On March 28, our annual North Carolina Hearts for Home Care Ambassador Symposium took place, where we provided tools and resources to our volunteer Ambassadors. The training focused on a variety of topics, including leading a legislative meeting and building relationships with lawmakers.
addition to special guests former Representative Bill Brawley, Senior Healthcare Campaign Director of MomsRising Felicia Burnett, Association for Home
& Hospice Care’s VP of Government Affairs Tracy Colvard, and Staff Attorney with Charlotte Center for Legal Advocacy
Louise Pocock, the shining star of the Symposium was client Dimpal, who inspired
all of our Ambassadors with her story of her journey into advocacy.
Beyond detailing the specific challenges she and her family face as a result of low state Medicaid reimbursement rates, Dimpal also described the ways in which home care and her nurses have changed her life and granted her independence:
“Without my nurses, I wouldn’t have been able to go to college and to live a full life. Without them, I’d likely be stuck in a hospital or a nursing home,” said Dimpal.
It was this gratitude for her nurses that propelled Dimpal to share her story and to advocate for others who rely on the state’s Private Duty Nursing (PDN) program to survive.
To hear more about Dimpal and the importance of advocacy, you can watch her full speech here. You can also read about her nursing care in the Gaston Gazette after a reporter came to her house to learn more about how her nurses impact her everyday life.
Special thanks to our Hearts for Home Care Ambassadors
for volunteering their time and talents advocating for our staff and clients!
On April 9, more than 300 home care advocates—clients,
families, caregivers, and employees—joined the Pennsylvania Homecare Association
(PHA) at the state capitol in Harrisburg. Advocates met with hundreds of the
state’s representatives and senators to deliver an important message: Home care
is important to me, and it should be important to you too.
Check out pictures from the legislative reception, the kickoff rally, legislative day meetings, and the PHA press conference! Care about home care and want to share your voice? Check out heartsforhomecare.com or email email@example.com to find out how you can get involved in advocacy today!
We know the struggles families can face with home care: The call-outs and missed shifts, the lack of sleep, the caregivers who are like family but can’t afford to make their own ends meet, and the frustration that comes when you or your loved one can’t access the care that is deemed medically necessary. We also know the value and impact that sharing our voices has.
care advocates have made the news for their efforts across the country. Specifically,
on December 28, the Washington
Post covered the impact that providers and parents are having in
driving public awareness of the struggles that Marylanders and Virginians are
having in accessing the skilled nursing home care their families need.
Washington Post reporter Tara Bahrampour points to low reimbursement rates in both states as the major issue contributing to families’ struggles—
“The reason lies in a stark state-by-state discrepancy in the pay in-home nurses receive through Medicaid. Maryland and Virginia have set reimbursement rates significantly lower than surrounding jurisdictions…As a result, licensed practical nurses [LPNs] are finding more lucrative positions out of state or at hospitals or other care institutions that pay more, leaving many homebound Medicaid patients without services.”
Hearts for Home Care has been leading the charge in Maryland, where a coalition of home care clients, parents, providers, and other advocates are pushing for a 25 percent increase for skilled home nursing services. Advocates say that this increase—half of which would have to come from state coffers—would serve to alleviate families’ inability to access care an average of 17 percent of the time, as reported by the state’s Department of Health. Hearts for Home Care advocate and BAYADA Home Health Care director Shannon Gahs says:
“Maryland is failing its citizens who have significant medical disabilities. Failing to provide care 17 percent of the time not only creates a dangerous situation for the person who relies on that care—it harms his or her family. Parents are calling out of work and losing the sleep they need to stay healthy to support their family. They’re doing everything they can to keep their family members safe, but this is not how it is supposed to be. We have to do better.”
In comparison, neighboring Delaware found that shifts are missed 7 percent of the time. There, the state reimburses providers at a rate approximately 30 percent higher for LPN home care services.
Governor Jerry Brown recently proposed a whopping
50 percent wage increase for home care nurses—a move that
advocates have pushed for over the past several years. As with families across
the country, Californians who require skilled nursing home care have been
struggling to get nursing care for their loved ones. Advocates report that under Medi-Cal—the state’s health care
system for low income and disabled Californians—rates have not been addressed
in 18 years.
While both the
Maryland and California proposals are still pending, home care advocates have been successful in driving public and
legislative awareness of low reimbursement rates and the impact on
families’ access across the country in recent years. Most recently, the home
care industry has seen reimbursement rate increases in Rhode Island,
Massachusetts, South Carolina, and New Jersey among other states. It starts
with educating legislators through advocacy via any number of channels:
Traditional and social media, letters, phone calls, meetings, and more.
can seem like an intimidating activity to many who do not yet engage in it,
it’s important that we share our advocacy wins with the home care and health
care community at-large. As illustrated in recent news, when we band together
to leverage our voices in unison, big changes can happen. It’s important to
take that first step and make your message heard on behalf of the millions of
Americans that rely on home care.
Thank you to our newest Hearts for Home Care Ambassadors, CSM Beth Schenck and Director Courtney Donald, for your coordination of an impactful legislative roundtable and office tour with Representative Julie Casimiro (D-North Kingstown, Exeter)! An additional thanks to Clinical Educator Cristina Gomes, Associate Sabrina Soares, and the RIS, RSP, and RAC offices!
After greeting everyone in the office, Rep. Casimiro walked through all of the BAYADA Rhode Island offices with a sense of curiosity and helpfulness. She asked about the services we provide, where our clients and employees are located, and the challenges we face.
Cristina Gomes took Rep. Casimiro into the Rhode Island Skilled Pediatric SIM Lab to demonstrate the sophisticated training we offer and how we use it to support our nurses and clients in the home. Cristina explained each piece of equipment and provided scenarios where she has been able to successfully use the lab, as well as virtual and in-home training to advance nurses, skills to care for medically complex children outside of a facility of hospital setting. She explained how we reevaluate each nurses skills annually and provide ongoing support as needed to make sure our nurses are confident, competent and prepared for any emergency.
We stood in front of the large white board with all of our open shifts, while she skimmed the cities and noticed there were in fact several pediatric clients in her District who are not currently receiving all of the PDN nursing services they are authorized for. She was determined to find out why this is happening and how she can help everyone on that board. The office staff explained that because the reimbursement rates for Medicaid mean that nurses pay rates at home are significantly lower than what they can earn in a hospital or facility. Even Massachusetts rates are approximately 40 percent higher than in RI, so our state’s nurses are traveling across state lines to care for people in other states instead of staying her to care for our vulnerable Rhode Islanders. It was clear that Rep. Casimiro completely understood the issue while we walked away from the board, towards the SIM Lab – she was shaking her head and said “How can I help? I want to help fix this”
Rep. Casimiro not only asked detailed and thoughtful questions about home care nursing and CNA services, but committed to a home visit with a pediatric client. She even offered her assistance with any legislation we propose this session to help ensure Rhode Islanders get the home care they need!
Thank you, Rep. Casimiro for being a friend of home care! For information about how you can get involved in advocacy on behalf of your staff and clients, contact me today!
This quarter, Hearts for Home Care (H4HC) Ambassador and Pocono Hospice Director Thomas Johnson-Medland represented BAYADA at a press conference with Senator Lisa Baker and Attorney General Josh Shapiro as they celebrated the passing of legislation which will protect Pennsylvanians by allowing hospice professionals to dispose of prescription drugs after a loved one dies.
Throughout the legislative process, Thomas and other BAYADA advocates vocally supported Senator Baker’s bill and were active in ensuring it reached the finish line on behalf of all of our staff, clients, and their families.
Thank you Tom for being such a great representation of the home care industry!
Below, Please see HPI Recruiter Associate’s take on why she decided to take her advocacy to the next step by becoming a Hearts for Home Care Ambassador.
“I wanted to become a Hearts for Home Care Ambassador so that I can advocate for families so that they in turn can enjoy peace and comfort in their home, and so they can hopefully live as normal of a life as possible.
I have worked in the health care field for over 12 years, and specifically as a Certified Nursing Assistance within hospice for seven years. I was able to see first hand while working with my clients in the nursing home the importance of caring for clients in general. The clients all had one thing in common: “They wanted to go home.” There is a lot of turnover in health care, and it was sad to see when some of the residents were not getting the proper care they should have been getting. I can say it was hard to watch at certain times.
It wasn’t until I started working for BAYADA Home Health Care that I was able to experience so much more opportunity to impact clients’ lives on a daily basis, particularly through advocacy. Working at BAYADA has opened up my eyes to lawmakers’ roles in home health care, and the importance of employees advocating for their clients. We are their voice and we must stand up for them!
I enjoy talking to legislators and pushing for home care in all ways possible. It is an experience that I not only appreciate, but truly enjoy doing. I attended my first Advocacy Day in May of 2018 and it wonderful experience. It was great to see how everyone came together for the same cause. I appreciate all of the support from our Government Affairs Office (GAO) and I look forward to continuing to advocate for our clients with BAYADA.”
Previously known as annual statewide “Ambassador Training,” this past year the Government Affairs Office’s (GAO) Grassroots Advocacy Team has worked hard to revamp the yearly program to make it more interactive and more engaging for both new and seasoned Ambassadors. 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!
Throughout the year we will be offering symposiums in Pennsauken, New Jersey; Harrisburg, Pennsylvania, North Carolina, New York, Georgia, South Carolina, and Rhode Island through the first half of the year. Contact me for more information and see below for dates. During these symposiums, new Ambassadors will learn about advocacy and what sharing their voice means, while the whole group will be trained on more concrete utilization tools to take their advocacy interactions to the next level! This year’s components and activities have been designed with your feedback in mind, and we are excited to show you what we have planned to allow you to be more confident and effective in your advocacy efforts.
Our Ambassador program serves as our “grasstops” program: Ambassadors commit to serving as their office’s liaison to government affairs activities and to educating their local elected officials and advocating for better policies on behalf of their office’s staff and clients. For example, check out what PA Ambassador and SEL Associate Christine Detweiler recently accomplished through her Ambassadorship. We have previously requested that each service office commit to having one Ambassador on staff, so if you’re office doesn’t have one (or even if it does!) please sign up to get more engaged with BAYADA, our clients, and your local electeds.
In addition to revamping the annual symposium, the grassroots team has been working on making sure ambassadors stay engaged and understand their importance in being a voice for home care throughout the year. Over the past 12 months, the Grassroots team has provided veteran ambassadors with monthly continuing education opportunities via 30-minute Zoom trainings to keep them abreast of new and existing advocacy tools and “tricks of the trade.” Because of the added engagement and positive feedback we’ve received, the GAO team is committed to keeping this practice ongoing throughout 2019.
For more information about the Ambassador programs, the annual 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 site TBD in Harrisburg
NJ – 3/13 at the New Jersey Learning Center in Pennsauken
NC – 3/28 at the North Carolina Learning Center in Charlotte
Christine’s advocacy efforts led to the ultimate win: a new law that will benefit families!
Pennsylvania Hearts for Home Care Ambassador Christine Detweiler has always been a diligent advocate, but recently, her efforts have proven that home care employees can truly go beyond the call of duty for clients and staff by serving as their voices in our state capitals.
“Home care is important to so many Pennsylvanians, and many aren’t as readily able to meet with legislators to share their stories,” said Christine. “I see advocacy as an extension of why I do what I do as a home care employee: We need to make sure we get out there to be a voice for those who don’t have one!”
Christine has been progressively adding more interactions to her advocacy portfolio—Over the past year-and-a-half she focused on meeting legislators in their district offices, and in the past few months she has hosted multiple home visits. Home visits are the most impactful way to demonstrate the importance of home care to legislators because it gives them a chance to see firsthand how clients receive services. To say Christine’s home visit resonated with Pennsylvania state Representative Marguerite Quinn is an understatement.
A few months ago, Christine led the representative on a home visit with five-year old client Gideon M. who suffers from Spinal Muscular Atrophy (SMA). His mother shared their heartwarming story and opened up about their family’s challenges and Gideon’s ever-growing needs. Her story impacted the representative so deeply that shortly after the visit, Rep. Quinn emailed Christine to further assess the family’s needs and determine how she could help them obtain a transportation cart that would make Gideon’s care easier. The outreach didn’t stop there.
Rep. Quinn recently reported to Christine that she has arranged for a builder to come into the family’s home to build custom doors to create a private area for Gideon downstairs. She also reported that she contacted a rotary to find out if the family can be provided with a generator so that they do not need to constantly worry about their home’s power going out. It is truly remarkable how Christine’s efforts have impacted her client and his care.
In addition to her efforts for Gideon’s family, Rep. Quinn introduced a bill that would add SMA screening to the newborn screening list to help diagnose this disease before a child is even born. After introducing this legislation, Rep. Quinn encouraged the state Newborn Screening Advisory Board to support the measure. As a result of her continued efforts, this past month Secretary of Health Dr. Rachel Levine signed the recommendation.
The Hearts for Home Care Team can’t be prouder of the impact that Christine has made! Her passion and tenacity has reached the hearts of many legislators, and she is truly making a name for herself in Harrisburg as a tireless advocate!
Whether you worry about your aging parents’ ability to remember to take their medication on time or you have a medically-complex child that requires 24-7 skilled nursing care, families that rely on home care across the country are feeling the squeeze: There just aren’t enough quality in-home caregivers, and it is quickly becoming a crisis. While more of the general public is beginning to understand the negative impact this is having on our communities, there is much more to be done to mitigate the impending consequences. Together, we can advocate to combat this looming access-to-care crisis.
We’ve read the articles and we know the facts. Home care is the most cost-effective and patient-preferred healthcare setting for individuals and families who want to remain at home. This is true for older Americans who wish to age in place to parents who believe their child should live at home and not be raised in costly institutional settings. Moreover, demand for in-home caregivers will be continue to increase as baby boomers age and better treatments for chronic illnesses and disabilities continue to become more widely available.
If home health care is in high demand, why are we still facing a shortage of available workers? Home care providers struggle to recruit and retain enough quality caregivers to keep up with the growing demand. Because many insurance companies still do not cover in-home healthcare services, many home care providers rely on government reimbursement rates to cover provided services. That is: When a patient is prescribed and authorized for in-home care, the state reimburses the home care provider for delivering that service. The provider relies on that reimbursement rate to not only pay the direct care worker’s wages, benefits, supplies, and training, but also to cover wages and costs for the workers needed to coordinate and supervise in-home staff.
While rates vary widely depending on the service and the state the care is delivered in, there is a dominant trend that contributes to providers’ inability to keep up with demand: State governments’ reimbursement rates are too low to attract and retain the proper, high-quality workforce necessary to deliver this care. And there are several competitors at play: Hospitals and other institutional settings like nursing homes are able to pay workers more because one caregiver can deliver multiple services to multiple people during one shift, so institutions are able to rely on multiple reimbursements to cover employee wages and costs. Additionally, the home care industry faces competition from non-healthcare industries like fast food companies and retailers, which can often pay workers at competitive rates and offer more consistent schedules and other benefits.
While home health care offers one-on-one care to vulnerable individuals at a lower cost, these reimbursement rates have stagnated and fallen past the cost-of-living across many states. Some states, have not addressed reimbursement rates for decades, putting home care providers at even more of a disadvantage when competing for labor. For example, California has not increased its reimbursement rate for Medicaid home nursing services for nearly two decades. Even the most compassionate home care workers who enjoy the personalized nature of home care are leaving the industry for better-paying jobs in neighboring states and in other settings and industries.
Who can resolve this issue? By and large, state governments are responsible for making decisions that affect home care, including reviewing reimbursement rates and adjusting them so that home health care providers can attract the workforce necessary to keep vulnerable state populations at home. While the rates vary in each state, one thing is consistent across state lines: legislators, who are responsible for making these decisions, are under great pressure to keep state budgets in line while making the necessary expenditures to all of the departments, industries, and populations that need the government’s financial support. All too often, other industries’ voices are heard louder, and home health care continues to fall by the wayside.
Is there any good news? Yes: People are beginning to see the problem. Public awareness of the importance of home care and of the impending access-to-care crisis is becoming more widespread. People care about the issue now more than ever before, and people across the country are beginning to realize that, even if it doesn’t affect them now, home care will impact their lives in the future.
Reports, studies, and articles have made information about the home care industry and the widening labor gap more available. Mercer Health Provider Advisory recently created an interactive map that visually depicts the deficit of home health aides and other healthcare workers in specific states and across the US through 2024. Articles have come out in the Washington Post, Boston Globe, Baltimore Sun, and in local news outlets in South Carolina and Rhode Island, among other states.
And the other good news is evident to many: Home care is simply the right choice. Many legislators are aware of home care’s cost-saving potential, especially as home care keeps people out of costlier institutional settings and prevents ER stays and hospital admissions. And while they may understand the advantages that home care offers families in general, not all legislators realize the impact home care has on the families that they directly represent as public officials.
Public awareness isn’t enough. Action is necessary. Studies, reports, articles, and direct lobbying efforts from home care providers and state and federal associations and partnerships have raised the public’s and legislators’ awareness of home care as a service. However, lawmakers’ awareness of home care issues have not yet spurred them into taking action to address stagnating reimbursement rates and providers’ inability to compete for a fair share of the labor market. We must leverage our collective voices by truly showing legislators what home care is, how it impacts us, and what happens if families can’t access care. Legislators must change laws and policies to reprioritize home health care for their constituents.
What can you do? Join the movement. As individuals, we are responsible for telling our elected officials what is important to us and what those we elect to office should prioritize and champion. Advocating for home care is easy: Call your state and federal representatives and senators to request a meeting to discuss home care, or even simply send a letter, an email, or even a Facebook message or Tweet to let them know about what home care means to you. The Hearts for Home Care platform was specifically created to help members of the home care community learn about opportunities to get involved in home care advocacy. There are plenty of ways big and small to get involved, the most important thing is that we share our voices with one unified message: Home care is important to me, and it should be important to you too.
Every day, BAYADA employees, clients, and families use social media to connect with one another, keep in touch with distant friends and relatives, and learn about news and events near and far. But social media has evolved far past the traditional definition of “social.” In today’s world, social media gives the home care community the opportunity to spread public awareness about home care’s impact and the opportunity to more conveniently advocate for better home care laws and policies.
Advocacy simply means communicating to elected officials what home care means to you and how it impacts your everyday life. Because our state and federal lawmakers make decisions that affect home care providers’ ability to recruit and retain quality caregivers to serve our clients and their families, it is important that they are able to connect home care to their constituents’ names and faces. Social media outlets, particularly Facebook and Twitter, allow for members of the home care community to advocate from the convenience of their home or office.
Sharing a video of a family expressing the value that their in-home nurse or aide brings to them and their loved ones, for example, enables other social media users to understand how home care impacts them, their neighbors, and thousands of people across the country. Our Hearts for Home Care platform is designed to share videos, quotes, photos, news, and advocacy opportunities with elected officials and the community at-large.
In addition to this platform, it’s important that members of the home care community—including staff, clients, and family members—are aware of the power they hold at their own fingertips. Getting involved in advocacy through social media is easy, and the more we share our voices the better we can be heard. In addition to following our Facebook and Twitter, you can tell your elected officials what home care means to you in three easy steps:
Like and follow them on social media (the links are right on the page!)
Connect with them regularly: Share Hearts for Home Care’s posts with your legislators, post on their pages about what home care means to you, or message them to ask them about meeting them in-person to talk about the value of home care. You’ll find that their pages will also give you information about news and events like Senior Expos and Town Halls that may be valuable for you, your staff, or your clients.
Social media not only brings people who value home health care together, but it shows those who have not yet needed home health care its value and necessity. It gives our industry a face and a voice and allow our representatives and senators to see that it affects real people in their communities, and it shows our elected officials that our friends and neighbors with special medical needs should be able to receive the care they need in the place the feel the safest and most comfortable–at home. To learn more about how you can be a voice for home care, join Hearts for Home Care today.