home care services were adjusted annually to keep up with real costs of living and conducting business.

By continuing to advocate for the renewal of the COLA increase every year, then Rhode Island service offices will be able to—at their discretion—increase field staff wages, thereby increasing caregiver recruitment and retention rates and enabling clients to experience less missed shifts.

BREAKING: Due to GAO, BAYADA, and industry advocacy, RI Governor Raimondo has already proposed a 5.9% increase for skilled nursing and CNA services in the 2020-2021 budget! If successfully passed through both chambers in the state house, effective July 1, 2020, this increase will add $219,791 to BAYADA’s yearly revenue, and $65,937 to BAYADA’s annual operating surplus.

Thank you to our RI staff and clients for your continued commitment to advocacy on behalf of all of Rhode Island’s caregivers, and the medically fragile and vulnerable populations!

GAO NJ: $2 Per Hour Increase for Personal Care Assistance (PCA) Services

BAYADA staff, along with GAO area director Louise Lindenmeier center) spoke with many NJ legislators, including NJ State Senator Kristin Corrado, about the need for higher reimbursement rates for our clients.

Throughout 2019, GAO and New Jersey home care clients, employees, and industry partners battled the state government on the state’s minimum wage increase. BAYADA has been a staunch supporter of an increased minimum wage, as home health aides’ roles are vital to the community and require compassionate, excellent, and reliable workers. However, GAO and other advocates worked to show legislators and stakeholders why a Personal Care Assistant (PCA) Increase was necessary for providers to be able to continue to recruit and retain these valuable workers.

Advocates’ efforts resulted in a much-needed $2 per hour increase to the PCA rate—but the battle wasn’t quite finished yet. The legislature had also included language that would require 100% of the increase to be passed through directly to aides’ wages. While such a mandate was admirable in spirit, in practice it would have the potential to crush the state’s home care industry as a whole. After additional advocacy from GAO, staff, and industry partners, this pass through was successfully eliminated in December 2019.

In 2020, one of GAO’s primary goals in New Jersey is to continue to battle for further increases to the state’s PCA rate so that BAYADA can continue to pay wages to recruit and retain quality aides as the state’s mandatory minimum wage continues to increase. 

Medically Complex and Turning 21: Rhode Island Families Struggle to Access Home Care

Brandon Stone (center, seated) has been able to grow up at home among his parents and siblings due to home care nursing. Turning 21 has threatened his ability to continue with that care.

For most people, turning 21 is a milestone to celebrate. But the State of Rhode Island is putting undue pressure on medically complex Rhode Islanders who are turning 21. For those who receive home care services under Medicaid, such as the Katie Beckett waiver, their medical coverage changes on their 21st birthday, which affects who pays for their services, the types of services available to them, and their state-authorized hours and funding levels. Without proper planning and communication, these changes can result in uncertainly of continuity of care and access to home care services.

For young adults like Zach, Corinna, Brandon, and their families, turning 21 has been a source of significant stress and uncertainty rather than the celebration it deserves to be. Upon “aging out” of Medicaid, they have received word from the state that their care would be changing without much warning. Parents of medically complex individuals tend to be lifelong advocates on behalf of their children, and so all three have been able to retain their services on a month-to-month basis. “This is just a band-aid that covers the issue,” says BAYADA Home Health Care’s Government Affairs Director Ashley Sadlier. “Each month, they don’t know whether that band-aid will stay on or get ripped off. Everyone deserves to stay at home if it’s their wish to do so, and it’s arbitrary that a birthday is basically a penalization in Rhode Island.”

The interesting fact is that the State has already created a policy stating that home care children and their families are to be educated on their options by the age of 17. But Rhode Island has not upheld its end of the bargain: Families find that they receive little to no communication from the State, and that when they reach out to find out their children’s care options, the State is slow to respond and typically unable to provide proactive guidance to help families navigate this change . “Modern medicine and advances in home care have allowed for many children to live past the age of 21. That should be a reason to celebrate, not a reason to cut an individual’s services off suddenly,” says Corinna’s mother Michelle. “Home care saves the state money, and it keeps families together. Why would you put a child in danger when it’s clear that home care has enabled them to live their best life?”

Families, home care providers, and and other organizations across the state are currently working with the State to identify a solution. Without home care, clients stand a greater risk of infection, hospitalization, or even a permanent move to a skilled nursing facility. Parents know that a child doesn’t stop being your child when they reach adulthood, but it’s time that Rhode Island recognize this as well.

Apply for an Absentee Ballot and Make Your Voice Heard

By Alisa Borovik, Senior Associate, GAO

Elected officials at the local, state, and federal level make political decisions that can have a significant impact on the life of you and your loved ones. The most effective way for you to help elect legislators who support home health care is to get out and vote on Tuesday, November 7.

If you are unable to get to your local polling place due to a disability or the need to care for a family member, you are eligible to vote by absentee ballot.

The instructions for applying for a free absentee ballot vary by state. Please visit the website listed below for your state to find out how to apply.

AZ: http://bit.ly/AZabsenteeballot

CO: http://bit.ly/COabsenteeballot

CT: http://bit.ly/CTabsenteeballot

DE: http://bit.ly/DEabsenteeballot

FL: http://bit.ly/FLabseenteeballot

GA: http://bit.ly/GAabsenteeballot

HI: http://bit.ly/HIabsenteeballot

IN: http://bit.ly/INabsenteeballot

MA: http://bit.ly/MAabsenteeballot

MD: http://bit.ly/MDabsenteeballot

MN: http://bit.ly/MNabsenteeballot

MO: http://bit.ly/MOabsenteeballot

NC: http://bit.ly/NCabsenteeballot

NH: http://bit.ly/NHabsenteeballot

NJ: http://bit.ly/NJabsenteeballot

NY: http://bit.ly/NYabsenteeballot

PA: http://bit.ly/PAabsenteeballot

RI: http://bit.ly/RIabsenteeballot

SC: http://bit.ly/SCabsenteeballot

VA: http://bit.ly/VAabsenteeballot

VT: http://bit.ly/VTabsenteeballot