Home Health Aides Deserve Better Wages! If Done Right, Mandatory Minimum Wage Increases Will Help

Home health aides provide a lifeline to millions of Americans, but low wages make it difficult to recruit and retain enough to keep up with the demand. If done thoughtfully, mandatory minimum wage increases can help support these valuable workers

It’s undisputable: Home health aides provide a lifeline to millions of Americans that need assistance living where they want to be—at home. But low wages often disincentivize home care workers from staying in the field. The problem lies in Medicaid reimbursement rates: Home health aides rely largely on state-determined Medicaid reimbursement rates for their wages, and those rates have stagnated well below the cost of living—and many states have not addressed this in years.

Luckily, many states have proposed increasing the mandatory minimum wage. And while many businesses often oppose such measures—many home care industry leaders have come out in support of it because they recognize the importance of aides in helping keep people at home and earning a fair wage for doing so. But we must ensure that minimum wage increases are done with the recognition that many home care programs rely on state funding to pay their workers. And if that funding isn’t increased in tandem with mandatory minimum wage increases, the state could unintentionally be putting vulnerable residents at risk.

Simply put, if Medicaid reimbursement rates for home care services are not increased at all, or at a rate too low to cover new minimum wage standards, then many home care providers will need to consider whether they can afford to keep their doors open. If providers do decide that they cannot remain sustainable and do decide to forgo providing Medicaid-based home care services, then the real loser is the millions of Americans that rely on that provider to live independently at home. Down the line, this could result in more people who can live at home with help from a home health aide into being forced into nursing homes.  

“People want to live at home. And it’s the most cost-effective option for states. Home health aides are the backbone of our industry and we absolutely support wage increases for our workforce, but states need to be thoughtful in their approach to protect the many seniors and individuals with disabilities that rely on home and community-based services. We are working with state legislatures to make sure that they understand the relationship between rates and wages, and the potential risk to vulnerable residents who need home care,” says BAYADA Chief Government Affairs Officer Dave Totaro.

So far this year, 18 states have started the year with higher minimum wages than the year before. If you live in a state where the minimum wage is set to increase, then you have a unique opportunity to advocate and tell your legislators about the importance of home care and of paying home health aides a living wage. Contact advocacy@bayada.com to find out ways you can play a role in ensuring that home care is accessible to the many that want to stay at home, and that home care workers continue to be attracted to a field that helps them do just that.

BAYADA’s 2018 Legislative Accomplishments and 2019 Goals

BAYADA’s Government Affairs Office (GAO) staff continue to push forward on our goals in our major states and in Washington, DC. We’ve worked hard to leverage our staff, clients’ and families’ voices to elected officials and legislative leaders, and we are excited to keep moving ahead for Medicaid rate increases, better policies, and more staff and client engagement throughout 2019. Below, read about our recent accomplishments and upcoming goals. 


2018 Major Accomplishment – In 2018, BAYADA’s Government Affairs Office expanded resources to support federal affairs and home health. We recently rejoined the National Association for Homecare & Hospice (NAHC) and expanded our involvement in national associations. We also have increased our advocacy efforts in Washington D.C. as David Totaro and Lindsey Wright are now registered as federal lobbyists and continue to meet with legislators on Capitol Hill.

2019 Major Goal At the federal level, our major goal is to pass legislation that counteracts the Patient Driven Groupings Model (PDGM). PDGM is the new Home Health Prospective Payment System CMS finalized on October 31, 2018. While PDGM has some positive effects on the home care industry, we seek to counteract the portion of the rule that will decrease Medicare payments to home health providers by 6.42% based on the use of “behavioral assumptions” beginning January 2020.

Impact: Successful passage of one of the three bills (H.R. 6932/S. 3458; S.3545) that have been introduced into Congress would counteract the “behavioral assumptions” by requiring Medicare to implement adjustments to reimbursement rates only after improper behavioral actions by home health agencies are actually observed affecting Medicare spending rather than assuming those improper activities will occur. Successful passage of any of these bills as currently written would ensure greater stability in the new payment model, thus ensuring the sustainability of BAYADA’s Home Health offices and ensuring that Medicare clients would not see a disruption or cancellation in services.


2018 Major Accomplishment – In Delaware, we were successful in building the momentum necessary to bring home a rate increase in 2019. GAO engaged office and field staff in advocacy and saw seven BAYADA employees provide testimony to the Joint Finance Committee. We also educated legislators in both chambers including committee chairs and leadership in both Chambers. 

2019 Major Goal – Our major goal in Delaware is to increase Medicaid Reimbursement for RNs and LPNs by 21.4%.

Impact: Delaware clients currently see 6.8% of prescribed hours go unserved and another 7.5% of hours where the nurse is working overtime, both up from the year before. We anticipate that this increase will enable BAYADA and other providers to recruit and retain the skilled nurses needed to meet the demand and fill the gaps needed to remedy both the missed shift rate and the overtime hours served.


2018 Major Accomplishment 2018 was the first year that Georgia saw a full-time GAO presence. Our advocacy efforts secured us a more than 6% rate increase for private duty nursing (PDN) services under the Georgia Pediatric Program (GAPP) waiver.

Impact: The PDN rate hike increased reimbursement rates for RN services by 6.3% and for LPN services by 6.5%, effective July 2018. This increase allows BAYADA to recruit and retain the nurses necessary to provide Georgians across the state with the services they need to remain at home with their families.

2019 Major Goal In 2019, our major goal in Georgia is to build upon our 2018 accomplishment and add $3 to both the RN and LPN reimbursement rate for private duty nursing (PDN) services under the Georgia Pediatric Program (GAPP) waiver.

Impact: This increase would allow BAYADA to better recruit and retain the skilled nurses that we need to keep up with the demand in Georgia.


2018 Major Accomplishment – In Maryland, we successfully passed legislation to mandate a Governor-appointed task force charged with looking into Maryland families’ access to home health care. At the behest of the task force, the Maryland Department of Health revealed data showing that on average, 17% of prescribed skilled home nursing hours go unserved.

Impact: The successful creation of this task force and the revealed data were the first steps we needed to accomplish before we could begin to advocate for our 2019 goal: Increasing reimbursement rates for LPN skilled nursing services by 24.6%. If achieved, BAYADA would be able to deliver pediatric skilled nursing services to the many families in Maryland that are currently struggling to access the care they are authorized for.

2019 Major Goal – Increase Medicaid LPN rate a further 24.6%.

Impact: If achieved, this rate increase would open the market to enable BAYADA to deliver pediatric skilled nursing services to the many families in Maryland that are currently struggling to access the care they are authorized for. We anticipate that this increase will enable BAYADA and other providers to recruit and retain the LPNs needed to meet the demand, and that the 17% missed shift rate would decrease as families access more of the hours they need.

New Jersey

2018 Major Accomplishment 1 – In New Jersey, we were able to secure a 9% rate increase for the state’s personal care assistance (PCA) program. Additionally, our advocacy efforts resulted in a “rate floor” bill, which ensures MCOs cannot reimburse providers at a lower rate than mandated by the state.

Impact: This increase ensures that BAYADA can continue to serve current clients without fear of disruption by MCOs’ varied reimbursement practices and better ensures the sustainability of the state’s PCA program. A sustainable program will allow BAYADA offices to take on new clients, thus enabling more families across the state to access the personal care services they deserve.

2018 Major Accomplishment 2 – Our advocacy efforts resulted in the passage of the “Parking Placard Bill,” which will allow nurses, therapists and aides to park on restricted street parking, municipal lots and overtime at meters to render home care when it is implemented in April 2020.

2019 Major Goal In 2019, our major goal in New Jersey is to increase the Private Duty Nursing (PDN) fee-for-service rate for both RNs and LPNs by $10 per hour.

Impact: If achieved, this increase will allow BAYADA to compete for a larger share of the state’s RNs and LPNs that are currently attracted to hospital and institutional settings where wages tend to be higher. As we gain the proper number of nurses to meet the demand, we will also likely see a decrease in missed shifts.

New York

2019 Major Goal 1 – In New York, our goal is to achieve the “Approved Vendor” status from the New York City Department of Education (NYC DOE). This will enable BAYADA to provide pediatric nursing services in the New York City schools.

Impact: If BAYADA achieves approved vendor status, we will be able to provide in-school care to children whose parents would like a BAYADA nurse to accompany their child to school but currently cannot do so. The ability for BAYADA nurses to work with a child at home and at school is critical to providing continuity of care for medically fragile children and their families. 

2019 Major Goal 2 – Our second major goal is to pass legislation to increase New York’s Medicaid fee-for-service private duty nursing (PDN) reimbursement rates by at least $20 per hour.

Impact: If we succeed in generating an increase to the PDN fee-for-service rate, BAYADA will be better able to recruit and retain the high-quality nurses needed to provide skilled care for medically fragile individuals in New York. Increases will ensure that home care providers can adequately compete with other settings and surrounding states and Medicaid beneficiaries can continue to access home care services.

North Carolina

2018 Major Accomplishment During this two-year budget cycle, our advocacy efforts resulted in rate increases in three Medicaid programs: Personal Care Services (PCS), Community Alternatives Program for Children (CAP-C) effective July 2018, and CAP for Disabled Adults (CAP-DA) effective January 2019.

Impact: This increase allows for us to continue to provide in-home aide services to 1,244 medically fragile children, disabled adults, and seniors across North Carolina who need care, and enables us to create jobs in the community while keeping families together in their homes.

2019 Major Goal 1 – The first major goal for the upcoming two-year budget cycle is to secure a $5.40 increase for nursing under Medicaid’s Private Duty Nursing (PDN) Program.

Impact: This nursing increase will allow BAYADA to recognize our staff with better compensation across North Carolina and help us better hire and retain the compassionate, high-quality staff that our clients and their families deserve.

2019 Major Goal 2 – The second major goal for the upcoming two-year budget cycle is to secure a further $1.40 increase for aide services under Medicaid’s Personal Care Services (PCS) Program, the Community Alternatives Program for Disabled Adults (CAP-DA) and CAP for Children (CAP-C).

Impact: This aide increase will allow BAYADA to recognize our staff with better compensation across North Carolina and help us better hire and retain the compassionate, high-quality staff that our clients and their families deserve.


2018 Major Accomplishment In Pennsylvania, our advocacy efforts led to the unanimous passage of the Hospice Drug Disposal Bill, which was signed into law by Governor Tom Wolf in June.

Impact: This new law allows hospice and home health nurses to help families dispose of unused narcotics following a patient’s death or discharge. This is important to our Hospice employees because they felt that families needed help and support in disposing of unused drugs. The law shows that the home care industry is doing our part to curb the opioid epidemic in Pennsylvania.

2019 Major Goal 1: Secure a 10% increase for personal assistant services (PAS) for programs under the Office of Long Term Living (OLTL).

Impact: This will allow us to increase compensation for our home health aides and better recruit and retain the caregivers necessary to keep up with the demand in Pennsylvania.

2019 Major Goal 2: Pass legislation allowing for deemed eligibility within home care services.

Impact: This is landmark legislation which will help shift the balance from favoring institutions, such as nursing homes, which are currently allowed to deem a person eligible for Medicaid-based institutional care after a cursory review of their financial application. If passed, this would extend this practice to home care providers, which currently must conduct a full review of a person’s application before delivering services. Because a full review can take months, passage would help ensure seniors will have access to home care when they need it and will help divert individuals from the costlier option of institutions. 

Rhode Island

2018 Major Accomplishment – In Rhode Island, our advocacy efforts helped secure two rounds of Medicaid increases, which range from 10% to 70% for home care services delivered by CNAs, LPNs, and RNs. This landmark increase includes the first-in-the-nation annual Cost of Living adjustment (COLa), which will provide additional increases to those rates every year based on the Bureau of Labor Statistics’ Cost of Medical Services annual adjustment.

Impact:  As a result of these significant increases, BAYADA and other home care providers can increase nurses’ and CNAs’ wages and better compete for a larger segment of Rhode Island’s workforce. We anticipate that better recruitment and retention will also result in increased access for Rhode Islanders who are currently authorized for home care services but are experiencing missed shifts or cannot find the adequate number of caregivers they need to remain safe at home.  

2019 Major Goal 1 – In Rhode Island we are seeking to secure a 10% high-acuity skilled nursing modifier rate for RNs and LPNs in all Medicaid-contracted home care services provided to tracheostomy/ventilated clients.

Impact: This rate differential will ensure that nurses who receive specialized training to care for clients with tracheotomies and ventilators receive a higher pay rate. This will enable BAYADA to better recruit and retain these specially trained nurses and thus ensure the continuity of care for these medically-fragile clients.

2019 Major Goal 2 – Our second 2019 goal is to collaborate with industry partners to submit legislation ensuring the Medicaid Home Care/Hospice COLa is included in the SFY 2020 budget.

Impact: Many states’ reimbursement rates have stagnated and have not been addressed for decades. Obtaining a COLa will protect Medicaid reimbursement rates from falling behind the cost of living and ensure that Rhode Island’s rates do not stagnate as they have elsewhere. This will better ensure we can compete with other health care settings to have the caregivers necessary to meet the demand.

South Carolina

2018 Major Accomplishment – 2018 was the first year that South Carolina saw a full-time GAO presence. Our advocacy efforts secured us an average 10.5% rate increase for all personal care Medicaid waiver services.

Impact: The in-home personal care rate increases brought the personal care (PC) rate up 8.%, the enhanced personal care (EPC) and adult attendant care (ATDC) rates up 8.2%, and the respite care (RC) rate up 17.25%, each effective July 2018. This allows BAYADA to provide aide services to vulnerable South Carolinians across the state and enables us to keep families together at home.

2019 Major Goal – In 2019, our major goal in South Carolina is to secure a 24% increase for RN services within the Medicaid nursing waiver program and a 36% increase for LPN services within the same program.

Impact: Currently, home care providers can currently only compete for approximately 10% of RNs and 25% of LPNs in the state. A successful increase for both RNs and LPNs would allow us to attract a greater share of available nurses in the state and serve more vulnerable South Carolinians in need of skilled nursing home care services.

Hearts for Home Care Kicks Off 2019 with Two Heartfelt Visits with New Jersey Clients

Last week, Hearts for Home Care members and BAYADA employees Dave Totaro, Tara Montague, and Alisa Fox traveled to northern New Jersey to meet two home care clients and their caregivers to learn more about how home care has impacted their lives and how they advocate on behalf of themselves and their loved ones.

Meeting Addy and Gloria

Photo: DOV client Addy R. and her HHA Gloria have an unbreakable bond

First, the team stopped by a BAYADA service office in Dover, NJ to meet the staff and learn about the struggles the office regularly faces in recruiting and retaining home health aides. Per staff member Helena Anton, challenges lie primarily within staunch competition in the area and finding the high-quality and compassionate caregivers that “you can tell are put on this earth to care for others,” as Helena puts it.

“Smaller home health care companies can usually pay the caregiver more in wages because we put that money into benefits, training, and supplies. But the real problem is that Medicaid reimbursement rates are so low that these caregivers—no matter what company they work for—aren’t making enough. That’s why we need to advocate to make sure the state sees how low wages are impacting so many New Jerseyans that are able to live and their communities and thrive with home care,” added Helena.

After the discussion, the Hearts for Home Care advocates met home care client Addy and her aide Gloria. The crowd was nearly brought to tears by Addy’s story regarding the challenges she has been able to overcome with her “teammate”—which is what she calls Gloria.

“I was extremely touched by Addy’s and Gloria’s relationship. Not only is it clear how much Gloria has impacted Addy’s daily life and her sense of self-worth, but the way that Gloria talks about Addy’s influence on her own life is incredible. You can tell that Gloria was truly put on this earth to be the nurturing, compassionate caregiver that she is,” said Tara Montague.

Recently, Addy and Gloria visited Senator Steve Oroho to share their story and to advocate for better state home care policies. “Helping people is important. And it’s important that those who help others get the help that they need too,” Addy told the group. Addy recommitted to continuing to advocate for herself and for others who are impacted by home health care. “I want to share my message with legislators. It’s my way of giving back,” she said.

Lili and Emma Welcome Advocacy into Their Home

Photo: Lili and her nurse Barbara share a high five

Next, Dave, Tara, and Alisa traveled to Morristown to visit home care client Liliana “Lili” and her mother Emma in their home. As a single mom, Emma relies on home nursing so that she can keep her full-time job and keep Lili at home. She told us that her service office team works hard to ensure that every one of Lili’s shifts are covered. She also shared about times when that coverage wasn’t so steady: “Our routine and our comfort level is only as good as today…When Lili’s main nurse Liz retired, we had a few months where we didn’t know what tomorrow would bring.”

Lili benefits from New Jersey’s private duty nursing (PDN) program, which allows for children and adults with skilled care needs to live at home. Without this program, it is unlikely that Lili would have been able to grow up with her mom and graduate from school as she did. The PDN program’s rates need to be raised in order to better attract more nurses to home care, as most can currently make a higher wage delivering skilled care in a hospital or nursing home. One of Hearts for Home Care’s major advocacy goals for 2019 is to educate legislators on the need for a rate increase and to secure one on behalf of all New Jersey home care clients, families, and nurses.

Like Addy, Emma is committed to ongoing advocacy to ensure that nurses see home care as an attractive employment option, so that other families can receive the home care that they need too. In recent years, Emma has hosted state elected officials in her home. “Seeing our daily routine and how important it is for Lili to have a nurse at home is the most impactful way for an assemblyman or senator to understand home care,” said Emma. “As a mother of someone who is able to stay home due to in-home nursing care, I see it as my duty to advocate…Not just for Lili, but for those in the state who are struggling to get the nursing they need.”

“It’s our clients’ and families’ voices that make the biggest impact on our state and federal elected officials’ decisions about home care. Because of advocates like Addy and Emma, legislators better understand the impact home care has on their communities,” said advocate Dave Totaro, who also serves as BAYADA’s chief government affairs officer.

There are plenty of ways to advocate, even from home! To find out ways that you can make an impact, contact us at advocacy@bayada.com. Together, we can share our voices to make 2019 the best year for home care yet.

PA Governor Tom Wolf Nominates New Secretary of Aging

Robert Torres will head the Department of Aging, replacing former secretary Teresa Osborne

As Pennsylvania begins another legislative session Governor Tom Wolf will be nominating cabinet members to serve as departmental leaders within his administration for the next four years. Robert Torres will be nominated as Secretary of the Department of Aging on to replace Teresa Osborne’s vacancy as she is nominated for the state’s civil service commission.

The Secretary of the Department of Aging is responsible for the administration of all aging programs in Pennsylvania, as well as to promote the protection for residents of the Commonwealth. This position is important to BAYADA as they oversee many of the waivers that we utilize for the large population of seniors that we serve in one of the top “graying” states in the country.

Robert Torres most recently served as the Secretary of the Commonwealth, a position he has held since 2017. Prior to that, Torres served in the State Department as Executive Deputy Secretary and as Deputy Secretary of Administration for the State Department of Health. In the private sector, Robert Torres was the Vice President of health information technology at Capital Blue Cross and at General Dynamics Information Technology.

Pennsylvania Government Affairs Director Laura Ness recently asked ambassadors to send welcome letters to the new Secretary of Aging. Join us in welcoming Robert Torres to this important position. GAO is excited to work with Secretary Torres and his team to help older adults living in Pennsylvania access the care they need.

NJ: GAO Hits the Road to Meet with Service Offices Across the State

GAO Director Louise Lindenmeier (center) meets with the PAS office to learn about their struggles recruiting and retaining quality aides

Every year, the Government Affairs Office (GAO) travels the state to connect with our service offices about our legislative priorities and the importance of advocacy. Not only do these visits give us the opportunity to share the work we do to improve the state of home health care in New Jersey, but they also give us the unique chance to hear about the challenges you all often face in attempting to deliver the compassionate, excellent, and reliable care that our clients deserve.

Throughout our visits so far, we have been able to celebrate our collective successes and accomplishments. In 2018, our GAO Ambassadors and service office employees attended a number of district office visits and legislative receptions, and participated in phone banks, letter writing campaigns, and action alerts all in support of accomplishing legislative priorities that support our nurses, aides, clients, and families. Without your partnership and collaboration, we would be unable to deliver on our promise to act as the voice for BAYADA and its clients and employees.

GAO gets groovy with the PER office!

In addition to celebrating last year’s successes, we have worked together to identify ongoing challenges and to form our 2019 legislative priorities and strategies. As we’ve formed these priorities, it is clear that our grassroots efforts and your continued commitment to advocacy will be integral to achieving our goals.

Thank you to the many offices who have made the time to meet with us. In 2019, we will continue our outreach effort to accomplish our goal of meeting with 100% of our New Jersey service offices. If you’d like to learn more about our road show, our 2019 legislative priorities, or getting more involved in advocacy at BAYADA, contact advocacy@bayada.com.

NC: SHE, GAS, and RAN Offices Demonstrate Advocacy by Building Relationships and Sharing Clients’ Stories

Sen. Alexander (back left) visits BAYADA client Rusty (front left) and his nurse, Vikki (front right) with BAYADA staff Cheryl, Jillian, and Rusty’s mother (back right).

GAO can’t do it alone, and in North Carolina we are proud to have so many employees that understand the impact of sharing their voice on behalf of all our staff and clients!

SHE and GAS Host Impactful Home Visit

Last month two offices, SHE and GAS, teamed up to host a home visit with newly elected Senator Ted Alexander. Our BAYADA team of advocates, including MIM Division Director Joe Seidel, GAS Clinical Associate Cheryl Reading and GAS Client Services Manager Jillian Fernald, as well as the client’s long-time nurse Vikki, spoke passionately about our services and the challenges we face in care delivery.

The visit was a grand success! The importance of home care and the work you do every day was certainly not lost on Sen. Alexander, whose wife and daughter are both nurses: “Our goal,” he explained, “is to keep families where they belong, together and at home.” These types of interactions lay the foundation for support of our legislative asks because the decision-makers see first-hand the impact home care has on families.

RAN Builds Relationships in a Different Way

BAYADA Ribbon Cutting Ceremony with Senator Wiley Nickel

Last month, the RAN office hosted a ribbon cutting ceremony to commemorate the grand opening of our new state-of-the-art simulation lab and training center. This was no regular ribbon cutting ceremony where the office invited current and prospective nurses to tour and see-in-action the simulation lab. We took the opportunity to educate lawmakers on the scope and breadth of what is possible in the home by inviting Senator Wiley Nickel to welcome the group. We also included Ed Troha, Vice President for the NC Chamber, who has four nurses in his family, to speak about the importance of the training center in job creation.

Additionally, former Senior Chairman for House Appropriations Nelson Dollar issued a proclamation to show his strong and constant support for home care. This center allows BAYADA to train nurses using real life scenarios that helps develop confidence, competence, and builds career-building skills to home health care nurse. Increasing awareness among legislators and other community leaders on the benefits of home care helps garner support as we work toward our legislative goals. 

Thank you to the many North Carolina staff and families that regularly share their voices in advocacy! To find out how you can get more involved, contact GAO Director Lee Dobson today!

NC: Legislature Kicks Off 2019, Former Home Care Champion Nelson Dollar Joins Speaker’s Staff

Former Representative and home care Champion Nelson Dollar joins Speaker of the House Tim Moore’s staff as Senior Policy Advisor

Lawmakers returned to Raleigh on January 9 for the 2019-2021 long legislative session.  We expect to see some changes in committee assignments and leadership, especially in the House Appropriations for Health & Human Service (HHS), with the election defeat of Chairman Nelson Dollar.

Dollar–the former chairman of the House Appropriation Committee—has transitioned from the public sector to a senior policy advisor to the Speaker of the House Tim Moore. Dollar has been a home care champion for years and was named BAYADA’s Legislator of the Year in 2016 and 2018 for his efforts. He was instrumental in securing much needed Medicaid reimbursement rates increases for nursing and aide services. He has also been instrumental in protecting from elimination the Certificate of Need (CON) process for our Medicare offices.  His expertise and knowledge on complex issues at the statehouse will serve North Carolina well. As you may recall, Dollar lost his seat by 884 votes last November to Democrat Julie von Haefen.

While we are sad to see our former Champion lose this leadership position, there are other home care Champions that we anticipate seeing in key roles. We expect to see Representatives Donny Lambeth and Josh Dobson as co-chairs of HHS. Further, we anticipate Senators Ralph Hise and Joyce Krawiec in chair positions serving the Finance and/or Health Committees. All four legislators are well-versed in home care and the challenges our clients and staff regularly face throughout North Carolina due to our collective advocacy efforts. This puts BAYADA in a great position to move forward with our next round of asks.

Our major reimbursement priority this session is to increase the Medicaid private duty nursing (PDN) rate from $39.60 to $45.00 over the course of two years. This increase is necessary to help us recruit and retain the high quality, compassionate nurses we need to care for the many North Carolinians that need skilled care to stay at home.

Sharing your voice is key to achieving our goals: Be sure to look for opportunities to advocate as we seek to support our clients and staff. Of note, please save the date and be sure to look out for communications regarding our Legislative Day, which will be held in Raleigh on May 1.

FED: Home Health to See Rate Decrease in January 2020. What Can You Do?

CMS recently finalized calendar year 2019 and 2020 payment changes for home health agencies. The new payment model, also known as the Patient Driven Groupings Model (PDGM), was finalized on October 31, 2018. There is some good news: We will see Medicare payments increase by 2.2%–or $420 million–based on finalized policies this year. The reimbursement rate increase is the first the home health industry has received in a decade. Unfortunately, the final rule addresses that home health will see a decrease of payments by 6.42% based on the use of “behavioral assumptions” which will take effect January 2020.

Luckily Congress is working with the industry and has introduced corrective legislation into the House and Senate that counteracts this measure. Several of our legislative champions, including Vern Buchanan (R-FL), sponsored one of the three bills introduced, each of which would serve to counteract the “behavioral assumptions” by requiring Medicare to implement adjustments to reimbursement rates only after improper behavioral actions by home health agencies are actually observed affecting Medicate spending rather than assuming those improper activities will occur. While this is a great first step, we need more legislative support to ensure that one of these bills crosses the finish line.

How can you help? The Government Affairs Office (GAO) has been working diligently to meet with key legislators and introduce them to our issues and those of our staff and clients, but we can’t do it alone. BAYADA has been asked to take the lead of home visits for our industry and we need office staff to help us communicate the importance of home care and proper Medicare reimbursement for our services.

To join in our advocacy efforts, please consider meeting with your federal Congressman or Senator through an office visit or home visit. Contact GAO Federal Associate Lindsey Wright today to learn more and to coordinate. The Federal Affairs team has a busy first month of the year and will be making visits to Home Health offices the year to hear what is most important in your office and how we can help.

Upcoming Events

Date Event Location
January 17 Home Health Office Visits CO
January 21-23 Home Health Office Visits AZ
January 24 NHPCO/HAN Board Meeting Phoenix, AZ
January 27-29 Home Care 100 Phoenix, AZ
January 30 HCAOA Board Meeting Tucson, AZ
February 7 PMHC Board Meeting Washington D.C.

New Hearts for Home Care Member Showcases Advocacy at Home!

Left: Gaston Gazette reporter chats with Dimpal and her BAYADA nurse Amy.
Center: Dimpal’s long-time nurse Chastity helped Dimpal live on campus and graduate from UNC Charlotte!
Right: Dimpal’s nurse Toni has been by her side for nearly a decade.

Oftentimes, when we hear the word “advocacy” we think about attending a BAYADA-sponsored lobby day in a state capitol or visiting a legislator’s local office to ask him or her to support or oppose a piece of legislation. While both those options are in fact forms of advocacy, they’re not the only ones.

North Carolina client Dimpal Patel recently joined Hearts for Home Care, a program that BAYADA’s Government Affairs Office began to get clients, families, staff members, and the community at-large more engaged in legislative advocacy. She expressed that she wanted to get involved, but as an individual with a trach, vent, and wheelchair, she would need a lot of assistance traveling to advocate in person.

The Hearts for Home Care team immediately encouraged her to reach out to her local paper by submitting a short opinion piece about her thoughts on home care. She shared an insightful take on how her nurses enabled her to live on campus and graduate from UNC Charlotte, as well as how important Medicaid is for her and so many others that rely on home care.

The Gaston Gazette received her piece, but instead of publishing it, they sent a reporter to Dimpal’s home to get a better look at how home care impacts her life first-hand. The reporter spoke with Dimpal and her nurse, Amy, about the importance of legislators’ mindfulness of continued Medicaid funding—and her story made the paper’s front page!

“I’ve always wanted to get more involved in advocacy because I think it’s important that our state and federal decision makers hear our voice and understand how important home care is in our communities… but I was always worried because I can’t get to the state capitol or to legislative hearings as easily as others can. I’m grateful that Hearts for Home Care has given me the tools to help me begin my advocacy journey from home,” Dimpal told us recently.

Home care by its very nature often helps those with limited mobility to live a full life and remain at home. That’s why the Hearts for Home Care team developed a robust menu of advocacy activities—so that anyone who wants to get involved in advocacy can! Reaching out to legislators via traditional media or social media, calling into a town hall, sending a newspaper clipping or an email are just a few of the many ways individuals can advocate from their own home.

In today’s world elected officials and regular individuals alike are bombarded with messages, from advertisements on the bus to a long social media newsfeed, all the way to robotic phone calls and junk mail. It’s important that we take a step back to cut through the noise to deliver our advocacy message to state and federal decision makers: Home care is important to me, and it should be important to you too.

For more information on how you, your colleagues, or your clients can share your voice in advocacy, please email advocacy@bayada.com or sign up to join Hearts for Home Care today!

2019: The Year of the Ambassador!

GAO continues to grow and strengthen our Ambassador program. Symposiums and other engagement activities are currently underway–don’t miss your chance to get involved!

US Senator Debbie Stabenow (D-MI) poses with Chief Government Affairs Officer Dave Totaro (center) and our Ambassadors of the Year at the 2018 Ambassador Awards trip in Washington, DC

When the Government Affairs Office (GAO) launched the Hearts for Home Care Ambassador program nearly ten years ago, we envisioned that each service office would have a designee who would essentially act as the GAO liaison for that office. How much we’ve grown! Today, our Ambassadors go above and beyond to be the voice for our staff and clients, and they truly exemplify the leadership and excellence qualities that have grown to be associated with the Ambassador program.

In 2018, GAO committed to a more robust and centralized grassroots program, including a stronger dedication to the Ambassador program. In 2019, under Grassroots Advocacy Manager Mike Sokoloski’s leadership, the program is set to have its strongest year yet. This year we will be sharing a new “Ambassador Dashboard” that will help our advocates stay engaged and track their progress, create more 30-minute advocacy Zoom trainings, and bring our top-performing advocates on an exclusive Ambassador Awards trip to Washington, DC in May!

Additionally, one of the most exciting changes we have underway is our newly-revamped state-by-state Ambassador Symposiums. Our Ambassador Symposiums are newly designed and structured to train rookie Ambassadors while simultaneously energizing more seasoned advocates. This year we are partnering with outside organizations and bringing in more legislative and client guest speakers to truly show attendees the impact that strong advocacy has in making meaningful changes for our staff and clients.

DE Senate Majority Leader Nicole Poore joined a recent Ambassador Symposium and shared her thoughts on the importance of advocacy with attendees

So far in 2019, we have held our first Ambassador Symposium in Newark, DE for both our Maryland and Delaware Ambassadors. Here, DE Senator and Majority Leader Nicole Poore came to share her passionate story about how she initially became involved in advocacy for her child, and how she now sees her role as being an advocate for all her constituents. Throughout the spring, we will continue to host Ambassador Symposiums in New Jersey, North Carolina, South Carolina, Georgia, New York and Rhode Island. Whether or not you’ve attended in the past, be sure to check out what being an Ambassador is all about during our upcoming symposiums!

As our Ambassador program continues to grow, we are seeking new Ambassadors from all service and support offices, and are seeking greater involvement from field staff, clients, and other organizations. It is vital that we join together as Hearts for Home Care to strengthen our collective voices in support of home care. Our Ambassadors serve as the forefront of our advocacy program, and truly make the difference in educating local legislators about home care and its impact on clients and communities.

For more information about the Ambassador program, upcoming Symposiums, or home care advocacy in general, contact me today!

2019 Ambassador Symposium Schedule*

SC – 2/20 at the state capitol in Columbia

GA – 2/21 at the state capitol in Atlanta

PA – 2/28  at the Hilton Garden Inn in Harrisburg

NJ – 3/13 at the New Jersey Learning Center in Pennsauken

NC – 3/28 at the North Carolina Learning Center in Charlotte


RI – 4/9 at the Capitol in Providence (morning of Advocacy Day)

*Please note that the DE/MD Symposium has already occurred, but it’s not too late to become an Ambassador if you are interested! Contact Mike Sokoloski for information.