Advocacy Essential to Clearing Up New Jersey Home Care Funding Uncertainty

New Jersey Troy Singleton meets with home care advocates from BAYADA - Personal Care Assistant (PCA) program funding and minimum wage
Hearts for Home Care advocates share the importance of home care with NJ Senator Troy Singleton

The COVID-19 pandemic has brought about changes in almost every facet of society. Impacted most severely has been our aging and elderly populations. The home care community has certainly felt the shock wave from this pandemic across all aspects of client care and operations, but in the hardest hit states such as New Jersey, the fate of home care looms.

As New Jerseyans continue to adapt to and understand the effects of this virus, one of the key takeaways has been the value and safety that New Jersey’s Personal Care Assistant (PCA) program provides. The PCA program allows New Jersey residents to stay independent, safe, and healthy in their homes. Simultaneously, this level of care diverts these often infection-prone clients from more congested group settings and nursing home placements, while saving the state tens of thousands of dollars a year per individual.

Currently, the PCA program faces funding uncertainty on the horizon as New Jersey is set to increase the state minimum wage to $12/hr. on January 1. However, the state has yet to permanently commit to adequate increases in PCA funding. State funding covers not only personal care assistant wages, but also training, benefits, and supplies. Compounding this issue, COVID-19 has driven up the costs across all fields of business including expensive PPE and adequate compensation for our frontline workers that provide this vital service.  

What is the solution? Well, as Dr. Seuss once said in The Lorax, “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.” Advocacy is the solution. It is evidently clear how essential home care is to so many medically fragile individuals − it is the saving grace that allows these residents to stay safe, healthy, and happy in the place they feel most comfortable. However, many decision-makers are not always aware of how crucial a program like PCA is to their constituents.

This is where advocacy plays such a significant role in raising awareness around the value of home care. Personal stories from clients, families, and employees highlight the compassion and care that the PCA program provides, while best contextualizing the benefits of the program to legislators. If you, or someone you know has been benefited from home care, please reach out to your legislator and urge them to support adequate funding to the PCA program. It is imperative that the state addresses this funding shortfall so that agencies can continue to attract and retain the high-quality home health aides that keep elderly and medically fragile New Jerseyans well-cared for in the comfort of their own homes.

Recognition and Fair Compensation for Frontline Home Care Workers—During COVID and Beyond

By: Dave Totaro, Chairman of the Partnership for Medicaid Home-based Care

Below, please find an opinion piece authored by Dave Totaro—Chairman of the Partnership for Medicaid Home-based Care (PMHC) and BAYADA Home Health Care’s Chief Government Affairs Officer. This was originally published in the Scranton Times-Tribune on May 10, 2020.

Our nation’s frontline healthcare workers have been recognized during the COVID-19 pandemic, arguably more than ever before—and rightfully so. These essential workers put their health and safety on the line in order to make sure that the most vulnerable populations are taken care of. But these workers—particularly the caregivers that keep these individuals at home and out of riskier settings like nursing homes—deserve more than cheers, front lawn signs, and complimentary cups of coffee. It is time that our federal and state governments fairly compensate these brave and compassionate workers for the sacrifices that they are making during this critical time through Hazard Pay—that is, temporary increases in hourly wages for workers who are risking the most yet earning the least.

Congress has passed three stimulus bills so far, and have done so quickly and commendably with an eye toward helping the economy and the unemployed. But these packages have not yet focused on compensation for those who are working—the essential employees that risk their safety to care for the many that can’t help themselves. And while many healthcare professionals within hospitals and institutions have been impacted, the federal government has not yet prioritized the caregivers that keep people healthy at home.

Congress is currently working on the fourth (and likely final) stimulus bill. This presents a vital opportunity to increase Hazard Pay for healthcare workers who put their safety on the line every day. While the first three stimulus packages have increased emergency funding for states, only a handful of states have used those funds to increase pay for frontline healthcare workers. Currently, there are three potential proposals that would serve to increase pay for these workers across the US—either of which would reward home care workers and incentivize many to begin or continue their career in a field that is much-needed during this time.

Home care workers—particularly home health aides—are largely females of color who are making slightly above minimum wage. Yet they are some of the most essential workers—caring for those who are unable to care for themselves. And not only is their job physically and emotionally tolling, but the prioritization of hospital care has made it increasingly harder for home care agencies to access personal protective equipment, such as masks, gloves, hand sanitizer, and gowns, for these workers. And, to top it all off, we are regarding them as heroes without considering fair compensation for their commitment and sacrifice.

Now more than ever, the potential dangers that go hand-in-hand with nursing home living are becoming a frightening reality and we as a nation need to consider the future of healthcare as our population continues to age. Nearly 20% of COVID-related deaths have occurred in nursing homes. Not only is in-home care the best way to ensure that the most at-risk populations—seniors and the medically fragile—stay as isolated as possible rather than be grouped in together, it also ensures that they are in the most cost-effective setting for their families and for the state and federal governments themselves.

COVID-19 has hit many Americans hard, and few are exempt from at least some negative consequences as a result. But it is clear that there are some who are risking more than others, and who are sacrificing their personal safety in order to keep others healthy and independent at home… both in times of crisis and times of normalcy. So while the recognition and support of frontline workers is certainly appreciated, it does little to truly show home care workers how valuable they are. Through the development of the fourth stimulus package, the federal government has the opportunity to meaningfully show at-home caregivers what they mean to America—both now and in the future. Home health care has been making headlines in recent media coverage.

In order to join those who are advocating for better home health care funding and policies on behalf of beneficiaries, their families, and frontline workers, contact us at advocacy@bayada.com

Home Health Care in the News

The New York Times recently published an article that highlights caregivers’ and home health care clients’ challenges

The looming home health care crisis has recently been making headlines. From Home Health Care News to the New York Times, industry leaders, home health aides, clients, and family caregivers have been sharing the same message: As Medicaid rates continue to stagnate, home health aides and nurses can’t make a fair wage. As a result, the industry is facing a worker shortage and clients’ access to care is being significantly threatened across the country. Below, please find links to recent media coverage on the issue, all of which present compelling data that point to an impending home health care crisis for the most vulnerable and medically fragile populations.

Home Health Care News, September 5: “Home Health Care Training Programs Popping Up As Caregiver Crisis Worsens”

New York Times, September 2: “On the Job, 24 Hours a Day, 27 Days a Month”

Thrive Global, August 30: “The Future of Healthcare: “First and foremost, reprioritize long-term care into the home setting” with David Totaro of BAYADA Home Health Care”

Vox, August 21:https://www.vox.com/the-highlight/2019/8/21/20694768/home-health-aides-elder-careHome health aides care for the elderly. Who will care for them?”

Everyday Health, July 27: “Demand on the Rise for Home Healthcare”

Home Health Care News, June 20: “Bayada Hits 1M Clients Served. Here’s Why Hitting 2M Will be More Difficult”

The Summer of the Home Visit: Across NJ, FL, and PA, home health care offices are hosting amazing visits!

Across our BAYADA states, offices and clients are engaging in advocacy through impactful home visits!

Clients and family members have been stepping up and opening their homes to help legislators better understand the vital role that home care plays in their lives. In collaboration with our Hearts for Home Care Ambassadors, in the last few months, six families in four states have taken the opportunity to educate their lawmakers and take a stand for home care.

The visiting legislator is hearing first-hand the problems clients are facing and it makes the issue about real families facing real problems – not about facts and figures.

NJ client Carly H. and her mother Lori hosted Assemblywoman Yvonne Lopez on a visit in their home earlier this year. Carly, who has spinal muscular atrophy and is attending Rutgers University with the assistance of her home care nurses, was able to boast that due to her nursing care at home, she has never needed to be hospitalized.

The family of client Unzilla Z. in Egg Harbor, NJ was extremely candid about the challenges they face during their home visit.  Assemblyman Armato shared that to “hear” through emails and calls are one thing, but the impact of “seeing” what families face is beyond compare.

Pennsylvania state senator Mario Scavello visited East Stroudsburg resident Mrs. Mliss S. to learn about the merits of hospice care. Smith, who receives end of life services from BAYADA Hospice in East Stroudsburg, welcomed the opportunity to meet her senator. Senator Scavello learned a great deal about how hospice care helps patients and their families, whether in a facility or a private home. Mrs. Smith’s daughters emphasized how supported they felt by their hospice team and were thrilled at the care and attention provided to their mother.

NJ Assemblyman Jim Benson visited client, Jim D., where a small group of ambassadors discussed the extensive needs of our clients and showed, firsthand, many of the behind-the-scenes activities that go into providing care for a client. It’s not just about scheduling a nurse or an aide. This is an important message, as we advocate for increased PDN coverage.

And client William B. in Florida hosted US Senator Vern Buchanon on a home visit to demonstrate to the federal legislator the value of home care and the need for our federal Medicaid and Medicare programs to cover home care as a cost-effective option to facility based care. Mr. B. receives physical therapy and occupational therapy to help him regain his strength and promote independence in home. He enjoyed the Congressman’s visit and his PT, John Lumpkin, was able to talk about the care he provides and demonstrate some of the exercises performed. Overall, the visit was great and informative for the Congressman, who plays a very important role in current legislation that is to help eliminate PDGM.

Hearts for Home Care continues to look for clients to host legislative home visits throughout the remainder of the summer and into the fall session. If you’d like to be considered for participation in one of these opportunities, please speak with your Clinical Manager or Client Services Manager today or reach out to us at advocacy@bayada.com.

Help us access the nursing care we need: Indiana Mom Annie Shares Her Voice with RTV6, and wih Lawmakers

Indiana families like the Goellers are struggling to access the in-home nursing care they need to keep their medically-complex children safe at home

Indiana moms are coming out to share their message with State decisionmakers: “Help us access the nursing care we need!” Recently, RTV6—Indianapolis’s ABC affiliate—aired coverage of mom Annie and her daughter Emma. Emma, and more than 14,000 like her across the state, rely on skilled nursing to live safely at home, but often struggle to access it. The State has until June 30 to make a decision to help alleviate families’ struggles by increasing funding for state programs that pay for in-home nursing coverage.

The issue lies in State funding for programs that allow families like the Goellers to access the skilled in-home nursing they need. Because nurses can make more money in hospitals, rehab centers, and other facilities, nurses are more attracted to those settings rather than home care. The constant turnover creates a revolving door of nurses. In the past six years, Emma, who has cerebral palsy, has had dozens of different nurses. “I would say probably at least 20 or 25,” said mom Annie.

Such turnover means that Emma doesn’t see reliable, consistent nursing coverage, which puts her at risk. For many families, this also means that shifts are missed and parents must bear the burden of providing care. Lack of sleep, calling out of work, and being unable to care for other family members are all unintended consequences that come from the lack of skilled in-home nurses.

No child deserves to grow up in a hospital or facility, and no parent deserves to be an untrained nurse for their child. When we unite our voices in advocacy, we can make sure that our message is heard and that decision-makers and key influencers are aware of the issues that they have the power to make changes on. Contact advocacy@bayada.com to learn about how you can share your story and make an impact today.

Delaware Hearts for Home Care Advocate Shares Heartfelt and Impactful Story with Legislators!

Recently, a Delaware pediatric licensed practical nurse (LPN), Charlene Chappell, signed up for Hearts for Home Care and wanted to get involved. And did she come out in full force!

After sharing powerful and heartfelt testimony in Dover, DE’s Legislative Hall about the impact she makes on families and the challenges low Medicaid rates bring to nurses who want to provide one-on-one care to families at home, Charlene listened to a radio show where host Joel Olsteen spoke about “an itch you just can’t scratch.”

That got Charlene thinking about more advocacy. Charlene said, “I feel that the majority of men and women that serve as elected officials have no clue what’s required of a family when they have a child that has special needs and is differently abled! They don’t understand that nurses need to be attracted to home care so that families can rely on this care to keep their medically-complex children at home.”

That inspired her to write the below story and send it to all Delaware legislators. Read Charlene’s powerful story below!

My Itch!

I have an itch! Mo matter how hard I try to let someone know, I can’t.  I’m 8 years old and I can’t tell Mommy where I itch! I can’t reach my itch! Its 2:30 in the morning and Mommy has fallen asleep in the chair next to my bed because she had to work today and then take my sister to her dance lesson. When she finally arrived home she threw some dirty laundry in the washer, and cooked dinner. After dinner she put the wash in the dryer, and then she loaded the dishwasher. She came in my room to check on me and feed me. Off she went to make sure my sister had done her homework and was in the shower. Oh no, an alarm is going off! Here comes Mommy. I wish I could tell her how much I love her for all she does and about my itch. She looks so tired. It’s almost 8:00 pm. The phone is ringing. Hurry Mommy before they hang up!

I can hear Mommy on the phone. “What! Oh no, please tell me it’s not true. I’m so tired tonight. I don’t know if I can stay up all night with him but I must. I have to make sure he’s ok on his ventilator and his medications are given at the right time, so he doesn’t have a seizure, and that the tube feeding is running properly. He has to be repositioned every two hours so his skin doesn’t break down. I have to check his diaper too. Well… thanks for the phone call.”

Oh no. Mommy just found out my favorite night nurse called out tonight, and the rest of forever. The agency is going to try and find a replacement as soon as possible, but that may take some time. Nurses aren’t as anxious to get into home health care nursing because they can make more money at a hospital. Mommy is going to miss work because she will have to stay up with me as Daddy’s gone from home with his job right now. Mommy may lose her job. I’m so sad my nurse left. She really knew me and she knew when I had an itch. She would gently scratch me all over till she found it, like Mommy does. She understands my cues and my facial expressions as I can’t talk, or walk, or move because of my illness. 

I heard Mommy talking to the lady at the agency about the nursing shortage in home health care. She told Mommy that the money provided for reimbursement by Medicaid, not Medicare, has not increased in 13 years! The last time there was an increase in Medicaid was in 2006! I wasn’t even born then! She also told Mommy that the companies are running out of their own funds to supply the raises the nurses deserve. God bless the nurses that do work in home health care, for a lesser wage then they deserve, and take care of not only me but my mommy and Daddy too. Without them my Mommy and Daddy would not get the proper rest, would have to quit work to care for me. It would not be a good thing for my family. We would all suffer. I don’t want to go anywhere but here in my room. What if we can’t find a new night nurse? Where will I go? I overheard the doctors and nurses at the hospital talking last time I was admitted for a bad seizure and they said that all children do better in the home setting for getting well once they can leave the hospital. They are less likely to get sick again from a disease they acquired while in the hospital, and all of us are more comfortable in our own bed!

I hope my story has helped you to understand why we need to increase the Medicaid budget. Not Medicare, but Medicaid. Mommy told me that some people get confused so that’s why I will say it one more time. Please increase the Medicaid funding for home health care nurses.

Thank you for reading this. Mommy thanks you as well as all the other children and their parents that require specialized home health care nursing.  And yes, Mommy found my itch!

Thank you, Charlene, for sharing your creative and passionate story with Delaware’s legislators. We must all share our voice to make an impact, and your advocacy highlights your deep commitment to your clients’ care.

Hearts for Home Care is seeking to advocate for higher reimbursement rates for skilled nursing services in Delaware so that nurses can be better attracted to home care, and so families that need this care to stay together at home can more easily and reliably access it. For information on how you can get involved, contact us today

Pennsylvania Homecare Association (PHA) Legislative Day Pictures

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 advocacy@bayada.com to find out how you can get involved in advocacy today!

CLICK TO SEE PICTURES

Home Health Aides’ Low Wages: Turning Public Awareness into Action

Home health aides keep hundreds of thousands of disabled adults and seniors at home and out of costlier settings. Low Medicaid reimbursement rates keep them from making a better wage, and it's up to state governments to address this issue.
Home health aides keep hundreds of thousands of disabled adults and seniors at home and out of costlier settings.

As home care clients, employees, caregivers, and family members, we know one thing for a fact: Home health aides do incredible, compassionate work that enable hundreds of thousands of residents across the country to stay at home and out of costlier, more infectious settings like nursing homes and hospitals. And we certainly know another fact: The work that aides do is invaluable, and it’s time that they begin to receive a fair wage for the hard work they do.

Low aide wages have recently made national headlines and the message is clear: We will need more and more home health aides as America’s population continues to age. But home health care providers are having trouble recruiting and retaining the quality, reliable workforce needed to keep up with the growing demand.

Recently, Hearts for Home Care advocate and BAYADA Home Health Care’s chief government affairs officer, Dave Totaro, submitted his opinion on the matter to STAT News, a media company focused on finding and telling compelling stories about health, medicine, and scientific discovery. He posed the question:

“To say that home health aides’ work is demanding is an understatement. They make it possible for 14 million Americans to stay in their homes and out of expensive and impersonal institutional settings like hospitals and nursing homes. Performing this necessary and in-demand work takes a physical and emotional toll, yet these individuals do it with compassion day in and day out.

So why do we treat home health aides as low-wage, low-value workers?”

The problem lies primarily in states’ low Medicaid funding for home care programs. Though states typically pay an hourly rate for providers who deliver home health aide services, these rates have largely been low for many years, or raised periodically, but at a rate too low to keep up with real costs of living and providing services. Because these rates must cover wages, training, benefits, new hire costs such as background checks and TB shots, and supplies, it is nearly impossible for home health care companies to take such a low rate and provide aides with a wage high enough to compete with industries like fast food and retail.

News coverage of the issue has been effective in bringing greater public awareness to the issue, especially as nearly all individuals will be touched by home care at least once in their lives, whether it be for themselves, a parent, friend, or other loved one. Now is the time to take awareness and turn it into action. Call your state legislator and let them know what home care means to you. Contact advocacy@bayada.com for information on what you can do to share your voice and support home health aides.

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.

Across the Country, Parents and Home Care Supporters Advocate for Better Wages for Caregivers

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.

Recently, home 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.

In California, 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.

While advocacy 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.

To learn more about how you can engage in home care advocacy, visit www.heartsforhomecare.com or email advocacy@bayada.com today.